Universal Health Coverage

1. Universal Health Coverage

2. Universal Health Coverage All people are able to use needed health services(prevention, promotion, treatment, rehabilitation, and palliation)of sufficient quality to be effective, and at affordablecost(does not cause the user financial hardship). Integrated Primary Health Care Khovd Aimag Tuv Aimag health centre

3. UHC is a direction, not a destination No country fully achieves all the coverage objectives But all countries want to: Reduce the gap between need and use of services Improve quality and financial protection So, every country can move towards Universal Health Coverage A practical orientation for policy reforms

4. Who is covered? What services are covered? What proportion of the cost is covered? 3 aspects of Universal Health Coverage All 3 parts are equally important Note: 100% of the population covered for only a few services, and still paying high co-payments, is NOT universal health coverage!

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6. UHC and Health System Strengthening UHC: what we want to achieve: Equity in service use relative to need Quality for improving service effectiveness Universal financial protection to avoid more poverty Equity in better health outcomes • HSS:actions (reforms) to progress towards UHC • Better mix, distribution and skill of health workers • Targeted incentives to promote use of priority services • Investment in effective public health services • Etc.

7. UHC needs more than health financing reforms Health financing is one part of overall health system The whole health system requires strong governance to ensure all the pieces fit together The whole health system combines to influence quality and use of services Leadership Governance Health workforce Information Service Delivery Finance Medical Products Technology

8. Health Systemcomponents Leadership Governance Interconnectedness of components For the system to function well, all parts must be balanced and coordinated No part more important – weakest part determines the outputs Health workforce Information Service Delivery Finance Medical Products Technology 8

9. Processes Governance Laws Policies Institutions Organizations Mechanisms Inputs Health financing Health workforce Medicines & other health technologies Infrastructure Health information Research Outputs Service access Service quality & safety Service integration Service utilization Pooled funding Emergency readiness Outcomes Coverage of interventions Coverage of financial risk protection mechanisms Mitigation of risk factors Impact Improved health status Improved household financial wellbeing Increased responsiveness Better health security Equity, efficiency and sustainability. UHC components Values, right to health, social determinants

10. 10 Health system inefficiencies - address in national health reforms Medicines and products use of substandard and counterfeit medicines underuse of generics & higher prices for medicines inappropriate and ineffective use overuse/supply of equipment, investigations & procedures Health-care services inappropriate hospital admissions and length of stay inappropriate hospital size (low use of infrastructure) medical errors and suboptimal quality of care Health workers (inappropriate, costly mix, lack of motivation) Health system wastage and leakages inefficient mix/inappropriate level of strategies waste, corruption and fraud 10 leading causes of inefficiency

11. Universal Health Coverage (UHC)

12. Health costs and poverty High charges for care or drugs (out-of-pocket payments) can cause: • low useof health services and/or • increased poverty 12

13. What is Universal Health Coverage?  • Free care for everyone? • The MDGs are no longer needed? • Mainly about clinical treatment? • Mainly about health financing? • Coverage of all health interventions for everyone? • Everyone covered by health insurance? • Is about public services, not private services? • A concern mainly for planners and politicians, not doctors?       

14. Thank you