Overview: UNIVERSAL HEALTH COVERAGE

Profile of the Author: Mudit Saxena is pursuing Integrated BBA+LLB (HONS.) from School of Law, Galgotias University, Greater Noida, and Uttar Pradesh.

INTRODUCTION

UHC implies that all individuals and communities get the wellbeing services they need without enduring financial hardship. Universal health coverage (UHC) guarantees a wide range of wellbeing administration and protects all citizens financially in any conditions due to illness. It incorporates the full range of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care. UHC requires health system strengthening around people, institutions, and resources to build resilience. [1]

UHC empowers everybody to get access to the services that address the main sources of infection and death and guarantees that the nature of those administrations is good enough to improve the soundness & health of the individuals' people who receive them.

Shielding individuals from the financial consequences of paying for wellbeing administrations out of their own pockets decreases the danger that individuals will be driven into poverty because unforeseen disease requires them to use up their life savings, sell resources, or borrow – devastating their prospects and often those of their children.

Globally, the UN sustainable development goal (SDG) gives high need to UHC as a wellbeing related objective. Accomplishing UHC is one of the objectives the countries of the world set while embracing the Sustainable Development Goals in 2015. Nations that progress towards UHC will gain ground towards the other wellbeing related targets, and towards different objectives. Great wellbeing permits youngsters to learn and grown-ups to acquire, helps people escape from poverty, and gives the premise to long haul economic development.

HOW CAN COUNTRIES MAKE PROGRESS TOWARDS UHC?

Numerous nations are now gaining ground towards UHC. All countries can take actions to move more rapidly towards it or to keep up the increases they have already made. In nations where wellbeing administrations have traditionally been available and affordable in nature, governments are discovering it progressively hard to react to the ever-developing wellbeing needs of the populaces and the expanding expenses of wellbeing administrations.

Moving towards UHC requires fortifying wellbeing frameworks in all nations. Robust financing structures are vital. At the point when individuals need to pay the greater part of the expense for wellbeing administrations out of their own pockets, the poor are frequently unfit to acquire a large number of the services they need, and even the rich might be presented to monetary difficulty in case of serious or long haul ailment. Pooling assets from necessary funding sources (such as mandatory insurance contributions) can spread the financial dangers of sickness over a populace.

Improving health service coverage and health outcomes rely upon the availability, accessibility, and capacity of health workers to deliver quality people-centred integrated care. It can be observed that investments in quality primary health care will be the foundation for accomplishing UHC around the globe. Putting resources into the primary health care workforce is the savviest approach to guarantee admittance to basic medical care will improve. Good governance, sound frameworks of procurement and supply of medicines and health technologies and well-functioning health information frameworks are other basic components.

IMPLEMENTATION OF UHC AROUND THE GLOBE: IS IT JUST AN INAPPLICABLE THEORY?

Universal health coverage isn't the equivalent across nations concerning levels of coverage, quality, and access to care, be that as it may, nations at all income levels can take steps to draw nearer to universal health coverage and it can be clearly observed that this isn’t too ambitious and countries all over the world are progressing and succeeding in its implementation:

• Nepal, where free universal health care was presented in 2008, is currently on target to accomplish its wellbeing related MDGs.
• In 2008, the Afghan Government, utilizing extensive donor funding, eliminated user fees in public health facilities and healthcare usage dramatically increased
• Thailand has recently celebrated ten years of its universal coverage scheme which has significantly decreased impoverishment brought about by out-of-pocket payments.
• More recently, El Salvador has dispatched a yearning to intend to expand health coverage including abolishing user fees and fortifying primary health care in distant and poor provincial regions.
• Other countries moving forward in Africa incorporate Liberia, Gabon, Ghana, Sierra Leone and Rwanda.[2]

THE IMPACT IN COUNTRIES HAVING UHC TO THOSE WITHOUT IT IN PRESENT TIMES

While the constant demographic transition takes place, ageing populations make UHC even more imperative, since otherwise older populaces will be at more serious danger of not receiving needed care. Ageing additionally has significant ramifications on health revenues, especially in health systems reliant on payroll taxes. Countries that are in the process of moving towards UHC are under great pressure to improve health services capacity and respond to the changing needs from ageing populations. A number of countries, for example, China, Vietnam, countries close to achieving UHC will have a higher share of the dependent workforce by 2050 (Approx.), and BRICS countries are also facing accelerated speed of ageing, likely to increase more over coming decades. With this, financial accessibility concerns shall also arise for elderly populations in a number of Asian countries as age is strongly associated with demand for health and long-term care services.[3]

Moreover, just as recently the Coronavirus pandemic which has struck the globe is delineating, yet on a lot bigger stage, the lessons gained from past outbreaks; that strength and resilience is a basic and savvy highlight of a wellbeing framework tending to complex difficulties. Those countries with effective universal health coverage, such as South Korea[4] and Singapore[5], have performed comparatively better during the covid-19 pandemic.

The impact of both natural and manmade disasters is exacerbated by weak health systems[6], and the health systems of affected countries were overwhelmed by Covid-19, incorporating some of the world’s wealthiest nations.[7] It has put the spotlight on inadequate health security and preparedness, including inadequate healthcare facilities and resources such as shortages of hospital beds, medicines, ventilators and healthcare workforce.[8]

The pandemic is wearing out public wellbeing frameworks in nations that have strived to give UHC, hampering their pathways and aspirations to accomplish the ethos of universal health coverage which is “to leave no one behind.” But the nations most affected by the pandemic are the ones that have done minimally in the past to reinforce their wellbeing framework through a proper interest in UHC, for example, the United States.

However, Iran is facing quite a unique paradox. It has transformed its health system to reach universal health coverage[9], insured more than 90% of its 83 million population, has a well-established primary healthcare network, and increased access to quality care and comprehensive programmes for prevention and control of non-communicable diseases.[10] And yet, Iran is the most affected Asian nation from covid-19, after China.[11] This is due not only to shortcomings in integrating emergency and preparedness response into primary health care but also to US sanctions hampering investment in and access to medicines and essential equipment.[12]

CONCLUSION

UHC has greater predictive power for long-term health outcomes than other components like education and economic growth rate.[13] The 2010 World Health Report reinforced calls for a push towards UHC across nations, extensively characterized as furnishing all individuals with admittance to required wellbeing administrations of adequate quality to be effective, without monetary difficulty related with their use. It proposed that numerous nations are as yet inadequate with regards to the essential investment in the health area so as to improve populace outcomes in accordance with the Millennium Development Goals. Consequently, it appears to be significant for nations with adequate assets to respect upgrades in health systems coverage as a key investment focus, just as for the worldwide network to guarantee that the poorest of nations can invest satisfactory measure of assets in the area over the coming years.

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REFERENCES

[1] Ghebreyesus T-A. Healthcare for all: every country can do it—an essay by Tedros Adhanom Ghebreyesus. BMJ. 2019;367

[2] World Health Organizations, Universal Health Coverage, Q & A, 11 June, 2013, https://www.who.int/news-room/q-a-detail/q-a-universal-health-coverage

[3] Universal health coverage and health outcomes, Final Report, Paris, 22 July 2016 https://www.oecd.org/els/health-systems/Universal-Health-Coverage-and-Health-Outcomes-OECD-G7-Health-Ministerial-2016.pdf

[4] Reuters. South Korea’s emergency exercise in December facilitated coronavirus testing, containment; 29 March 2020 . Available from: https://www.reuters.com/article/us-health-coronavirus-southkorea-drills/south-koreas-emergency-exercise-in-december-facilitated-coronavirus-testing-containment-idUSKBN21H0BQ.

[5] Ng Y, Li Z, Chua Y-X, Chaw W-L, Zhao Z, Er B, et al. Evaluation of the effectiveness of surveillance and containment measures for the first 100 patients with COVID-19 in Singapore–January 2–February 29, 2020. 2020.

[6] Organization PAH. Resilient health systems CE158/14. In: One hundred fifty-eighth session of the Executive Committee, Washington, 20-24 June 2016. Washington, 2016. Available from: https://www.paho.org/hq/dmdocuments/2016/CE158-14-e.pdf

[7] Horton R. Offline: COVID-19 and the NHS—“a national scandal”. The Lancet. 2020;395(10229):1022.

[8] World-Health-Organization. Critical preparedness, readiness and response actions for COVID-19; 19 March 2020. Available from: https://www.who.int/publications-detail/critical-preparedness-readiness-and-response-actions-for-covid-19.

[9] Doshmangir L, Bazyar M, Majdzadeh R, Takian A. So Near, so far: four decades of health policy reforms in Iran, achievements and challenges. Archives of Iranian medicine. 2019;22(10):592.

[10] Bakhtiari A, Takian A, Majdzadeh R, Haghdoost A-A. Assessment and prioritization of the WHO “best buys” and other recommended interventions for the prevention and control of non-communicable diseases in Iran. BMC Public Health. 2020;20(1):1-16.

[11] Raoofi A, Takian A, Akbari Sari A, Olyaeemanesh A, Haghighi H, Aarabi M. COVID-19 pandemic and comparative health policy learning in Iran. Archives of Iranian Medicine. 2020;23(4):220–234. doi: 10.34172/aim.2020.02.

[12] Takian A, Raoofi A, Kazempour-Ardebili S. COVID-19 battle during the toughest sanctions against Iran. The Lancet. 2020.

[13] Ranabhat C. L., Kim C.-B., Singh D. R., Park M. B. (2017b). A comparative study on outcome of government and co-operative community-based health insurance in Nepal. Front. Public Health 5:250. https://doi.org/10.3389/fpubh.2017.00250