Universal Health Coverage for Undocumented Migrants. The Spanish Case

2018 ◽  
Vol 25 (2) ◽  
pp. 283-299
Author(s):  
María Dalli

Implementation of the universal right to health, along with the UN’s goal to achieve universal health coverage (UHC), face common challenges to ensuring universal health care entitlement. One of these difficulties is health care restrictions for undocumented migrants. A recent example is the Spanish health care regulation that places universal coverage at risk by restricting access to it by this group. The work herein examines the right to health and UHC’s regulations with the aim of determining if access to health care services for undocumented migrants is indeed recognized and if this recognition could therefore be valid to limit those kinds of measures. The UHC proposal does not sufficiently deal with this problem. Regarding the right to health, even though there are some limitations within international human rights laws regarding protection for this group, it can be concluded that the right to health is also applicable to undocumented migrants.

Author(s):  
Gorik Ooms ◽  
Laila A Latif ◽  
Attiya Waris ◽  
Claire E Brolan ◽  
Rachel Hammonds ◽  
...  

2018 ◽  
Vol 3 (5) ◽  
pp. e001031 ◽  
Author(s):  
Kristine Husøy Onarheim ◽  
Andrea Melberg ◽  
Benjamin Mason Meier ◽  
Ingrid Miljeteig

As countries throughout the world move towards universal health coverage, the obligation to realise the right to health for undocumented migrants has often been overlooked. With unprecedented millions on the move – including refugees, asylum seekers, internally displaced persons, and returnees – undocumented migrants represent a uniquely vulnerable subgroup, experiencing particular barriers to health related to their background as well as insecure living and working conditions. Their legal status under national law often restricts access to, and affordability of, healthcare services. While striving to ensure health for all, national governments face challenging priority setting dilemmas in deciding: who to include, which services to provide, and how to cover out-of-pocket expenses. Building on comparative experiences in Norway, Thailand and the United States – which reflect varied approaches to achieving universal health coverage – we assess whether these national approaches provide rights-based access to affordable essential healthcare services for undocumented migrants. To meet the shared Sustainable Development Goal on universal health coverage, the right to health must be realised for all persons – including undocumented migrants. To ensure universal health coverage in accordance with the right to health, governments must evaluate laws, regulations, policies and practices to evaluate: whether undocumented migrants are included, to which services they have access, and if these services are affordable. Achieving universal health coverage for everyone will require rights-based support for undocumented migrants.


Author(s):  
Viviane Helena de França ◽  
Celina Maria Modena ◽  
Ulisses Eugenio Cavalcanti Confalonieri

Objective: to investigate the knowledge of managers and health professionals, social workers and education professionals regarding the principal barriers to universal health coverage and universal access to health on the part of the extremely poor population; and to point to the contributions made by nursing for the promotion of this right. Method: a qualitative study whose reference was, for ensuring the right to health, the reorientation of the Brazilian Unified Health System (SUS) towards universal coverage and access in these territories. Interviews were held with 27 members of the multi-professional team of a municipality with high social vulnerability. The data were worked on using thematic content analysis. Results: the following were ascertained as the principal barriers to universal health coverage and access to health: failures in the expansion and strengthening of the services; absence of diagnosis of the priority demands; shortage of technology, equipment, and material and human resources; poor local infrastructure; and actions with low resolutive power and absence of interdepartmental policies. Within the multi-professional team, nursing acts in the SUS in unique health actions and social practices in these territories, presenting an in-depth perspective on this harsh reality, being able to contribute with indispensable support for confronting these disparities in universal health coverage and universal access to health. Conclusion: nursing's in-depth understanding regarding these barriers is essential for encouraging the processes reorienting the SUS, geared towards equality in the right to health.


Author(s):  
Joia S. Mukherjee

This chapter explores the seminal topic of Universal Health Coverage (UHC), an objective within the Sustainable Development goals. It reviews the theory and definitions that shape the current conversation on UHC. The movement from selective primary health care to UHC demonstrates a global commitment to the progressive realization of the right to health. However, access to UHC is limited by barriers to care, inadequate provision of care, and poor-quality services. To deliver UHC, it is critical to align inputs in the health system with the burden of disease. Quality of care must also be improved. Steady, sufficient financing is needed to achieve the laudable goal of UHC.This chapter highlights some important steps taken by countries to expand access to quality health care. Finally, the chapter investigates the theory and practice behind a morbidity-based approach to strengthening health systems and achieving UHC.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Arrivillaga

Abstract Background Colombia has an insurance-based, private and public health care system, with the intermediation of health insurance agencies that control the resources. At present, the Universal Health Coverage (UHC) is around 97%. However, there is wide scientific evidence that criticizes the structure and operation of the system due to the persistent differences between the UHC indicator and real accessibility to health services. This study aimed to analyze the concept of accessibility of health services in order to design and validate alternatives instruments for its assessment beyond UHC. Methods A mixed methods approach with concurrent design in three phases was conducted between 2014 and 2017: 1) systematic review of literature and documentary research; 2) design, content validation with experts and pilot test of instruments to assess health care accessibility and 3) definition of a route to assess accessibility. Results The reviewed literature revealed five conceptual logics to define accessibility: decent minimum of health care, health care market, factors and multicausality, needs and, social justice and human right to health. A Household Survey on Accessibility to Health Care Services and a Health Care Services Availability Questionnaire was designed and validated with experts and pilot test in representative samples of households and care centers in three cities in Colombia was conducted. Those instruments were designed under the conceptual logic of human right to health. Finally, an alternative route to assess accessibility in Colombia was proposed. Conclusions The route for assessing accessibility with primary data, territorial approach and without intermediation of health insurance agencies allow obtaining an overview of the real situation beyond the UHC indicator. The instruments included in this assessing process can be useful to monitor progress in guaranteeing the human right to health, declared in Colombia and other countries. Key messages The UHC indicator is not enough to assess real accessibility to health services. This study presents an alternative route and two validated instruments for its assessment with primary data and territory-based approach, applicable to countries with public-private health systems.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257348
Author(s):  
Vivian Naidoo ◽  
Fatima Suleman ◽  
Varsha Bangalee

Background The implementation of Universal Health Coverage in SA has sought to focus on promoting affordable health care services that are accessible to all citizens. In this regard, pharmacists are expected to play a pivotal function in the revitalization of primary health care (PHC) during this transition by the expansion of their practice roles. Objectives To assess the readiness and perceptions of pharmacists to expand their roles in an integrated health care system. To determine the availability and pricing of primary health care services currently provided within a community pharmacy environment and to evaluate suitable reimbursement for the provision of such services by a community pharmacist. Methods Community pharmacists’ across SA were invited to participate in an online survey-based study. The survey consisted of both open- and closed-ended questions. Descriptive statistics for closed-ended questions were generated and analysed using Microsoft Excel® and Survey Monkey®. Responses for the open-ended questions were transcribed, analysed, and reported as emerging themes. Results Six hundred and sixty-four pharmacists’ responded to the online survey. Seventy-five percent of pharmacists’ reported that with appropriate training, a transition into a more patient-centered role might be beneficial in the re-engineering of the PHC system. However, in order to adopt these new roles, appropriate reimbursement structures are required. The current fee levied by pharmacists in community pharmacies that offered these PHC services was found to be lower to that recommended by the South African Pharmacy Council; this disparity is primarily due to a lack of information and policy standardisation. Therefore, in order to ensure that fees levied are fair, comprehensive service package guidelines are required. Conclusions This study provides baseline data for policy makers on pharmacists’ readiness to transition into expanded roles. Furthermore, it can be used as a foundation to establish appropriate reimbursement frameworks for pharmacists providing PHC services.


2019 ◽  
Vol 44 (3) ◽  
pp. 112
Author(s):  
Md Habibe Millat

Abstract not available Bangladesh Med Res Counc Bull 2018; 44: 112


2021 ◽  
pp. 134-153
Author(s):  
Joia S. Mukherjee

As part of the Sustainable Development Goals the right to health is captured under the rubric of universal health coverage (UHC). That is that all people should have access to the high quality care they need without suffering financial hardship. This chapter explores this seminal topic reviewing the theory of universal coverage and definitions that shape the current conversation about UHC. This chapter also highlights some important steps taken by countries to expand access to quality health care but challenges the rhetoric that financing care through insurance schemes, a common approach to UHC) is sufficient when the inputs into the health systems do not match the disease burden. Finally, the chapter investigates the theory and practice behind a morbidity-based approach to strengthening health systems and achieving UHC.


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