scholarly journals Universal health coverage necessitates a system approach: an analysis of Community-based Health Planning and Services (CHPS) initiative in Ghana

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Abraham Assan ◽  
Amirhossein Takian ◽  
Moses Aikins ◽  
Ali Akbarisari
Keyword(s):  
Universal Health Coverage ◽  
System Approach ◽  
Health Planning ◽  
Health Coverage ◽  
Community Based ◽  
Universal Health

scholarly journals Challenges to achieving universal health coverage through community-based health planning and services delivery approach: a qualitative study in Ghana

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024845 ◽  
Author(s):  
Abraham Assan ◽  
Amirhossein Takian ◽  
Moses Aikins ◽  
Ali Akbarisari
Keyword(s):  
Qualitative Study ◽  
Universal Health Coverage ◽  
Low Income ◽  
Health Planning ◽  
National Level ◽  
Health Coverage ◽  
Community Based ◽  
Services Delivery ◽  
Universal Health ◽  
Local Levels

ObjectiveCommunity-based initiatives have enormous potential to facilitate the attainment of universal health coverage (UHC) and health system development. Yet key gaps exist and threaten its sustainability in many low-income and middle-income countries. This study is first of its kind (following the launch of the Sustainable Developments Goal [SDG]) and aimed to holistically explore the challenges to achieving UHC through the community-based health planning and service (CHPS) initiative in Ghana.DesignA qualitative study design was adopted to explore the phenomenon. Face-to-face indepth interviews were conducted from April 2017 until February 2018 through purposive and snowball sampling techniques. Data were analysed using inductive and deductive thematic analysis approach.SettingData were gathered at the national level, in addition to the regional, district and subdistrict/local levels of four regions of Ghana. Sampled regions were Central Region, Greater Accra Region, Upper East Region and Volta Region.ParticipantsIn total, 67 participants were interviewed: national level (5), regional levels (11), district levels (9) and local levels (42). Interviewees were mainly stakeholders—people whose actions or inactions actively or passively influence the decision-making, management and implementation of CHPS, including policy makers, managers of CHPS compound and health centres, politicians, academics, health professionals, technocrats, and community health management committee members.ResultsBased on our findings, inadequate understanding of CHPS concept, major contextual changes with stalled policy change to meet growing health demands, and changes in political landscape and leadership with changed priorities threaten CHPS sustainability.ConclusionUHC is a political choice which can only be achieved through sustainable and coherent efforts. Along countries’ pathways to reach UHC, coordinated involvement of all stakeholders, from community members to international partners, is essential. To achieve UHC within the time frame of SDGs, Ghana has no choice but to improve its national health governance to strengthen the capacity of existing CHPS.

scholarly journals COMMUNITY PHARMACY ROLE IN UNIVERSAL HEALTH COVERAGE IN MOMBASA COUNTY

2021 ◽  
pp. 331-341
Author(s):  
Kailong J. M ◽  
Aggrey A ◽  
Mulinya S
Keyword(s):  
Community Pharmacy ◽  
Universal Health Coverage ◽  
Close Contact ◽  
Health Planning ◽  
Essential Medicines ◽  
Bivariate Analysis ◽  
Community Pharmacies ◽  
Health Coverage ◽  
Controlled Drugs ◽  
Universal Health

Community pharmacy role in universal health coverage was a qualitative study that entailed close contact to the role played by community pharmacies in healthcare provision. As a "small healthcare" in provision of pharmaceutical services, community pharmacies are required to be included in realization of Universal Health Coverage in Mombasa since it is among the Big 4 Agenda of the national government (MOH, 2013). The objective of the study was to determine community pharmacy role in universal health coverage. A descriptive cross sectional study design was used to collect both qualitative and quantitative data and the design estimate the prevalence of the outcome of interest commonly for the purpose of public health planning. A sample size of 196 was calculated using fishers formula. Data was collected using in-depth interviews and structured questionnaire were administered on a target population of community pharmacies health providers and clients seeking services respectively. The collected data was analysed using SPSS version 20 and interpreted using tables and pie charts. On community pharmacy practitioners respondents; 58% were male, 90.3% diploma holders in pharmacy, 39.8% registered with PPB and 65% had practised for less than two years. 78% of the respondents agree that community pharmacy has a role in UHC and there was 74% affordability of community pharmacy medicines. Bivariate analysis findings show that training and inspection on UHC (P=0.003) Covid 19 (p=0.000) and inspection fee (p=0.000). Accessibility; location of community pharmacies (p=0.000) and doctors attitudes (p=0.000). Essential medicines; acyclovir 200mg tablets (p=0.000), chlorpromazine 100mg tablets (p=0.000) and tetanus toxoid vaccine (p=0.000). Key determinants of community pharmacy role in UHC were diploma (AOR 666.7; CI 129.6-3429.5), Erythromycin 125mg suspension (AOR 120.3; CI 15.4-940.8), Acyclovir 200mg tablets (AOR 46.823; CI 17.7-124.1) and Occupation (AOR 45.271; CI 15.363-133.404. The study recommends reduction of tax on essential medicines, MOH revise the UHC policy to incorporate community pharmacies and empowerment on management of controlled drugs and vaccines in order to realize effective and efficient UHC in Kenya

scholarly journals Healthcare Financing in Low and Middle-Income Countries and Achieving Universal Health Coverage

2021 ◽  
Vol 4 (2) ◽  
pp. 86-94
Author(s):  
Amadou Baubacar ◽  
Keyword(s):  
Universal Health Coverage ◽  
System Approach ◽  
Health Sector ◽  
Health Coverage ◽  
Healthcare Financing ◽  
Sovereign Wealth Funds ◽  
Middle Income ◽  
Middle Income Countries ◽  
Universal Health ◽  
Low And Middle Income

Using a comparative healthcare system approach, this paper discusses the existing healthcare financing methods in low-and middle-income countries in the move towards achieving universal health coverage (UHC). The article finds that traditional channels of financing the health sector in these countries include government’s budget, donors’ aid, national health insurance, and out-of-pocket model. Moreover, the paper explores other alternative mechanisms for raising resources for the health sector including tax on demerit goods, remittances, and sovereign wealth funds’ revenues. This paper is of particular interest to policymakers in low-and middle-income countries targeting to achieve UHC.

scholarly journals Realist evaluation of the role of the Universal Health Coverage Partnership in strengthening policy dialogue for health planning and financing: a protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022345 ◽  
Author(s):  
Emilie Robert ◽  
Valery Ridde ◽  
Dheepa Rajan ◽  
Omar Sam ◽  
Mamadou Dravé ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Low Income ◽  
Expert Knowledge ◽  
Health Planning ◽  
Realist Evaluation ◽  
Low Income Countries ◽  
Policy Dialogue ◽  
Health Coverage ◽  
Support Policy ◽  
Universal Health

IntroductionIn 2011, WHO, the European Union and Luxembourg entered into a collaborative agreement to support policy dialogue for health planning and financing; these were acknowledged as core areas in need of targeted support in countries’ quest towards universal health coverage (UHC). Entitled ‘Universal Health Coverage Partnership’, this intervention is intended to strengthen countries’ capacity to develop, negotiate, implement, monitor and evaluate robust and integrated national health policies oriented towards UHC. It is a complex intervention involving a multitude of actors working on a significant number of remarkably diverse activities in different countries.Methods and analysisThe researchers will conduct a realist evaluation to answer the following question: How, in what contexts, and triggering what mechanisms, does the Partnership support policy dialogue for health planning and financing towards UHC? A qualitative multiple case study will be undertaken in Togo, Liberia, Democratic Republic of Congo, Cape Verde, Burkina Faso and Niger. Three steps will be implemented: (1) formulating context–mechanism–outcome explanatory propositions to guide data collection, based on expert knowledge and theoretical literature; (2) collecting empirical data through semistructured interviews with key informants and observations of key events, and analysing data; (3) specifying the intervention theory.Ethics and disseminationThe primary target audiences are WHO and its partner countries; international and national stakeholders involved in or supporting policy dialogues in the health sector, especially in low-income countries; and researchers with interest in UHC, policy dialogue, evaluation research and/or realist evaluation.

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