12.12.2012

UN Pushes for Universal Health Care in Member States

The Guardian recently ran a story about how the United Nations is expect to vote today on a resolution which would require member states to provide universal health coverage within their country:
The UN resolution calls on its members to ensure they have health systems that avoid significant direct payments at the point of delivery and a mechanism to pool risks among the population to avoid catastrophic healthcare spending and impoverishment as a result of seeking care.
I, for one, think that this resolution is long overdue. When Obama was pushing his health care bill through the U.S. Congress, I knew many people who tried to label this act with an “-ism”; Socialism, Communism, you name it. I am still unsure why so many opposed a bill that provides people with much needed access to health care. Whether or not there are those out there who want to label universal health coverage with an “-ism” is their prerogative. I know that I consider access to affordable health care a basic human right, and not a matter of politics.

M.M. Maternity. Bo, Sierra Leone
For those unclear as to what universal health coverage entails, WHO considers it to be “access [for all] to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality…while also ensuring that people do not suffer financial hardship when paying for these services”.

State of the World’s Health Care Systems
I’d consider the state of much of the world’s health care systems to be in pretty poor shape; however, with increased efforts of international organizations, local governments, and communities, the situation has improved slowly but surely over the past several decades.

According to WHO, “100 million people [are] pushed into poverty because of direct health payments, [only] 48% of births [are] attended by a skilled health worker in the African region, and 79 countries devote less than 10% of general government expenditure to health". 

These statistics illustrate how universal health coverage is not a top priority for many nations. When governments fail to take the necessary steps to ensuring a healthy population, then poverty is perpetuated and development is hard to obtain. If states want to have increased development, then they need to realize the importance that a healthy population factors into that equation.

Financing Universal Health Coverage
When Obama was pushing his U.S. health care bill through Congress, I know many that were questioning how it would be paid for. If the UN passes this resolution then there will obviously need to be a series of discussions among member states about how best to feasibly support universal health coverage given each nation’s specific financial situation (as we know that one solution will not fit all in the case of health care).

I am no expert in finance, government expenditures or even health care, but I am confident that each country has the ability to creatively think of ways to finance universal health coverage for their population. If the government of each state brings together health care workers, economists, and civil society workers and together they brainstorm ideas to finance universal health coverage without a huge burden to the population, then I am sure that a solution will be found. For example, Ghana “funded its national health insurance partly by increasingvalue-added tax by 2.5%”.

Financing is no excuse to refuse to pass this resolution. Although it may be expensive in the short-term, the long-term benefits will far outweigh the initial costs because the nation will have a more healthy and productive population that is better able to contribute to their own development.

Case Study: Sierra Leone
If my experiences in health clinics, hospitals, and maternities in Sierra Leone have taught me anything, it is that there is no quick or easy fix to national health problems. I have learned that what might seem to be the best solution to a problem (such as maternal mortality) sometimes does not work as anticipated. I have learned that improving the health system is not a quick process; rather, it is only through making mistakes and learning from those mistakes that real change is made.

Although Sierra Leone’s health system is still pretty dismal in my opinion, I recognize that it has come a long way from the state it was in a decade ago. IRIN recently reported that “maternal mortality rates have dropped 61percent [in Bo, Sierra Leone] since 1990 thanks to cost-free 24/7 emergency obstetric care and an efficient ambulance service and referral system”.

Gila's Children and Community Hospital. Bo, Sierra Leone
My experiences in Bo have proven to me that communities and NGOs alike are working hard to ensure increased access to (free) health services. However, I still witnessed needless deaths due to logistical problems such as no access to transportation to hospitals with better equipment in times of emergencies and complications.

The Sierra Leonean government has realized in the past few years that it needs to boost its efforts in decreasing maternal/child mortality rates, which is why they now offer free health care to pregnant/lactating women as well as infants. Before they passed this law, I knew women who would show up to the government hospital in Bo and be refused treated unless they paid on the spot. Since the law has been passed, the situation has improved greatly.

However, despite this great improvement, many logistical problems remain, such as transportation between health facilities. For example, if a woman shows up to a small midwifery clinic and experiences complications, many times there is no means of transport to the local government hospital or a nearby NGO. Furthermore, for women living in remote villages, their access to health care is significantly less than their urban counterparts. That is why both government and NGOs need to emphasize training midwifes in villages so that there is a local health care professional who can assist in simple births in times when transportation to cities impossible.

Although Sierra Leone has a long road ahead in improving its health care system, it is a (small) example of what universal health coverage could achieve. I hope the UN member states make the right decision and pass this resolution. I look forward to hearing the outcome. 

3 comments:

  1. Want more like this above, i want to know much more about the health care managments,
    Regards
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    ReplyDelete
  2. The UN still has a lot of work do though. Providing universal health care at such a large scale will entail a lot of adapting and overlapping. Add that to the fact that not all member-states are capable enough to provide it at the moment.

    ReplyDelete
  3. Great writing and thank you for sharing it with us I really like that …

    ReplyDelete

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