scholarly journals Reflections on Japan’s G20 Presidency in 2019 and The Lessons for Future Political Commitment to Universal Health Coverage

2020 ◽  
Author(s):  
Maaya Kita Sugai ◽  
Aya Ishizuka ◽  
Mina Chiba ◽  
Hiroyasu Iso ◽  
Yasushi Katsuma
Keyword(s):  
Global Health ◽  
Universal Health Coverage ◽  
Vulnerable Groups ◽  
Health Coverage ◽  
Political Commitment ◽  
Pharmaceutical Sector ◽  
Expert Meeting ◽  
And Gender ◽  
Multi Stakeholder ◽  
Universal Health

Abstract Background: The Group of 20 (G20) Osaka Summit 2019 was a large step forward for global health diplomacy to build consensus on universal health coverage (UHC). To strengthen multi-stakeholder UHC partnership, Japan involved the research and policy advice network for G20 (Think 20: T20), civil society (Civil 20: C20), private initiatives of medical professional groups (H20), and the pharmaceutical sector. We attempted to identify UHC-related issues addressed and left unaddressed at the G20 Osaka, to bring lessons for the G20 Riyadh Leaders’ Summit 2020. Methods: We reviewed the G20 Osaka Leaders’ Declaration, policy-related statements, and voices of the relevant G20 engagement groups and sectors. In 2019 July, after the G20 Osaka Leaders’ Summit, we organized an expert meeting convening Japan-based UHC-related key global health stakeholders. The main findings were presented in form of classifying the voices expressed in the meeting by UHC-related topics, and then definitional ranges of UHC were summarized.Results: The T20, H20, and the pharmaceutical sector noted during our expert meeting that the ministerial-level health -finance collaboration was one of the key agendas suggested at the G20. T20 and C20 called for a recognition of health needs of refugees, migrants and other vulnerable groups in achieving UHC. Sexual and reproductive health and rights (SRHR) with a human rights-based approach through UHC was raised by the C20 as an issue unaddressed in G20 Osaka. Variation in operative purposes between global health stakeholders led to a definitional difference in the scope of UHC. Discussion: The definitional difference could delay progress of UHC attainment. Addressing migrant and refugee health and SRHR within the context of UHC is further needed. Understanding perspectives of various stakeholders will become increasingly important to well-coordinate multi-actor cooperation with adequate social responsibility and transparency in UHC achievement and public-private partnership. Conclusions: At the G20 Riyadh, for UHC there is need of 1) ensuring an integrated yet comprehensive multi-stakeholder approach towards UHC; 2) incorporating important dimensions such as the marginalized population and gender; and 3) ensuring adequate investments toward health information systems and governance to track health data for the vulnerable population and gender-responsive financing.

scholarly journals Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health System ◽  
Universal Health Coverage ◽  
World Health ◽  
Health Coverage ◽  
Health Security ◽  
Universal Health ◽  
Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

scholarly journals The Legal Determinants of Health: How Can We Achieve Universal Health Coverage and What Does it Mean?

2020 ◽  
Author(s):  
Lawrence O. Gostin
Keyword(s):  
Public Health ◽  
Global Health ◽  
Social Determinants ◽  
Universal Health Coverage ◽  
Good Health ◽  
Essential Medicines ◽  
Health Coverage ◽  
Public Health Services ◽  
The Right ◽  
Universal Health

How can we keep people – wherever they live – healthy and safe? Among all global health initiatives, universal health coverage (UHC) has garnered most political attention. But can UHC (as important as it is) actually achieve the two fundamental aspirations of the right to health: keeping people healthy and safe, while leaving no one behind? There is a universal longing for health and security, but also a deep-seated belief in fairness and equity. Can UHC achieve both health and equity, or what I have called, "global health with justice?" What makes a population healthy and safe? Certainly, universal and affordable access to healthcare is essential, including clinical prevention, treatment, and essential medicines. But beyond medical care are public health services, including surveillance, clean air, potable water, sanitation, vector control, and tobacco control. The final and most important factor in good health are social determinants, including housing, employment, education, and equity. If we can provide everyone with these three essential conditions for good health (healthcare, public health and social determinants), it would vastly improve global health. But we also need to take measures to leave no one behind. To achieve equity, we need to plan for it, and here I propose national health equity programs of action. Society’s highest obligation is to achieve global health, with justice.

Introduction to Part 5: Health for the whole population—leaving no-one behind

2015 ◽  
Author(s):  
Francis Omaswa ◽  
Nigel Crisp
Keyword(s):  
South Africa ◽  
Global Health ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Health It ◽  
Universal Health ◽  
The Way

Chapter 16 addresses the way in which universal health coverage has become one of the most important concepts in global health. It sets the scene for the following chapters in which leaders discuss the implementation of universal health coverage in Rwanda, South Africa, and Ghana.

scholarly journals Are we advancing universal health coverage through cataract services? Protocol for a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e039458
Author(s):  
Chan Ning Lee ◽  
Jacqueline Ramke ◽  
Ian McCormick ◽  
Justine H Zhang ◽  
Ada Aghaji ◽  
...  
Keyword(s):  
Global Health ◽  
Universal Health Coverage ◽  
Scoping Review ◽  
Population Based ◽  
Financial Protection ◽  
Health Coverage ◽  
Surgical Services ◽  
Ethical Approval ◽  
Service Data ◽  
Universal Health

IntroductionUniversal health coverage (UHC) includes the dimensions of equity in access, quality services that improve health and protection against financial hardship. Cataract continues to be the leading cause of blindness globally, despite cataract surgery being an efficacious intervention. The aim of this scoping review is to map the nature, extent and global distribution of data on cataract services for UHC in terms of equity, access, quality and financial protection.Methods and analysisThe search will be constructed by an Information Specialist and undertaken in MEDLINE, Embase and Global Health databases. We will include all published non-interventional primary research studies and systematic reviews that report a quantitative assessment of access, equity, quality or financial protection of cataract surgical services for adults at the subnational, national, regional or global level from population-based surveys or routinely collected health service data since 1 January 2000 and published through to February 2020.Screening and data charting will be undertaken using Covidence systematic review software. Titles and abstracts of identified studies will be screened by two authors independently. Full-text articles of potentially relevant studies will be obtained and reviewed independently by two authors against the inclusion criteria. Any discrepancies between the authors will be resolved by discussion, and with a third author as necessary. A data charting form will be developed and piloted on three studies by three authors and amendments made as necessary. Data will be extracted by two reviewers independently and summarised narratively and using maps.Ethics and disseminationEthical approval was not sought as the scoping review will only use published and publicly accessible data. The review will be published in an open access peer-reviewed journal. A summary of the results will be developed for website posting, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.

scholarly journals Towards universal health coverage: governance and organisational change in ministries of health

2019 ◽  
Vol 4 (5) ◽  
pp. e001735 ◽  
Author(s):  
Peter Berman ◽  
Azrina Azhar ◽  
Elizabeth J Osborn
Keyword(s):  
Health System ◽  
Universal Health Coverage ◽  
Organisational Change ◽  
Health Financing ◽  
Comparative Case Study ◽  
Health Coverage ◽  
Political Commitment ◽  
Middle Income ◽  
High Level ◽  
Universal Health

Countries have implemented a range of reforms in health financing and provision to advance towards universal health coverage (UHC). These reforms often change the role of a ministry of health (MOH) in traditionally unitary national health service systems. An exploratory comparative case study of four upper middle-income and high-income countries provides insights into how these reforms in pursuit of UHC are likely to affect health governance and the organisational functioning of an MOH accustomed to controlling the financing and delivery of healthcare. These reforms often do not result in simple transfers of responsibility from MOH to other actors in the health system. The resulting configuration of responsibilities and organisational changes within a health system is specific to the capacities within the health system and the sociopolitical context. Formal prescriptions that accompany reform proposals often do not fully represent what actually takes place. An MOH may retain considerable influence in financing and delivery even when reforms appear to formally shift those powers to other organisational units. MOHs have limited ability to independently achieve fundamental system restructuring in health systems that are strongly subject to public sector rules and policies. Our comparative study shows that within these constraints, MOHs can drive organisational change through four mechanisms: establishing a high-level interministerial team to provide political commitment and reduce institutional barriers; establishing an MOH ‘change team’ to lead implementation of organisational change; securing key components of systemic change through legislation; and leveraging emerging political change windows of opportunity for the introduction of health reforms.

scholarly journals Advancing universal health coverage in China and Vietnam: lessons for other countries

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wenhui Mao ◽  
Yuchen Tang ◽  
Tra Tran ◽  
Michelle Pender ◽  
Phuong Nguyen Khanh ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Universal Health Coverage ◽  
Secondary Data ◽  
World Health ◽  
Health Coverage ◽  
Political Commitment ◽  
Population Coverage ◽  
Service Coverage ◽  
Universal Health

Abstract Background China and Vietnam have made impressive progress towards universal health coverage (UHC) through government-led health insurance reforms. We compared the different pathways used to achieve UHC, to identify the lessons other countries can learn from China and Vietnam. Methods This was a mixed method study which included a literature review, in-depth interviews and secondary data analysis. We conducted a literature search in English and Chinese databases, and reviewed policy documents from internal contacts. We conducted semi-structured interviews with 16 policy makers, government bureaucrats, health insurance scholars in China and Vietnam. Secondary data was collected from National Health Statistics Reports, Health Insurance Statistical Reports and National Health Household Surveys carried out in both countries. We used population insurance coverage, insurance policies, reimbursement rates, number of households experiencing catastrophic heath expenditure (CHE) and incidence of impoverishment due to health expenditure (IHE) to measure the World Health Organization’s three dimensions of UHC: population coverage, service coverage, and financial coverage. Results China has increased population coverage through strong political commitment and extensive government financial subsidies to expand coverage. Vietnam expanded population coverage gradually, by prioritizing the poor and the near-poor in an incremental way. In China, insurance service packages varied across regions and schemes and were greatly determined by financial contributions, resulting in limited service coverage in less developed areas. Vietnam focused on providing a comprehensive and universal service packages for all enrollees thereby approaching UHC in a more equitable manner. CHE rate decreased in Vietnam but increased in China between 2003 and 2008. While Vietnam has decreased the CHE gap between urban and rural populations, China suffers from persistent disparities among population income levels and geographic location. CHE and CHE rates were still high in lower income groups. Conclusion Political commitment, sustainable financial sources and administrative capacity are strong driving factors in achieving UHC through health insurance reform. Health insurance schemes need to consider covering essential health services for all beneficiaries and providing government subsidies for vulnerable populations’ in order to help achieve health for all.

Population Coverage to Reach Universal Health Coverage in Selected Nations: A Synthesis of Global Strategies

2020 ◽  
Author(s):  
Minoo ALIPOURI SAKHA ◽  
Najmeh BAHMANZIARI ◽  
Amirhossein TAKIAN
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Health Coverage ◽  
Political Commitment ◽  
Population Coverage ◽  
Definite Indicator ◽  
Expanding Population ◽  
Universal Health

Background: This study aimed to provide tailored transferrable lessons for expanding population coverage through a descriptive lens by reviewing the population coverage policies, reforms and strategies in selected nations. Methods: In this comparative short communication, 14 countries with different status of population coverage and political economy that had successful experiences with coverage expansion were selected and categorized in four groups to study their approaches to reach Universal Health Coverage (UHC). Results: Although each country needs to tailor its policies and reforms based on its own contextual factors, the legal right of citizens to social security and health protection are enshrined in most countries' Constitution. Some countries adapted political and economic reforms to evolve their Social Health Insurance schemes. National laws to push governments to adapt UHC as a national strategy for ensuring that every resident is enrolled in health insurance schemes are key policies to reach UHC. Conclusion: A series of reforms are required to provide total population coverage through various approaches. To create an effective insurance coverage, physical merger of all insurance funds is not necessarily required. Further, the share of GDP for health is not a definite indicator to reach UHC. Finally, strong political commitment and citizens’ participation are the key issues in reaching UHC, while considering the poorest, remote and neglected population really matters.  

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