scholarly journals Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

2019 ◽  
Author(s):  
Yibeltal Assefa ◽  
Peter S Hill ◽  
Wim Van Damme ◽  
Judith Dean ◽  
Charles F Gilks
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Universal Health Coverage ◽  
Hiv Treatment ◽  
Public Health Approach ◽  
Health Coverage ◽  
Primary Health ◽  
Universal Health ◽  
Over Time

Abstract Background The third Sustainable Development Goal (SDG-3) aims to ensure healthy lives and promote well-being for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the importance of all people and communities having access to quality health services without risking financial hardship. The objective of this study is to review progress towards UHC using antiretroviral treatment (ART) as a case study.Methods We used a mixed-methods design including qualitative and quantitative approaches. We reviewed and synthesised the evidence on the evolution of the WHO HIV treatment guidelines between 2002 and 2019. We calculated ART coverage over time by gender, age group, and location. We also estimated ART coverage differences and ratios.Findings ART guidelines have evolved from “treating the sickest” to “treating all”. ART coverage increased globally from under 7% in 2005 to 62% in 2018. There have been successes in increasing ART coverage in all populations and locations. However, progress varies by population and location in many regions. There is inequity in ART coverage: women (68%) versus men (55%), and adults (62%) versus children (54%). This inequity has widened over time, and with expanded ART eligibility criteria. On the other hand, data from at least one high-burden country (Ethiopia) shows that inequity among regions has narrowed over time due to the improvements in the primary health care systems and implementation of the public health approach in the country.Conclusion ART coverage has increased at global, regional and national levels to all population groups. However, the gains have not been equitable among locations and populations. Policies towards universality may widen the inequity in resource-limited settings. We argue that primary health care and public health approaches, with multi-sectoral actions, are vital to minimize inequity and achieve UHC.

scholarly journals Leaving no one behind: lessons from implementation of policies for universal HIV treatment to universal health coverage

2020 ◽  
Author(s):  
Yibeltal Assefa ◽  
Peter S Hill ◽  
Wim Van Damme ◽  
Judith Dean ◽  
Charles F Gilks
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Universal Health Coverage ◽  
Hiv Treatment ◽  
Public Health Approach ◽  
Health Coverage ◽  
Primary Health ◽  
Universal Health ◽  
Over Time

Abstract Background: The third Sustainable Development Goal (SDG-3) aims to ensure healthy lives and promote well-being for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the importance of all people and communities having access to quality health services without risking financial hardship. The objective of this study is to review progress towards UHC using antiretroviral treatment (ART) as a case study. Methods: We used a mixed-methods design including qualitative and quantitative approaches. We reviewed and synthesised the evidence on the evolution of the WHO HIV treatment guidelines between 2002 and 2019. We calculated ART coverage over time by gender, age group, and location. We also estimated ART coverage differences and ratios. Findings: ART guidelines have evolved from “treating the sickest” to “treating all”. ART coverage increased globally from under 7% in 2005 to 62% in 2018. There have been successes in increasing ART coverage in all populations and locations. However, progress varies by population and location in many regions. There is inequity in ART coverage: women (68%) versus men (55%), and adults (62%) versus children (54%). This inequity has widened over time, and with expanded ART eligibility criteria. On the other hand, data from at least one high-burden country (Ethiopia) shows that inequity among regions has narrowed over time due to the improvements in the primary health care systems and implementation of the public health approach in the country. Conclusion: ART coverage has increased at global, regional and national levels to all population groups. However, the gains have not been equitable among locations and populations. Policies towards universality may widen the inequity in resource-limited settings unless countries take precautions and “put the last first”. We argue that primary health care and public health approaches, with multi-sectoral actions and community engagement, are vital to minimize inequity, achieve UHC and leave no one behind.

scholarly journals Roles and reimbursement of pharmacists as South Africa transitions towards Universal Health Coverage (UHC): An online survey-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257348
Author(s):  
Vivian Naidoo ◽  
Fatima Suleman ◽  
Varsha Bangalee
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Universal Health Coverage ◽  
Health Care Services ◽  
Online Survey ◽  
Health Coverage ◽  
Care Services ◽  
Primary Health ◽  
Comprehensive Service ◽  
Universal Health

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.

scholarly journals From primary health care to universal health coverage—one step forward and two steps back

The Lancet ◽  
2019 ◽  
Vol 394 (10199) ◽  
pp. 619-621 ◽  
Author(s):  
David Sanders ◽  
Sulakshana Nandi ◽  
Ronald Labonté ◽  
Carina Vance ◽  
Wim Van Damme
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Primary Health ◽  
One Step ◽  
Universal Health
Sign in / Sign up

Export Citation Format

Share Document