…….governments need to be deliberate in improving health financing policies, focusing on equitable access to health care and financial protection of the population especially the most vulnerable……
On June 27th-28th, 2017, Rwanda hosted the first ever WHO Africa Health forum with a theme, #Putting people first: The road to Universal Health Coverage in Africa. Not only as a participant, but also as a seasonal medical practitioner and an advocate of proper governance systems, the forum was of keen interest to me because it convened a broad representation of the African people from policy makers, health and finance ministries, African Union, private sector to CSOs and the media among many other sectors. Participants at the end of the forum, committed individually and collectively among other things to sustain strong political will and commitment, increase and sustain domestic and external mechanisms, ensuring value for money and increased accountability – I couldn’t resonate with this commitment more than I already do because it is coined with some of the core principles of good governance.
As various African countries contemplate on how to extend health care to more of their citizens while protecting them against the financial hardship associated with paying for the health care, nations ought to put proper governance structures in place, if the concept is to turn into a reality. When people have to pay a lot at the time they use health services, it poses a real, severe economic risk to their households which later affects the community and eventually the entire country in general. My argument is crystal clear – governments need to be deliberate in improving health financing policies, focusing on equitable access to health care and financial protection of the population especially the most vulnerable.
In a bid to achieve universal health coverage, the population needs:
- Well trained health workers both at community and referral health facilities. For this to be possible, health workers must be compensated with a fairly good remuneration (I know this is relative), or brain drain will take effect. African countries have labored to ensure that their health care workers get the best education only to lose them to the highest bidder once they graduate. Nevertheless, governments need to combat this so that we have skilled people on the frontline of the efforts to prevent and treat different diseases. Well-trained and highly motivated health workers are the bedrock of a strong and functioning healthcare system. Staffing challenges can be exacerbated especially in emergency situations. A quick but also sad example is the Ebola virus outbreak in Sierra Leone and Liberia that exposed weaknesses in both countries’ health systems and knowledge gaps among the health workers. In total, the epidemic caused over 296 reported infections among frontline health staff, and 221 reported health worker deaths in Sierra Leone alone.
- State of the art health care facilities – products, drugs and hospitals. If citizens need to travel either from one town to another or one country to another, worst one continent to another in search for better treatment, then we still have a long way to go. How many people can afford that without organizing fundraising campaigns? Does that mean the vulnerable are already condemned to early untimely death? They are given no chance to redeem themselves another minute or month, even a year with their loved ones. On top of that patients holding community insurance cards or lowest medical scheme need to also access treatment at the state of the art facilities.
- Investment in Africa’s health systems is key to inclusive and sustainable growth. The health care sector is made up of many different industries – from pharmaceuticals and devices to health insurers and hospitals – and each has different dynamics. Healthcare investing requires a multifaceted approach to understand the underlying drivers. Investors can profit from investments in both the overall sector and/or its industries. This requires the private sector to make their contribution and support the efforts of government to achieve universal health coverage. However, the investors need to be attracted in to the sector through favorable incentives, subsidies and tax exemptions.
- Political hygiene across Africa. Many African countries need to clean up their governments and uproot all the corruption and the offenders. Health care funds have been swindled by African senior leaders yet people in impoverished areas are left to die from treatable diseases. Corruption seems to be holding back development because governments are often caught up in a series of scandals – when will they get time to concentrate on adopting the right policies or making plan to put up state of the art or even standard health facilities. As we wait for government to do their part, also citizens can meet in the middle – if people refuse to allow corruption into their lives, there will be no opportunity for the corrupt to carry out their illegal deeds – so individuals most definitely can make a difference by breaking the chain of corruption.
- Be aware about public health. Health sector players need to create public awareness about the anatomy (body organisms and parts), their physiology (how the body functions) and pathophysiology (when the body is sick). Instead of having facilities underutilized because citizens are not well informed, it would be better for people to know about their bodies and how they functions and also be able tis kef detect some symptoms so they can seek medical attention before their disease advances gravely.
- Evidence based policies. To address the health needs of the population, proposed health policies should be grounded in methodologically sound analysis of the existing evidence. Too often, policy decisions are made without full consideration of the available research evidence or the results of policy modeling to understand likely economic and health outcomes. Therefore, health ministries need to adopt policies that reflect the best research evidence that improves the sustainability of the system and the well-being of all people.
I know that there is no one-size-fits-all approach to achieving universal health coverage; strategies need to depend on local circumstance and national dialogue but as this is considered, governments need to put people first.
Caution: The health sector is one area that can’t be avoided because it can haunt an entire community if not well catered for!