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Universal Health Coverage - Coggle Diagram
Universal Health Coverage
What is UHC?
"providing financial protection from the costs of using health services for all people of a country as well as enabling them to use the health services that they need, where these services should be of sufficient quality to be effective" WHO 2010
Key parts
Financial protection
Serves all people (equity)
Services the people need
Quality
LMICs
Restrictions
Unavailability of resources
Direct payments reliance (co-payments, OOPP)
Inefficient use of resources
Inequity
How to Progress:
Reliance of compulsory funding (tax base, mandatory payments)
Reduce fragmentation of pool of funds
Move towards Strategic Purchasing
Strategic purchasing in healthcare refers to the efficient allocation and use of health resources to improve health outcomes, equity, and efficiency in the health system. It involves making informed decisions on what health services to buy, how to buy them, and from whom to buy them, aiming to get the best value for money.
Compared with passive purchasing
Financial Protection
Financial protection relates to funding health services in a way that protects households from adverse effects of paying for health care
Achieved when:
No financial barrier to access health services
No financial hardship due to out-of-pocket health spending
Avoids Catastrophic spending on healthcare
Poverty trap
Paying OOPP that put a household below the poverty line
What percentage is considered Catastrophic?
Coverage of services is key.
May need to sacrifice number of services vs Equity of basic services.
Use UHC Service Coverage Index to measure.
Utilization of services relative to need. Reduce gap between need and use of services. Must be quality services
UHC Coverage Index
Access and Barriers to UHC
Access
Physical Access / Availability
Location, opening hours, medicines available, skills available
Type, range, quantity and quality of services and how they suit the population
technical ability of services (quality). Related to inputs - staff, medicine, equipment.
Financial Access / Affordability
Ability of population to pay
Cost of services
Cultural Access / Acceptability
attitudes, expectations, beliefs and perceptions of
providers and patients
Patient perception of healthcare services (quality)
Barriers
Understanding access barriers to healthcare can help fix them and improve equity of care through the 3 As
Moving towards UHC
Need expansion in 3 areas
Population coverage
Of those who lack access to services or protection against
financial consequences of health care
Service coverage
Expanding range of services necessary to address people’s
health
Cost coverage
Expanding pre-payment and pooling mechanisms
Financing of UHC
Financing systems need to be specifically designed to: provide all people with access to needed health services (including prevention, promotion, treatment and rehabilitation) of sufficient quality to be effective; [and to] ensure that the use of these services does not expose the user to financial hardship (WHO. 2010)
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