A practical approach to universal health coverage

Mukherjee, Joia S.; Mugunga, Jean Claude; Shah, Adarsh; Leta, Abera; Birru, Ermyas; Oswald, Cate; Jérôme, Gregory; Almazor, Charles Patrick; Satti, Hind; Yates, Robert; Atun, Rifat; Rhatigan, Joseph; Gottlieb, Gary; Farmer, Paul

doi:10.1016/s2214-109x(19)30035-x

Cited by 16 publications

(12 citation statements)

References 7 publications

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“…Universal health coverage (UHC) is gaining increasing importance as a global health priority [1]. In 2015, the Sustainable Development Goals (SDGs) enshrined the attainment of UHC by 2030 in the new international development agenda [2]. According to the World Health Organization (WHO), universal health coverage is ‘the single most powerful concept public health has to offer’ [3].…”

Section: Introductionmentioning

confidence: 99%

Leveraging the lessons learned from financing HIV programs to advance the universal health coverage (UHC) agenda in the East African Community

Zakumumpa

Bennett

Ssengooba

2019

glob health res policy

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Background Although there is broad consensus around the need to accelerate progress towards universal health coverage (UHC) in Sub-Saharan Africa, the financing strategies for achieving it are still unclear. We sought to leverage the lessons learned in financing HIV programs over the past two decades to inform efforts to advance the universal health coverage agenda in the East African Community. Methods We conducted a literature review of studies reporting financing mechanisms for HIV programs between 2004 and 2014. This review is further underpinned by evidence from a mixed-methods study entailing a survey of 195 health facilities across Uganda supplemented with 18 semi-structured interviews with HIV service managers. Results Our data shows that there are six broad HIV financing strategies with potential for application to the universal health coverage agenda in the East African Community (EAC); i) Bi-lateral and multi-lateral funding vehicles: The establishment of HIV-specific global financing vehicles such as PEPFAR and The Global Fund heralded an era of unprecedented levels of international funding of up to $ 500 billion over the past two decades ii) Eliciting private sector contribution to HIV funding: The private sector’s financial contribution to HIV services was leveraged through innovative engagement and collaborative interventions iii) Private sector-led alternative HIV financing mechanisms: The introduction of ‘VIP’ HIV clinics, special ‘HIV insurance’ schemes and the rise of private philanthropic aid were important alternatives to the traditional sources of funding iv) Commodity social marketing: Commodity social marketing campaigns led to an increase in condom use among low-income earners v) The use of vouchers: Issuing of HIV-test vouchers to the poor was an important demand-side financing approach vi) Earmark HIV taxes: Several countries in Africa have introduced ‘special HIV’ taxes to boost domestic HIV funding. Conclusions The lessons learned from financing HIV programs suggest that a hybrid of funding strategies are advisable in the quest to achieve UHC in EAC partner states. The contribution of the private sector is indispensable and can be enhanced through targeted interventions towards UHC goals.

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Section: Introductionmentioning

confidence: 99%

Leveraging the lessons learned from financing HIV programs to advance the universal health coverage (UHC) agenda in the East African Community

Zakumumpa

Bennett

Ssengooba

2019

glob health res policy

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“…The global move focuses on strengthening insurance systems, changing service paradigms, and raising the awareness of health-care professionals. [ 16 17 ] Many countries are redesigning health systems and moving toward sustainable financing. [ 18 ] It should not be forgotten to empower professionals and staff to facilitate UHC.…”

Section: Discussionmentioning

confidence: 99%

Training needs assessment of nursing managers for achieving university health coverage

Tourani

Malmoon

Zaboli

et al. 2020

J Edu Health Promot

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BACKGROUND: University health coverage gives everyone accesses to health services focused on the most important causes of illness and death and ensures that the quality of services is high enough to improve the health of those receiving services. Nurses as the largest group of staff in the health system play an important role in achieving UHC. This study aimed to determine the training needs of nursing managers in universities of medical sciences of Iran in achieving UHC. MATERIALS AND METHODS: This study was a qualitative study conducted in 2019 using the framework method. There were 15 experts in nursing management, health management, and nursing authorities at the national level using the purposive random sampling. Data were collected from the expert panel. We used the Atlas.ti software version 7.2 and using the framework method for the analysis of qualitative data. A set of codes organized into categories that were jointly developed by the researchers involved in the analysis. The UHC framework used to summarize data in a way that could support answering research questions. RESULTS: This study showed that three educational modules leadership and strategic thinking, management, and decision-making, achieving excellence in nursing management to capacity building of nursing managers in the country. CONCLUSION: Training leadership skills and strategic thinking in the nursing empowerment modules illuminate global and national health roadmaps and policies and change attitudes to the model of nursing service delivery. Since nurses are the largest group of professionals in the health system, it facilitated by changes in the role and functions of the hospital and nurses to reach UHC.

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“…Patients with mild symptoms attending facility-level services may have further limited time for psychotherapy service provision to patients with moderate symptoms. A better understanding of the staffing and the distribution of staffing necessary to adequately address the burden of illness is sorely needed within global health implementation more broadly (Mukherjee et al ., 2019 ), and studies such as this serve to inform practical knowledge on mental health implementation.…”

Section: Discussionmentioning

confidence: 99%

Evaluating clinical outcomes of routinely delivered task-shared care for depression in rural Haiti

et al. 2021

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Background There is a growing literature in support of the effectiveness of task-shared mental health interventions in resource-limited settings globally. However, despite evidence that effect sizes are greater in research studies than actual care, the literature is sparse on the impact of such interventions as delivered in routine care. In this paper, we examine the clinical outcomes of routine depression care in a task-shared mental health system established in rural Haiti by the international health care organization Partners In Health, in collaboration with the Haitian Ministry of Health, following the 2010 earthquake. Methods For patients seeking depression care betw|een January 2016 and December 2019, we conducted mixed-effects longitudinal regression to quantify the effect of depression visit dose on symptoms, incorporating interaction effects to examine the relationship between baseline severity and dose. Results 306 patients attended 2052 visits. Each visit was associated with an average reduction of 1.11 in depression score (range 0–39), controlling for sex, age, and days in treatment (95% CI −1.478 to −0.91; p < 0.001). Patients with more severe symptoms experienced greater improvement as a function of visits (p = 0.04). Psychotherapy was provided less frequently and medication more often than expected for patients with moderate symptoms. Conclusions Our findings support the potential positive impact of scaling up routine mental health services in low- and middle-income countries, despite greater than expected variability in service provision, as well as the importance of understanding potential barriers and facilitators to care as they occur in resource-limited settings.

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A practical approach to universal health coverage

Cited by 16 publications

References 7 publications

Leveraging the lessons learned from financing HIV programs to advance the universal health coverage (UHC) agenda in the East African Community

Leveraging the lessons learned from financing HIV programs to advance the universal health coverage (UHC) agenda in the East African Community

Training needs assessment of nursing managers for achieving university health coverage

Evaluating clinical outcomes of routinely delivered task-shared care for depression in rural Haiti

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