As Uganda joins the rest of the world to commemorate the Universal Health Coverage Day on 12th December 2018, Health Systems Advocacy Partners (HSAP) in Uganda comprising of African Centre for Global Health and Social Transformation (ACHEST), Amref Health Africa and Coalition for Health Promotion and Social Development (HEPS-Uganda) have called upon the government, implementing partners and Ugandans at large to implement Universal Health Coverage (UHC).
This day is the anniversary of the first unanimous United Nations Resolution of 2012 calling for countries to provide affordable, quality health care to every person, everywhere.
Universal Health Coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. Beyond financial considerations, however, UHC must include a strong, efficient and well run health system; including access to essential medicines and technology, and sufficient numbers of well-trained, motivated and supported health workers.
Uganda in moving towards UHC are advised to define essential packages of health services that should be made available to the whole population funded through taxation. On top of this, National Health Insurance schemes should be rolled out through employer funded and voluntary contributions and Community Insurance Schemes should also be supported in a flexible and progressive manner that expands the size of the population covered and deepens the scope of services provided. A major challenge is the management of the pooled funds. Until there is public confidence in these schemes, uptake and contributions will remain unsatisfactory and less than optimal.
In order to achieve UHC, efforts must be made to go beyond the health system and to address the social determinants of health by engaging other sectors. These may entail programmes that include better living conditions, upgrading housing, improved nutrition, safe water and sanitation, promotion of practices to seek Antenatal health care so that no woman dies before, during and after child birth due to avoidable circumstances, etc.
Access to health care is a fundamental human right, spelt out in the UN declaration of Human Rights and availability and affordability of medicines is one of the most recognisable elements in the fulfilment of the right to health. Over 20% of government health spending goes to medicines. Whereas the population spends 40% of total health spending out of pocket mostly in the private sector, most of this spending (50%) goes to medicines. Therefore ensuring that medicines are part of available health package and are accessible to all is one way to ensure UHC.
Call to action
- Everyone can take action toward achieving universal health coverage! First of all take care of your own health and that of your family and community. Use your voice to demand for better Health services from your political leaders.
- Civil Society organizations
- Civil society is instrumental to achieving UHC. If your advocacy is successful, communities will take action to promote health and governments will build on your efforts.
- Pass the National Health Insurance bill into law and increase the national allocation for Health in the financial year annual budgets and ensure that health services are well managed and have quality.
- Supporting UHC is a political choice. Please make this choice for Uganda. Make bigger and smarter investments in health, and encourage diverse groups to make commitments to help move Uganda and the world closer to UHC by 2030.