Universal Health Coverage; A Way Forward

Abstract

Universal health coverage means every person has access to quality health care without suffering financial hardships. The basis of universal health coverage lies in the primary health care concept, which was envisioned way back in 1978, as mentioned in Alma Ata Declaration¹. The "World Health Report" published by the World Health Organization (WHO) in 2008 structures primary health care reforms in four groups. One of the crucial reforms was universal coverage reform to improve health equity². WHO and UNICEF in 2018 documented how primary health care will be in the 21^st century? The approach was towards universal health coverage and sustainable development goals. Sustainable development goals were to be achieved by 2030, and they were a continuation of millennium development goals 2000–2015³. The resolution on Transforming our world: the 2030 Agenda for Sustainable Development adopted the target of universal health coverage by 2030, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all⁴. Currently, many developing nations do not have access to health services. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. To make health for all, we need individuals and communities to have high-quality health services to take care of their families health. Skilled health workers providing quality, people-centred care and policy-makers should be committed to investing in universal health coverage. Universal health coverage should be based on intense, people-centred primary health care. Good health systems are rooted in the communities they serve. They focus not only on preventing and treating disease and illness but also on helping to improve well-being and quality of life⁵. Pakistan, the developing country, is struggling to provide good quality health services, mostly availed from the out-of-pocket expenditure.

Both private and public sector hospitals were trying to deliver health services, but poor people failed to have access to many services due to poverty. To overcome this obstacle and address indicator 3.8 of SDGs, the current government developed a five-year program to improve the targeted population's health by increasing their access to quality health services. The initiative will also reduce poverty, as the government will cover most of their health budget through the "Sehat Sahulat Program". The program was part of the National vision to ensure Universal Health Coverage (UHC) for all Pakistani families. No one is denied quality healthcare services only because of financial constraints. Initially, it was piloted in selected four districts of Khyber Pakhtunkhwa, which was later extended to all over the province. Currently, 7.2 million families are getting free in-patient health care services, and the program's annual cost is 18 billion. It was a bold initiative of the current government, which helped improve access to UHC, thus addressing one of the sustainable development goals^6,7.