9 September 2015

What gets measured, gets done: How to track Universal Healthcare Coverage and make it a reality

The June 2015 report, Tracking Universal Health Coverage, from the World Health Organization (WHO) and World Bank Group (WBG) shows that 400 million people do not have access to essential health services. This report is a wake-up call demonstrating the need for universal healthcare coverage (UHC). UHC means all people receive the quality, essential health services they need, without being exposed to financial hardship. Over the past year, the world has witnessed the importance of strong health systems with the recent Ebola outbreak in West Africa. UHC is the foundation needed for resilient health systems which provide promotion, prevention, treatment, rehabilitation and palliation. UHC is also necessary to reduce inequity and eradicate extreme poverty (less than $1.25/day), as people are often tipped or pushed further into extreme poverty as they have had to pay for health services out of their own pockets. '

Many perceive the greatest challenge to achieving UHC is that UHC-progress is not easily quantifiable. Monitoring of UHC-progress must account for whether people receive the services they need, as well as the quality of services and the impact on health. The June 2015 report is the first of its kind and uses innovative indicators to measure health service coverage and financial protection to assess progress towards UHC.

The report identifies the following eight core tracer indicators for differing aspects of health service coverage:

  • Reproductive and newborn health: family planning, antenatal care, skilled birth attendance
  • Child immunization: 3 doses of diphtheria, tetanus and pertussis (DTP)-containing vaccine
  • Infectious disease: antiretroviral therapy (ART), tuberculosis (TB) treatment
  • Non-health sector determinants of health: improved water sources, improved sanitary facilities

The indicators have been chosen as they indicate a population's health and well-being, regardless of the country's socioeconomic, development, health system or other considerations.

Effective monitoring of these indicators is necessary to achieve UHC. By monitoring these indicators, policy-makers and decision-makers can set appropriate targets and goals for their countries as they work towards the UHC objectives and strengthen their existing health systems. Each of the eight core tracer indicators have also been included in the recently launched Global Reference List of 100 Core Health Indicators, which was developed by WHO and its partners. The Global Reference List will be a global standard for health data collection.

Dr. Mary E. Norton is a professor and Executive Director of Global Academic Initiatives at UNAI member institute, Felician College-The Franciscan College of New Jersey in the United States of America, and has extensive knowledge of health systems across the world having developed baccalaureate and graduate nursing programmes in Iran, Pakistan and Jordan and taught in Qatar, Bahrain, China and Finland. She applauds the WHO and WBG's comprensive data collection approach to identify each country's individual needs. However, she states there are limits to the report saying, "We need to ask ourselves is such a 
daunting task sustainable? How long can it be sustained? Who will finance the data gathering?"

She also emphasizes the importance of determining how to collect the health data of vulnerable populations, such as refugees and countries experiencing conflict. Dr. Norton asks, "How will the quality of care in these countries, and this population be measured and monitored? Who will pay for their care?"

By encouraging the production of accurate and timely health data, action is being taken to ensure academics and researchers have the information needed to identfy and solve the world's most daunting health challenges. This is a necessary and important first step to achieving universal healthcare for all. 

By UNAI Intern, Zinnia Batliwalla