A new report, titled: ‘Tracking Universal Health Coverage: 2017 Global Monitoring Report’, published by the World Bank and the World Health Organisation last week, has stated that at least half of the world’s population cannot obtain essential health services, and each year, large numbers of households are being pushed into poverty because they must pay for health care out of their own pockets. This is indeed unacceptable and it is hoped that governments and policy makers would make the bold decisions and do what is necessary to ensure that persons have adequate access to affordable and proper health care services.
According to the report, around 800 million people spend at least 10 percent of their household budgets on health expenses for themselves, a sick child, or other family member. For almost 100 million people, these expenses are high enough to push them into extreme poverty, forcing them to survive on just US$1.90 or less a day.
World Bank Group President Dr Jim Yong Kim has said the report makes clear that if we are serious – not just about better health outcomes, but also about ending poverty – we must urgently scale up our efforts on universal health coverage. According to Kim: investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. However, he pointed out that the system is broken; as such, there is need for a fundamental shift in the way resources are mobilized for health and human capital, especially at the country level.
That said, there is some good news: The report shows that the 21st century has seen an increase in the number of people able to obtain some key health services, such as immunization and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria. In addition, fewer people are now being tipped into extreme poverty than at the turn of the century.
But progress is very uneven. According to the report, there are wide gaps in the availability of services in Sub-Saharan Africa and Southern Asia. In other regions, basic health care services such as family planning and infant immunization are becoming more available, but lack of financial protection means increasing financial distress for families as they pay for these services out of their own pockets.
This is even a challenge in more affluent regions, such as Eastern Asia, Latin America and Europe, where a growing number of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses. Inequalities in health services are seen not just between, but also within, countries: national averages can mask low levels of health service coverage in disadvantaged population groups. For example, only 17 percent of mothers and children in the poorest fifth of households in low-income and lower-middle-income countries received at least six of seven basic maternal and child health interventions, compared to 74 percent for the wealthiest fifth of households.
Delivering adequate health care and providing the key elements of Universal Health Care (UHC) to all has always been a challenge for developing countries, with limited resources and underdeveloped systems. As once stated by Health Minister Volda Lawrence, it is known that creating awareness with regard to social determinants of health; promoting health at all levels of the community; ensuring that healthy public policies are in place; and developing and implementing innovative approaches that work, along with a public/private mix that addresses the high-end needs, can arrest the escalating demands faced by countries.
We believe that stronger efforts must be made by developing countries, including Guyana, to revise financing at national levels, so that health could be positioned as a top priority for funding. Among other critical areas that need urgent support, there should be targeted allocation of resources to address the growing shortage of health workers and improve conditions at hospitals and other community health centres, so that patients could be better served.
Every Government must seek to increase investments in the health sector, so as to improve health care delivery at all levels. Without affordable and effective health care, it would be very difficult for children to reach their full potential. Similarly, without a healthy, productive population, societies would not be able to realize their aspirations.
