scholarly journals The complexity of achieving UHC through PHC: how do we connect the competing narratives?

2021 ◽  
Author(s):  
Akiko Maeda
Keyword(s):  
Healthcare Workers ◽  
System Development ◽  
Health Coverage ◽  
Development Framework ◽  
Primary Health ◽  
Desirable Outcome ◽  
Adaptive Policy ◽  
The Individual ◽  
Systems Framework ◽  
Universal Health

The commentary discusses the importance of developing Universal Health Coverage strategies through the lens of complex systems framework that evaluates policies not only in terms of the final desired outcome but also as an interplay of disparate views among diverse actors in the system. This view also confers a degree of agency and autonomy on the individual actors, whether they be patients or healthcare workers, and necessitates the inclusion of bottom-up participatory process in the development of UHC policies and interventions. These are consistent with the Primary Health Care principles articulated in the 1978 Alma Ata Declaration and will need to be integrated into the health system development framework to achieve UHC. Ultimately, this approach would encourage the creation of a more cooperative and adaptive policy environment in which each actor is encouraged to collaborate and are nudged toward a desirable outcome rather than through coercive means.

scholarly journals COVID-19 Pandemic: An Inhibitor of Universal Health Coverage Programme: A ViewPoint

2021 ◽  
Vol 4 (5) ◽  
pp. 1-13
Author(s):  
Helen Idubamo Wankasi
Keyword(s):  
Universal Health Coverage ◽  
Healthcare Workers ◽  
Sustainable Development Goals ◽  
Health Coverage ◽  
The Sustainable Development ◽  
Healthcare Facilities ◽  
Effective Governance ◽  
Development Goals ◽  
Frontline Healthcare Workers ◽  
Universal Health

Ever since the re-emergence of Covid-19 as a pandemic, healthcare facilities (human and materials) have been overstressed, evidenced by the rate at which frontline healthcare workers fall sick and die in the course. In some healthcare institutions, the narrative has changed with regards to the number of days to access physicians for treatment, but selected and booked only on specific days and periods, except in extreme emergencies are able to access physicians un-booked. This is inconsistent with the intent of Universal Health Coverage and the Sustainable Development Goals. This paper, therefore, highlighted the objectives, covering a brief overview of COVID-19 and Universal Health Coverage; identified countries developed (Germany 1883) and emerging (South Africa/Nigeria) that have adopted Universal Health Coverage as well described how COVID-19 stands as an inhibitor to the achievement of Universal Health Coverage. At the tail end, recommendations are made on the way forward on the need for effective governance, manpower sourcing and general strengthening of the healthcare system.

scholarly journals Politicking with Health Care and Its Implications for the Attainment of Universal Health Coverage

2020 ◽  
Author(s):  
Aloysius Odii ◽  
Pamela Ogbozor ◽  
Charles Orjiakor ◽  
Prince Agwu ◽  
Obinna Onwujekwe
Keyword(s):  
Universal Health Coverage ◽  
Local Governments ◽  
Health Workers ◽  
Health Centre ◽  
Healthcare Delivery ◽  
Health Coverage ◽  
Healthcare Staff ◽  
Community Members ◽  
Primary Health ◽  
Universal Health

Abstract Background Primary Health Centres (PHCs) are acknowledged key to the achievement of Universal Health Coverage (UHC) owing to their closeness to the grass-root and the constant patronage by low- and middle-income class citizens. An impediment to the efficiency of PHCs is the nature of politics on-going in its operation beginning from its physical construction, employment of staff, among others. This study provides evidence of politicking marring the efficiency of PHCs as well as possible solutions to the issue. Method The study was carried out in eight purposively selected PHC facilities drawn from three local government areas in Enugu State, southeast Nigeria. Data were collected using in-depth interviews (IDIs) and focus group discussions (FGDs). The IDIs involved sixteen participants that cut across frontline health workers, heads and supervisors of health units at the local governments, and chairpersons of the health facility committees (HFCCs). In addition, four FGDs were held with male and female service users of the facilities. Findings It was discovered that certain powerful community members influenced the locations of PHCs, even when the general community is disfavoured by such decision. Powerful group of persons equally influence the recruitment and sanctioning of healthcare staff. The consequences include weak patronage of the facilities and poor healthcare delivery. Of the several solutions, obtaining localised support from powerful persons in the community to enforce fairness featured strongly. Conclusions The politics around primary healthcare is a threat to the achievement of UHC, since it discourages patronage and encourages inefficiency of healthcare staff. To overcome this, there is the need to facilitate genuine participation of community members and implementing local actions and policies in the facilitation of PHCs, and also, rapidly addressing the excesses of powerful groups and individuals. Key words: Primary Health Centre; Politicking; Universal Health Coverage; Power; Politics

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.

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