The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way towards Universal Health Coverage (UHC),choosing a path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entir...e population by 2020 while increasing financial protection.
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Policy Note: Thailand Health Systems in Transition
By 2002, Universal Health Coverage was achieved through three public insurance schemes: the Civil Servant Medical Benefit Scheme (CSMBS) for civil servants and their dependents, Social Health Insurance (SHI) for formal sector employees, and the U...niversal Coverage Scheme (UCS) for the remainder of the population.
The establishment of these three schemes has changed the way health care is financed. A supply-led system, under which all Ministry of Public Health (MOPH) health facilities received an annual budget allocation from the MOPH, has now been completely replaced by a system in which the three public purchasers - separated through a purchaser-provider split - manage a demand-led system of financing.
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The National Health Plan (NHP) aims to strengthen the country’s health system and pave the way towards Universal Health Coverage (UHC),choosing a path that is explicitly pro-poor. The main goal of NHP 2017-2021 is to extend access to a Basic Essential Package of Health Services (EPHS) to the entir...e population by 2020 while increasing financial protection.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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For the first time WHO and UNICEF bring together the data on sanitation coverage and investment, and how it impacts health, economies, and the environment. Citing evidence on what works from successful countries and global guidelines, WHO and UNICEF call for strong government leadership and investme...nt in resilient sanitation services. The report charts an ambitious way forward following the SDG6 global acceleration framework themes of governance, financing, capacity development, data and information, and innovation to achieve universal access to safe sanitation.
Read the full publication report here: https://www.who.int/publications/i/item/9789240014473.
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Measuring progress towards universal health coverage.
This sixth edition of Health at a Glance Asia/Pacific presents a set of key indicators of health status, the determinants of health, health care resources and utilisation, health care expenditure and financing and quality of care across 27 Asia-...Pacific countries and territories. It also provides a series of dashboards to compare performance across countries and territories, and a thematic analysis on the impact of the COVID-19 outbreak on Asia/Pacific health systems.
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Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar...y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness,... equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards universal health coverage (UHC), health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guid...ance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
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This technical note provides tailored advice on further adjustments in health financing policy in the context of war based on principles of universal health coverage, solidarity and equity.
It summarizes international evidence and accounts for specific features of health financing reform in Ukraine....
The primary focus will be on short-term adjustments and to a lesser extent on medium-term measures.
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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma ...and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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Rebuilding Liberia’s health system is crucial for improving the country’s overall health outcomes. This annual report highlights key achievements, challenges,and lessons learned in implementing programmes of technical cooperation with the Government of Liberia from January to December 2022. T...he key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
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The 2030 health-related Sustainable Development Goals call on countries to end AIDS as a public health threat and also to achieve universal health coverage. The World Health Organization (WHO) promotes primary health care (PHC) as the key mechanism for achieving universal health coverage, and the PH...C approach is also essential for ending AIDS and reaching other Sustainable Development Goal targets.
The PHC approach is defined as a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: (1) primary care and essential public health functions as the core of integrated health services; (2) multisectoral policy and action; and (3) empowered people and communities.
This publication helps decision-makers to consider and optimize the synergies between existing and future assets and investments intended for both PHC and disease-specific responses, including HIV. Specifically, it aims to:
• provide guidance to policy-makers, health system managers and programmatic leads from both PHC and HIV backgrounds regarding opportunities to jointly advance their respective efforts to strengthen PHC and end AIDS as a public health threat; and
• provide a resource for all stakeholders who seek to contribute to strengthening PHC and ending AIDS as a public health threat in a synergistic manner, including people living with HIV, members of key and vulnerable populations, community and civil society representatives, people working in all areas of health systems, researchers, funders and private-sector decision-makers.
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Background and aims: Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationshi...p between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country's efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country.
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Background: Primary health care (PHC) is a driving force for advancing towards universal health coverage (UHC). PHC-oriented health systems bring enormous benefits but require substantial financial investments. Here, we aim to present measures for PHC investments and project the associated resource ...needs. Methods: This modelling study analysed data from 67 low-income and middle-income countries (LMICs). Recognising the variation in PHC services among countries, we propose three measures for PHC, with different scope for included interventions and system strengthening. Measure 1 is centred on public health interventions and outpatient care; measure 2 adds general inpatient care; and measure 3 further adds cross-sectoral activities. Cost components included in each measure were based on the Declaration of Astana, informed by work delineating PHC within health accounts, and finalised through an expert and country validation meeting. We extracted the subset of PHC costs for each measure from WHO’s Sustainable Development Goal (SDG) price tag for the 67 LMICs, and projected the associated health impact. Estimates of financial resource need, health workforce, and outpatient visits are presented as PHC investment guide posts for LMICs.
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An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we furth...er explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends.
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Health systems strengthening (HSS) and health security are two pillars of universal health coverage (UHC). Investments in these areas are essential for meeting the Sustainable Development Goals and are of heightened relevance given the emergence of the 2019 novel coronavirus disease (COVID-19). This... study aims to generate information on development assistance for health (DAH) for these areas, including how to track it and how funding levels align with country needs.
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The evaluation covers the period January 2020 to August 2023. The geographical scope of the evaluation has involved the three levels of WHO (global, regional and country levels) and external key partners. The programmatic evaluation scope was concerned with assessing the SP-PHC in the following area...s/evaluation criteria: relevance, coherence, effectiveness, efficiency, added value, sustainability and equity, gender and human rights considerations. The evaluation did not assess the Universal Health Coverage Partnership (UHC-P) as it has its own separate governing body and reviews/evaluations, but instead considered how the SP-PHC had enhanced the value of the UHC-P and vice versa. The resilience and essential public health functions (REPHF) team and Systems’ Governance and Stewardship (SGS) were also not within the scope of this evaluation. However, these workstreams were considered in the wider conclusions and recommendations for the SP-PHC, as appropriate. Finally, the evaluation was focused on the SP-PHC; its scope did not include assessing the configuration and capacity of WHO’s departments and functions as they relate to UHC and health systems.
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In 2018 the Astana Declaration reaffirmed a global commitment to PHC as a cornerstone of sustainable health systems for accelerated progress on universal health coverage (UHC) (1). The vision for PHC in the 21st century is for a wholeof-government and whole-of-society approach to health that combine...s: 1) multisectoral policy and action; 2) empowered people and communities; and 3) primary care and essential public health functions as the core of integrated health service. Signatories, including Nigeria, were urged to implement the vision and commitments of the Declaration according to their national contexts. This case study examines Nigeria’s response to COVID-19 from a PHC perspective between March 2020 and mid-2021.
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Jordan has more than 3 million migrants (one third of the country's total population) and has witnessed three major waves of refugees in its modern history: Palestinians (1948 and 1967), Iraqis (1990 and 2000) and Syrians (since 2010). Under its commitment to achieving universal health coverage (UHC...), Jordan has been continually supporting vulnerable populations such as refugees and migrants by offering subsidized access to essential health services.
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