Strategy for Universal Health Coverage

National Consultation
 Outline
• Regional Strategy
– Introduction
– Background
– Current situation: challenges in moving toward
Universal Health Coverage
– Strategic Lines

• Strategy Development: Road Map

 Strategy for Universal
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Universal health coverage means that

all people and communities have
equitable access to the
comprehensive, and guaranteed
quality services that they need,
throughout the life course, without
financial hardship.

It addresses the social determinants

of health emphasizes on groups in
conditions of poverty and
vulnerability.
Values
Right to Health
Equity
Solidarity
 Objective of the Strategy

The Strategy defines the conditions sine qua non that will
allow countries to focus their policies and measure the
success and speed of their progress toward Universal Health
Coverage.
Our history: from PHC to Universal Health
Coverage

Alma Ata PHC Renewal

1978 2005 The PHC Reforms
WHR 2008
 Background

• Rio Political Declaration on Social Determinants of

Health (2011).
• Rio+20 United Nations Conference on Sustainable
Development (2012).
• Debate on the Post-2015 development agenda.
• Member States Commitment at the 52nd. PAHO/WHO
Directing Council (2013).
 Current situation: challenges in advancing
toward Universal Health Coverage
• Significant advances in recent history.
• Political commitment to response to the health needs of their population.
• Very high inequity levels in health outcomes.
• New epidemiological and demographic patterns.
• Problems of exclusion and lack of access to quality services
• Escalating costs: Health systems segmentation and fragmentation.
• Lack of regulatory capacity and integration.
• Lack of adequate financing and inefficiencies
• Strengthening of the stewardship and governance .
• Social Determinants. Strengthening intersectoral action to address the
social determinants of health.
 Four Simultaneous and Interdependent Strategic Lines

Strategic line 1: Expanding equitable access to comprehensive, quality,

people- and community-centered health services.

Strategic line 2: Strengthening stewardship and governance.

Strategic line 3: Increasing and improving financing, promoting equity

and efficiency, and eliminating out-of-pocket expenditure.

Strategic line 4: Strengthening intersectoral action to address the

social determinants of health.
Expanding equitable access to comprehensive,
quality, people and community centered health
services
• Define the universal package of legally guaranteed services.
• Transform the organization and management of health services
(IHSNs and PHC).
• Increase the investment in the first level of care
• Increase employment options at the first level of care.
• Ensure sufficient response capacity with access to health
information and telehealth services
• Implement programs for the empowerment of people and
communities.
Strengthening stewardship and governance
• Establish formal mechanisms for broad-based social
participation and ensure accountability
• Develop policies and plans that explicitly and clearly state the
intention of the State to transform its health system to
advance toward universal health coverage, established targets
that can be monitored and evaluated.
• Develop a regulatory framework as an effective instrument for
assuring the quality of care, the strengthening of public health
functions and the governance.
• Strengthen national information systems to monitor and
evaluate progress, including advances in equity
Increasing and improving financing, promoting
equity and efficiency, without out-of-pocket
expenditure
• Increase public expenditure on health equivalent to
6% of GDP
• Eliminate direct payment at the point of service and
replace it through a pre-paid integrated pool based
on the principle of solidarity
• Improve efficiency in financing and organization of
the health system.
Strengthening Intersectoral action to address
the social determinants of health
• Establish intersectoral coordination mechanisms.
• Generate evidence to support interinstitutional actions that
have an impact on the health of people and communities;
• Promote Universal Health Coverage in the social protection
programs, strengthen participation in social programs,
including conditional cash transfers.
• Empower people and communities in order for them to
understand health determinants and to play an active role in
health promotion and protection.
 Roadmap
Setting up of Analysis of
Setting up of National Consultations
the Member National
the Internal
States Work Consultations
Work Team
Team

MAR APR MAY JUN JUL AUG SEP OCT

Approval of Presentation Finalization

of First Draft of Strategy Presentation
the Table of First Draft of
to EC and Document of Document
Contents Strategy and
progress of and and Strategy
and Road Resolution
National Resolution to Directing
Map
Consultations for DC Council

Regional and Subregional Consultations

Thanks!

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