Advancing universal health coverage - English

1. Advancing
universal health coverage
in the Eastern Mediterranean Region
Agenda item 4(a)
65th Session of the Regional Committee for the
Eastern Mediterranean
15‒18 October 2018, Khartoum

2. Overview
 Status of UHC in the Region
 Estimated regional contribution to UHC goal of
GPW13
 Way forward for advancing UHC in the Region
2

3. 3
Stepping up
leadership –
diplomacy and
advocacy;
gender
equality,
health equity
and human
rights;
multisectoral
action;
finance
Driving public health impact in every country –
differentiated approach based on capacity and vulnerability
Focusing
global public
goods on
impact –
normative
guidance and
agreements;
data, research
and innovation
• Measure impact to be accountable and manage for results
• Reshape operating mode to drive country, regional and global impacts
• Transform partnerships, communications and financing to resource the strategic priorities
• Foster culture change to ensure a seamless, high-performing WHO
Strategic
shifts
Service
delivery – to
fill critical
gaps in
emergencies
Technical
assistance
– to build
national
institutions
Strategic
support – to
build high
performing
systems
Policy
dialogue –
to develop
systems of
the future
Fragile health systemMature health system
Organizational
shifts
Ensuring healthy lives and promoting well-being for all at all ages by:
Achieving universal health coverage- 1 billion more people benefitting from universal health
coverage
Addressing health emergencies – 1 billion more people better protected from health
emergencies
Promoting healthier populations – 1 billion more people enjoying better health and well-being
Strategic
Priorities
(and goals)
Mission
Promote health – keep the world safe – serve the vulnerableOur case for
change:
WHO 13th
General
Programme
of Work
2019−2023
SDG
indicators
3.8.1
(service
coverage)
3.8.2
(financial
protection)

4. 4
650 million
people
Diverse
socioeconomic and
geopolitical
environments
Emergencies
A large proportion of the population live
in countries with graded emergencies –
huge health care needs
9 countries in a fragile situation
30 million displaced people
Disease outbreaks
4

5. Population coverage
Financialprotection
UHC means that all
people and
communities can use
the promotive,
preventive, curative,
rehabilitative and
palliative health
services they need, of
sufficient quality to be
effective, while also
ensuring that the use
of these services does
not expose the user to
financial hardship.
SDG Target 3.8
Achieve universal health coverage, including financial risk protection,
access to quality essential health-care services, medicines and vaccines
for all
5

6. 1. Developing a vision and strategy for UHC
2. Improving health financing system performance and
enhancing financial risk protection
3. Expanding the coverage of needed health services
4. Ensuring expansion and monitoring of population coverage
Four strategic components of the Framework for action on
advancing UHC in the Eastern Mediterranean Region
The Region’s journey towards UHC
Regional
Committee
2016
Salalah UHC
Declaration
2018
UHC2030
Global
Compact
6

7. 7
UHC service coverage index
SDG 3.8.1 – as in 2017 global monitoring report
Reproductive, maternal,
newborn and child health
 family planning
 pregnancy and delivery
 immunization
 child treatment
Infectious diseases
 tuberculosis
 HIV
 malaria
 water and sanitation
Noncommunicable diseases
 cardiovascular disease
 diabetes
 cancer
 tobacco control
Service capacity and access
 hospital access
 health worker density
 essential medicines
 health security
Advancing UHC
involves
adequate
functions in all
aspects of the
health care
system
7

8. 77
77
72
72
70
68
68
68
65
65
65
63
63
63
60
47
43
40
39
34
22
53
0 10 20 30 40 50 60 70 80 90
Kuwait
Qatar
Bahrain
Oman
Jordan
Egypt
Lebanon
Saudi Arabia
Iran (Islamic republic of)
Morocco
Tunisia
Iraq
Libya
United Arab Emirates
Syrian Arab Republic
Djibouti
Sudan
Pakistan
Yemen
Afghanistan
Somalia
EMRO Region
UHC coverage Index, 2015
Source: WHO/WB, 2017 8

9. 0 10 20 30 40 50 60 70 80 90
Somalia
Syria
Djibouti
Palestine
Libya
United Arab Emirates
Yemen
Lebanon
Iraq
Bahrain
Saudi Arabia
Afghanistan
Jordan
Tunisia
Kuwait
Oman
Morocco
Qatar
Sudan
Pakistan
Iran (Islamic republic of)
Egypt
Reporting on regional core indicators, 2014─2018
percent_2018 percent_2014
Recent country
consultation:
Health
information
system was
given high-
priority (12
countries) or
medium-
priority (8
countries)
Data challenges and health information systems
9

10. Using the UHC index to plan
for achieving regional strategic priorities
 Projecting tracer indicators to 2023 and project UHC status at the end
of GPW 13
 Used data from most recent period, 2010−2015
 Calculate annual changes in indicator values over the recent period
 Assume recent trends will continue to 2023
 Project tracer indicator values to 2023 for each country
 Recalculating UHC index for 2023
 Compare changes with UHC index of 2015
10

11. 11

12. 80
80
80
77
75
72
72
72
70
70
69
68
64
64
61
56
53
50
48
43
41
36
60.2
0 10 20 30 40 50 60 70 80 90
Bahrain
Qatar
Islamic Repulic of Iran
Kuwait
Oman
Egypt
Saudi Arabia
United Arab Emirates
Jordan
Lebanon
Tunisia
Morocco
Iraq
Palestine
Libya
Syrian Arab Republic
Afghanistan
Sudan
Pakistan
Yemen
Djibouti
Somalia
EMRO Region
UHC index 2023 projections – as estimated in July 2018
12

13. Projected progress in UHC coverage 2015─2023
0
10
20
30
40
50
60
70
80
90
Regional population adjusted
coverage
Regional median value country range 2015 country range 2023
UHC coverage in the Region, 2015─2023
2015 2023
13

14. GPW 13 projection for advancing in UHC in the Region
• 108 million more people covered by UHC by 2023Achievable
• Political, economical and programmatic challenges
• Requires improvements to all aspects of health care
Challenging
• New index may mean new realities
• Limitation in data in the Region
Measurement
caveats
• Bringing financing and service delivery together
• Marginalized, refugees and migrant populations
UHC three
dimensions
14

15. Recommendations for advancing UHC
to realize and go beyond UHC index projections for 2023
• Formulate country-specific UHC vision and roadmaps – UHC can and
should be pursued in all countries
• All countries need to define a context-specific and cost-effective
national essential package of health services
• Expand prepayment arrangements to ensure full population coverage in
order to reduce out-of-pocket payments and ensure financial protection
• Improve health information system to better monitor UHC
15

16. Thank you
16