Universal Health Coverage (UHC) Lecture Notes

Introduction

• Universal Health Coverage (UHC): Ensures all people get the health services they need without financial hardship.
• Key concept in public health.
• Some argue it's too costly or limits services, but studies show it can deliver better health outcomes at lower costs when managed well.

Challenges to UHC

• Aging population.
• Rise of non-communicable diseases (e.g., diabetes, heart disease, cancers).
• Increasing costs of new, cutting-edge treatments.
• Balancing expectations and cost containment while achieving optimal health.

Importance of Understanding UHC Principles

• UHC aims to provide basic healthcare benefits to everyone.
• Misunderstandings can lead to over-expectations and strain on government resources.

Global Support and Progress

• 2012: UN General Assembly adopted a resolution emphasizing health as essential for sustainable development.
• Few countries have fully achieved UHC, but many are making progress.

Case Studies of Countries Progressing Towards UHC

China

• Coverage expanded significantly in the past four years.
• Rural coverage increased from 10% to 97%.

Oman

• Challenges due to widely dispersed population.
• 200 primary health care centers established, one within half an hour of even the most remote village.
• Focus on prevention and early diagnosis to reduce hospital care costs.

Mexico

• Comprehensive health package called the People's Insurance.
• Ensures access to primary health care (e.g., vaccinations, skilled health workers during childbirth).
• Expanding to meet needs of long-term treatments (e.g., diabetes, cancer).

Turkey

• Increased coverage to 98% in the last decade.
• Expanded range of services available.
• Improved maternal and child programs, maternal mortality almost halved, 97% of children receive essential vaccines.

Thailand

• Started UHC journey 10 years ago.
• Focus on both primary and emergency care.
• Innovative ways to expand services for expensive treatments (e.g., home-based kidney dialysis devices).

Rwanda

• 55% of health budget managed at the community level.
• Progress measured against specific health targets.
• Government covers insurance premiums for the poorest 25%.
• Coverage increased from 7% to 97% in the last decade.
• Significant improvements in life expectancy, child mortality, and malaria deaths.

Key Takeaways

• Each country's approach to UHC varies based on health needs and system capacities.
• No one-size-fits-all model; historical development and capability must be considered.
• Essential to provide basic primary care to prevent diseases or diagnose them early.
• Aim: Healthier communities and affordable healthcare for all.