At the Forefront: UHC, Women, and Faith
Jonathan D. Quick, MD,MPH, President, Management Sciences for Health
CCIH Annual C...
"Qu'est-ce que c'est?!"
HOLLANDE MERKEL OBAMA
5Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
MDGs a tipping point ...
6Management Sciences for Health
A vision for the future?
1. Comprehensive Health Care
2. Community Orientation
3. Co-opera...
7Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
Health for All – Alma...
8Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
Universal Health Cove...
10Management Sciences for Health
The UHC vision – ―Access for all to appropriate
health services at an affordable cost‖ (W...
11Management Sciences for Health
Now is the time – Momentum is gaining
for universal health coverage
1883 Germany – Health...
12Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
The UHC approach – c...
13Management Sciences for Health
Thailand – evolving expansion of coverage
over more than four decades
Sources: www.jointl...
14Management Sciences for Health
UHC in action – moving toward UHC in Ghana
through health spending and reform
McKinsey Co...
15Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
The UHC Movement – ―...
16Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
Growth fuels health ...
17Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
Universal Health Cov...
19Management Sciences for Health
650,000 annual deaths from breast and
cervical – 70% in low & middle income
countries
20Management Sciences for Health
Services for women are highly income
dependent
(Mean coverage for interventions in 54 Cou...
21Management Sciences for Health
Impact of income on women’s access to
services varies in magnitude, but occurs
everywhere
23Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
Universal Health Cov...
24Management Sciences for Health
Report of the High-Level Panel on the
Post-2015 Development Agenda
Eradicate poverty and ...
25Management Sciences for Health
Universal Goals , National Targets
26Management Sciences for Health
Goal 4: Ensure healthy lives – 5 sub-goals
1. End preventable infant and under-5 deaths
2...
27Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact
Universal Health Cov...
28Management Sciences for Health
CONCLUSIONS
At the Forefront: UHC, Women, and Faith
1. “WE MUST BE the generation that
de...
30Management Sciences for Health
Stronger health systems. Greater health impact.
Saving lives and improving the health
of ...
CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick
CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick
CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick
CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick
CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick
CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick
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CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick

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Jonathan Quick of Management Sciences for Health explores the relationship between the present effort for universal health coverage and the quest for Health for All pioneered by Christian health leaders like John Bryant.

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Transcript of "CCIH 2013 Plenary 4 Universal Health Coverage: Women and Faith Jonathan Quick"

  1. 1. At the Forefront: UHC, Women, and Faith Jonathan D. Quick, MD,MPH, President, Management Sciences for Health CCIH Annual Conference, June, 2013 The pool at Bethesda, John 5:2-8
  2. 2. "Qu'est-ce que c'est?!" HOLLANDE MERKEL OBAMA
  3. 3. 5Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact MDGs a tipping point for global health – a ‘decade of megafunds’ and movements 2001 GDF – Global Drug Facility 2002 Global Fund to Fight AIDS, TB & Malaria 2003 PEPFAR – U.S. President’s Emergency Plan for AIDS Relief 2005 U.S. President’s Malaria Initiative (PMI) 2006 UNITAID 2007 Women Deliver $100 billion committed in less than a decade 2004 PMNCH – Partnership for Material, Newborn & Child Health 2000 GAVI Alliance for Immunization
  4. 4. 6Management Sciences for Health A vision for the future? 1. Comprehensive Health Care 2. Community Orientation 3. Co-operation with Government & Other Agencies 4. Inter-church Co-ordination and Co- operation 5. Dynamic Planning Process with locally determined priorities set within guidelines and norms established by donors 6. Reorientation of Personnel 7. Administrative re-organization for planning and evaluation 8. Data gathering systems focused on only essential information 9. Facing the Problem of Population Dynamics Farmers’ club gathering in Jamkhed, India Christian Medical Commission 1968 Statement
  5. 5. 7Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact Health for All – Alma Ata and the Christian Medical Commission John Bryant Halfdan Mahler (WHO) (CMS) Carl Taylor (CMC)
  6. 6. 8Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact Universal Health Coverage UHC for Women and Girls Post-2015 Agenda for Health At the Forefront: UHC, Women, and Faith
  7. 7. 10Management Sciences for Health The UHC vision – ―Access for all to appropriate health services at an affordable cost‖ (WHO, 2005) ―universal health coverage [UHC] implies that all people have access, without discrimination, to nationally determined sets of needed promotive, preventive, curative and rehabilitative basic health services and to essential, safe, affordable, effective and quality medicines, while ensuring that the use of these services does not expose the user to financial hardship, with special emphasis on the poor, vulnerable, and marginalized segments of the population.‖ WHA Resolution 58.33 Geneva: WHO; 2005. United Nations General Assembly. Resolution. A/67/L.36 (6 December 2012). Available: http://www.un.org/ga/search/view_doc.asp?symbol=A/67/L.36 All people Essential healthcare package Essential medicines Affordable Emphasis on poor, vulnerable, marginali zed
  8. 8. 11Management Sciences for Health Now is the time – Momentum is gaining for universal health coverage 1883 Germany – Health Insurance Bill 1948 Universal Declaration of Human Rights – Article 25's right to health 1948 UK – first of many post-war European counties committed to UHC 1975 Thailand – one of first from Global South to start toward UHC 1978 Health for All – Alma Ata 1980s Selective Primary Health Care movement 2005 WHA resolution in favor of UHC 2010 World Health Report on UHC 2012 WHO DG Margaret Chan: UHC is ―single most powerful concept‖ 2012 UN resolution calls for UHC 2013 WB President Jim Yong Kim: ―the generation that delivers‖
  9. 9. 12Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact The UHC approach – common core principles, country-specific adaptations Pre-Payment Risk Pooling  Domestic-plus financing  Limited out-of-pocket fees Priority Health Needs  Rich and poor  Healthy and sick  Prevention  Early detection  Care and treatment Common Core Principles Country Models Vary Widely Financing  Tax-based  Social health insurance  Community insurance  Employer-based Delivery  Public sector  Private sector  Local/NGO services  Hybrid Creation  Progressive  “Big Bang”
  10. 10. 13Management Sciences for Health Thailand – evolving expansion of coverage over more than four decades Sources: www.jointlearningnetwork.org/ and McKinsey Co 2010 Year, policy, population coverage as of 2007 (Bold = still operational) 1963 – Civil Servants Medical Benefits Scheme 8% 1975 – Free medical care for low income 1990 – Voluntary public health insurance 1992 – Compulsory Social Security Scheme 13% 1993 – Free care for children 1995 – Free care for the elderly 2001 – Universal Coverage Scheme (UCS/”30-Baht”) 75% Private Health Insurance 2% Year 20 25 30 35 40 45 1994 1996 1998 2000 2002 2004 2006 2008 Out-of-pocket spending as percent of total health expenditures 70% of population covered (1995) 96% of population covered (2003) UHS/30 Baht Scheme (2001)
  11. 11. 14Management Sciences for Health UHC in action – moving toward UHC in Ghana through health spending and reform McKinsey Co 2010 1985: cash-and-carry fees 1990s: health sector decentralized 2000: New Patriotic Party wins with promise to replace cash-and-carry 2004: National Health Insurance Scheme created (NHIS) created Financed from:  health insurance tax  formal sector employees  member premiums  investment income Accredited service providers: clinics, hospital, pharmacies, licensed chemical sellers (LCS) 35 40 45 50 55 1994 1996 1998 2000 2002 2004 2006 2008 Out of pocket spending as percent of total health expenditure Less than 1% of population covered (2000) 45-70% of population covered (2008) NHIS created (2004)
  12. 12. 15Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact The UHC Movement – ―Access for all to appropriate health services at an affordable cost.‖* Formal health coverage 95-100% (dark) & 70-95% (light) Implementing (dark) or interested in (light) UHC reforms No data * WHO, 2005 SOURCE OF DATA: Results for Development Rockefeller Foundation
  13. 13. 16Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact Growth fuels health spending. Health spending grows the health system. But what kind of system? Average Annual Growth Rates per Capita 2007-2011 Source: The sun shines bright, The Economist, 2011 Nigeria 465 Thailand 311 Bangladesh 298 Kenya 263 Tanzania 198 India 193 Vietnam 173 Ghana 150 Cambodia 142 Uganda 84 Rwanda 79 South Africa 36 Projected percent total health expenditure growth next decade
  14. 14. 17Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact Universal Health Coverage UHC for Women and Girls Post-2015 Agenda for Health At the Forefront: UHC, Women, and Faith
  15. 15. 19Management Sciences for Health 650,000 annual deaths from breast and cervical – 70% in low & middle income countries
  16. 16. 20Management Sciences for Health Services for women are highly income dependent (Mean coverage for interventions in 54 Countdown countries) Measles DPT-3 ANC visits Skilled birth attendant FP needs satisfied
  17. 17. 21Management Sciences for Health Impact of income on women’s access to services varies in magnitude, but occurs everywhere
  18. 18. 23Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact Universal Health Coverage UHC for Women and Girls Post-2015 Agenda for Health At the Forefront: UHC, Women, and Faith
  19. 19. 24Management Sciences for Health Report of the High-Level Panel on the Post-2015 Development Agenda Eradicate poverty and transform economies through sustainable development A universal agenda driven by five “big, transformative shifts”: 1. “Leave no one behind” – eliminate extreme poverty 2. Sustainable development – especially environmental 3. Economic opportunity 4. Peace and accountable governance 5. New global partnerships
  20. 20. 25Management Sciences for Health Universal Goals , National Targets
  21. 21. 26Management Sciences for Health Goal 4: Ensure healthy lives – 5 sub-goals 1. End preventable infant and under-5 deaths 2. Increase by x% the proportion of children, adolescents, at-risk adults and older people that are fully vaccinated 3. Decrease the maternal mortality ratio to no more than x per 100,000 4. Ensure universal sexual and reproductive health and rights 5. Reduce the burden of disease from: • HIV/AIDS, tuberculosis, malaria, • neglected tropical diseases • priority non-communicable diseases HLP on Universal Health Coverage Though we focus on health outcomes in this goal, to achieve these outcomes requires universal access to basic healthcare. We must make steady progress in ensuring Universal Health Coverage and access to quality essential health services.
  22. 22. 27Management Sciences for Health — 40 years of Strengthening Health Systems for Greater Health Impact Universal Health Coverage UHC for Women and Girls Post-2015 Agenda for Health At the Forefront: UHC, Women, and Faith
  23. 23. 28Management Sciences for Health CONCLUSIONS At the Forefront: UHC, Women, and Faith 1. “WE MUST BE the generation that delivers universal health coverage.” Dr. Jim Yong Kim, President, World Bank 2. UHC is the only approach that address all the health needs of women and girls: infections diseases, chronic diseases, sexual and reproductive health. 3. Health for All through UHC should be the foundational health goal in the 2015 agenda.
  24. 24. 30Management Sciences for Health Stronger health systems. Greater health impact. Saving lives and improving the health of the world’s poorest and most vulnerable people by closing the gap between knowledge and action in public health. Thank You

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