By MOSES CHIMFWEMBE –
IT is possible to live in an environment where all individuals and communities will receive the health services, they need without suffering financial hardship, an environment where the people will enjoy a full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
Many countries around the globe, including Zambia are striving to attain such an environment for their citizens through the implementation of Universal Health Coverage (UHC).
Universal Health Coverage refers to a system that provides health care and financial protection to all citizens of a particular country and it is enshrined in the Sustainable Development Goals (SDGs),target 3.8.
In the human rights contexts, it reflects an approach which is entrenched in the right to health, everyone is entitled to the healthcare they need without facing financing hardship.
The World Health Organisation (WHO’s) General Comment on the right to health which was adopted in 2000 by the Committee on Economic, Social and Cultural Rights set out four criteria by which to evaluate the right to health.
These included ensuring availability of commodities, services, and programmes in sufficient quantity, accessibility that is devoid of any form of discrimination in terms of physical accessibility, affordability and information accessibility.
Other determinants of a right to health are acceptability which entails ethical, gender-sensitive and culturally appropriate facilities, commodities and services, as well as quality which demands health facilities, goods and services such as trained health professionals, and safe drugs to be of good quality.
However, the 2017 global monitoring report for tracking Universal Health Coverage released by the World Bank and WHO revealed that at least half of the world’s population still does not have full coverage of essential health services and that there were wide disparities in UHC within countries in Africa.
This was despite the 2017 Tokyo Declaration at the UHC forum calling for greater global commitment to accelerate progress towards UHC by 2030 without ‘leaving no one behind.’
Another call to action was made at the Africa Health Agenda International Conference (AHAIC) held recently in Kigali, Rwanda from March 5-7, 2019 which placed more emphasis on leaders to make bold commitments to scaling up access to health for all in their countries.
What has Zambia achieved so far in respect of UHC?
Parliamentary Committee on Health, Community Development and Social Services Chairperson Christopher Kalila said during the conference that Zambia had already started integrating Universal Health Coverage as a goal in its health strategies and is committed to the attainment of the SDG goals.
Dr Kalila said, “We have already started implementing Universal Health Coverage. We have been strengthening our health systems, our current Minister of Health (Chitalu Chilufya) is very passionate about UHC and together with his team, they are rolling out health facilities in various parts of the country, building district and specialised hospitals.”
Zambia’s National Health Strategic Plan 2017-2021 clearly states the mission of the Ministry of Health as that of providing the population with equitable access to cost effective, quality health services as close to the family as possible.
Further, the Zambian government in its Seventh National Development Plan(7NDP) has prioritised health as a key economic investment and emphasises that the successful attainment of the country’s goal of being a prosperous, middle income country by 2030 as stipulated in its Vision 2030 is dependent upon having a healthy and productive population.
With this in mind, the government has embarked on strengthening health systems in the country by scaling up training of health personnel, rolling out facilities to various areas in a bid to bring healthcare services closer to the people.
Zambia also passed the National Health Insurance (NHI) law last year which will allow every citizen to easily access healthcare without having to pay for the services.
This NHI law is expected to increase the resource envelope for health and enhance UHC in the country.
In addition, the country has also established the Levy Mwanawasa Medical University, the country’s first ever specialised university for health studies which has an enrolment capacity of 3000 students to beef up the training needs of health staff.
The various measures Zambia has put in place have culminated in the improvements in the coverage of life saving interventions and improved health status in the past few years.
For example, the Zambia Demographic Health Survey (ZDHS) shows that HIV prevalence declined from 14 percent in 2007 to 13.3 percent in 2013-2014, maternal mortality reduced from 591 deaths per 100,000 live births in 2007 to 398 deaths in 2013-2014 the child mortality rate dropped from 197 deaths per 1,000 live births in 1996 to 75 per 1,000 live births in 2013-14.
“Strengthened health systems ensure that government provides health facilities, it ensures that there are health workers in these facilities and people have easy access to healthcare without having to pay because they are on insurance,” Dr Kalila said.
The WHO country office in its 2018 bulletin on UHC observed that Zambia still faces a high burden ofcommunicable and non-communicablediseases in addition to structural and socialdeprivation including poverty, inequalitiesand marginalisation remain major threatsto health.
WHO observed that by investing in UHC, Zambia could make a sound investment in human capital.
This was echoed by Rwanda’s Minister of Health, Diane Gashumba during the 2019 AHAIC conference whourged governmentsacross Africa to work together to fund health care systems on the continent.
“Investing in Universal Health Coverage is one of the smartest investments a country can make,” Dr Gashumba said.
“In the past two decades, African countries have displayedcommendable leadership in furthering the UHC agenda across the continent. We must ensurethat this movement is sustained through greater domestic investments in health care and that allministries and stakeholders do their part.”
Political will is vital in the attainment of Universal Health Coverage in Zambia and around the globe. Therefore, with increased commitment from political leaders and other stakeholders, the UHC dream is not far from being achieved.