Equitable Access in Universal Health Coverage

Greg Olson

Communications Senior Associate

On December 12, 2014, a global coalition of organizations, institutions, and governments launched the first-ever Universal Health Coverage Day calling for broader attention and action towards health for all. Recognizing—and more importantly institutionalizing—health as a human right adds value to health systems, societies, and people.

MSH CEO Jono Quick says, "Accountability for Universal Health Coverage is imperative to ensure the most vulnerable benefit first." (Image: Global Coalition for Universal Health Coverage)

Deliberate organizing at the local, national, and international levels is imperative to achieve Sustainable Development Goal #3 (ensure healthy lives and promote well-being for all at all ages), and to frame universal health coverage (UHC) in a human rights paradigm. Although obstacles to UHC appear daunting, UHC Day is a perfect example of the first organizing step that local, national, and international partners have taken toward advocating for and achieving health for all.

Continued progress towards UHC requires a shared understanding of three key components: access, quality, and cost; however, in this blog, I aim to discuss only one aspect of “access,” access by vulnerable populations to health services.

Too often development funding structures lead to silos where vulnerable populations’ rights, including the right to health, are championed only by Disabled People’s Organizations (DPOs), disability rights experts, or persons with disabilities themselves. However, funding from the U.S. Agency for International Development’s Bureau for Democracy, Conflict and Humanitarian Assistance has helped the Leadership, Management, and Governance (LMG) Project begin to bridge the gap between disability programming and public health programming.

According to the World Health Organization’s World Report on Disability, around 15 percent of the world’s population lives with some level of disability. That statistic alone—equalling nearly 1 billion people—should be enough to ensure inclusion of disabled people in discussions of UHC.

The LMG Project implements activities with different partners that support vulnerable populations. Some examples include:

Furthermore, the LMG Project is connecting the disability and global health sectors to break down their silos and to shape a global conversation on inclusive services and equitable access to healthcare. A recent example of this was the #InclusiveHealth Twitter chat that the LMG Project hosted on December 3, the International Day of Persons with Disabilities. The LMG Project, led by Management Sciences for Health (MSH), convened disability rights partners and MSH’s broader public health audience to foster ideas about deliberate collaboration. Similarly, the conversation benefitted from a variety of perspectives including donors, DPOs, and individuals. A few of the recurring themes were including persons with disabilities in decision-making and program design, focusing on grassroots DPO empowerment with a path toward national-level coalitions, and educating the health workforce to understand that people with disabilities retain their human right to all essential health services.

Advocating for UHC is already a daunting task that requires delicately navigating political and social norms; however, progress can already be seen throughout many low- and middle-income countries. For example, Ghana has implemented policies to address all three areas: reducing geographic barriers to access with the Community-based Health Planning and Services program, improving the quality of services through district health systems strengthening, and costing through a National Health Insurance Scheme. For far too long, we have seen the impact of policies that do not explicitly include vulnerable populations in the debate. However, the time is right, on UHC Day 2015, to ensure that decision-making is deliberately inclusive, and that UHC conversations, policies, and actions ensure equitable access for all, including vulnerable populations.

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