By Awa Sowe
Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.
Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because the cost of needed services and treatments requires them to use up their life savings, sell assets, borrow and destroying their futures and often those of their children.
Universal access to health and universal health coverage require determining and implementing policies and actions with a multi-sectoral approach to address the social determinants of health and promote a society-wide commitment to fostering health and well-being. The right to health is the core value of universal health coverage, to be promoted and protected without distinction of age, ethnic group, race, sex, gender, sexual orientation, language, religion, political or other opinions, national or social origin, economic position, birth, or any other status.
UHC is the target for SDG 3.8 and includes financial risk protection, access to quality essential healthcare services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all. Undoubtedly, access to quality health services is the cornerstone of UHC, and the delivery of these services requires adequate and competent healthcare workers with optimal skills-mix at every level of the healthcare system; from primary to tertiary.
During the Universal Health Coverage (UHC) High-Level Meeting on Pandemic Prevention, Preparedness and Response (HLM-PPPR), the Minister of Health Dr Lamin Samateh described PHC serves as the “front door” of the health system and provides a ‘programmatic engine for UHC.
“PHC focuses on people’s needs and early possible along the continuum from health promotion, disease prevention, treatment, rehabilitation, and palliation, and as close as feasible to people’s everyday environment”.
While investment in PHC is directly related to the health system and access to health services, the Minister went on to explain that other factors beyond health services play a critical role in shaping health and wellbeing.
In The Gambia, the government expenditure on health as a percentage of total health expenditure is about 33%, while the donor expenditure accounted for about 37%. Household out-of-pocket expenditure in the same period accounted for about 20%.
Dr Samateh assured that the Government of The Gambia is concerned and conscious of the high cost of accessing health care by households; hence the reason the government is introducing an innovative National Health Insurance Scheme to reduce out-of-pocket expenditure on health while addressing the issue of accountability of health staff to communities, he indicated.
This method, he explained has results-based financing integrated into the insurance system. It also addresses our perennial challenge of not remunerating our Primary Health Care health workers in the villages whose mode of engagement until now has been entirely voluntary.
According to Dr Samateh, this goes to the core of ensuring community health workers are a priority everywhere so that they provide care to all people wherever they may be and in whatever circumstances they may be in. “Our community health workers should be formally employed, trained, and adequately supervised,” he submitted.
The Health Minister emphasised that UHC strengthens the spirit of social solidarity, which The Gambia is known for. Investment in UHC, therefore, he argued, is not only a moral obligation or a right but also a good investment. “We will continue to work together to attain UHC as part of the SDGs targets,” he concluded.
