The Tracking Universal Health Coverage:
One of the key tenets of Sustainable Development Goals, (SDGs), number three is to promote well-being for all at all ages- be it the adolescents and or adults.
In brief, by 2030, SDG goal seeks to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
Further the goal aims to achieve Universal Health Coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines for all.
Today, there are thousands of people suffering inessentially from preventable diseases, and some even end up dying prematurely. So overcoming disease and ill health will require concerted and sustained efforts, focusing on identified target population at risks.
Take for instance, sense data on Reproductive, maternal, newborn and child health presented by Africa Advocacy Foundation Programme Director Dr. Dennis Onyango.
Globally, from 2000 to 2016, the under-5 mortality rate dropped by 47 per cent, and the neonatal mortality rate fell by 39 per cent. Over the same period, the total number of under-5 deaths dropped from 9.9 million to 5.6 million.
Even in the region facing the greatest health challenges, progress has been impressive. Since 2000, the maternal mortality ratio in sub-Saharan Africa has been reduced by 35 per cent, and the under-5 mortality rate has dropped by 50 per cent. In 2018, the global adolescent birth rate is 44 births per 1,000 women aged 15 to 19, compared to 56 in 2000. The highest rate (101) is found in sub-Saharan Africa. (WHO Report).
Infectious diseases and non-communicable diseases
Globally, the incidence of HIV declined from 0.40 to 0.26 per 1,000 uninfected people between 2005 and 2016. For women of reproductive age in sub-Saharan Africa, however, the rate is much higher, at 2.58 per 1,000 uninfected people.
Unsafe drinking water, unsafe sanitation and lack of hygiene continue to be major contributors to global mortality, resulting in about 870,000 deaths in 2016. These deaths were mainly caused by diarrheal diseases, but also from malnutrition and intestinal nematode infections.
In Kisumu County, Prevalence rates of Hiv/Aids infections and deaths in Kisumu County has reduced, but statistics show that young people are still highly exposed to risks of getting the disease.
According to the latest National AIDS Control Council (NACC) scientific data carried in the 2017/2018 report, the overall preference of HIV has dropped from 19 percent recorded last year to 16.3 percent.
Although, the rates dropped, Regional NACC -Hiv/Aids Coordinator Mr. Edwin Lwanya disclosed they are still worried about young people who are increasingly being infected. Some of these young people, Lwanya say Concede Hiv/Aids is not the problem because it has cure. For them their biggest fear is teenage pregnancy.
UHC milestone and impact and to find out if the UHC programme was headed in the right direction, toward achieving the set universal goals.
That launch of UHC has increased demand and enrolment for health care services
Increased demand for specialized treatment, e.g. scanning and chemotherapies
Increased enrolment of people under UHC, tagged by County Health at 113 percent
Quality services offered through UHC gone up due to purchase of new modern medical kits
Increased medical supplies to treat the rising demand for primary health care
Expansion of over stretched medical Health facilities to cater for the growing need
Budget re-adjustments to meet the cost of treatment and advocacy
Strengthening referral Hospitals and increasing linkages to cope with demand
Periodic/quarterly stakeholders review, success, challenges and budget constraints including and not limited to finding partners to bridge the funding gaps, like Danida, World Bank, DFID et al
Leverage—Patients taking advantage of financing to go for treatment under UHC
Work plan and key policy interventions strategies
Arguably, improved health system performance requires global, national, and county action plans in service delivery, health financing, governance, staffing and advocacy and the media to reach out to the widely dispersed target audience.
Service Delivery: Key suggestions
Identify key partners or line organizations keen to see UHC succeed
Expanding primary health care in the rural areas or sub counties
Scale up investment in skilled health care services
Use media to disseminate key message targeted at the right groups or TAs
Improving access to medicines and modern health technologies
Advocate for allocation or more resources or budget towards UHC as was indicated by the County CEC for Health. Currently, the Sh1,800 capitation for a patient is under review to Sh1,700 due to funding gaps
Innovate to meet the health needs of vulnerable and marginalized groups
Expand engagement with non-state actors
Improve patient safety by ensuring quality of health services
Fostering multi-sectoral action to address the social determinants of health
Employ more health personnel to cope up with the increased demand for services. There exist huge human resource gap today
Identify the most at risk populations(MARPs), and where possible target them, for reproductive health advocacy, prevention and treatment including and not limited to use of PREPs
Create and establish more health infrastructure including building new one and expanding existing and overstretched health facilities and provide the adequate and requisite human resource input, (Staffing).
Integrate the UHC –re-adjusted budgets in County integrated development programmes, (CIDP)
Create a stakeholders and multi sectoral groups to share wide experiences
Expand health consortium pooling arrangements to improve financial protection for all patients put under UHC
Launch a website, purchasing ambulances for referral services, hire key staff
Promoting regional and global advocacy mechanisms for collective action and partnership as is evidenced in Africa Advocacy Foundation. (AAF).
Strengthening research and development, including and not limited to health technology transfer mechanisms
Promotion citizens or stakeholders platforms to hear feedback. This includes dialogue platforms for multi-sectoral action group’s policy.
Promote freedom of information and expanded use of quality data-via Media
Adopt and enforce legal frameworks supporting access to quality health services
Intended intervention plans
Build political support and grassroots demand for UHC at the county level to motivate policies and investments that targets all.
Build high-level political support Convince more partners and funding agencies that UHC is a right, smart and affordable investment that yields massive social and economic returns for countries – and wins votes.
Work with in-country advocates to make the case for UHC and ensure that influential Global voices continue to name it as a priority for all countries.
Support these efforts by sharing lessons learned, human stories, and messages that have proven effective, and by providing resources for community engagement activities through the media.
AAF was particularly established as a key catalysts in promoting advocacy messages across all platforms and key segment paired with Global Health Innovations.
Time lines and costs
Time line was suggested to be enforced within the next three months
Cost was not calculated given that it required statistics and time not sufficient then
Key Line actors identified
The World Bank, National Government, County government of Kisumu, Reproductive health experts, global health partner’s et al.
God bless. Team, Kepher, Ellen, Kennedy, Okioma and Omach