AFRICA – The government of Sweden and the Clinton Health Access Initiative (CHAI) have announced a partnership to accelerate progress in Africa toward the goals of sexual and reproductive health and human rights and universal health coverage (UHC).
The new partnership will provide US$34 million to support CHAI’s technical assistance to governments across Africa to strengthen and finance resilient healthcare systems that in turn ensure equitable access to quality primary care and sexual and reproductive health services.
This includes sharing learnings from focus countries in South Africa, Ethiopia, Rwanda, Malawi, Nigeria, Eswatini, and Uganda, as well as engagement with regional institutions and champions.
Håkan Juholt, Ambassador of Sweden, remarked, “Sexual and reproductive health and rights are a fundamental part of the social contract. Ensuring equitable distribution of resources and access to services is ultimately about social justice.”
Across Africa, governments are committed to this goal of addressing sexual and reproductive health needs, despite significant challenges including the COVID-19 pandemic and subsequent economic fallout.
While health is regarded as a public good and a basic human right, it is not currently provided solely by the government.
Involving the private sector in order to supplement and reinforce the public sector’s services is becoming increasingly important.
Accordingly, the new technical assistance program by the Swedish and CHAI will support governments to ensure that all people can access the lifesaving services they need, closer to where they live, without paying more than they can afford.
that all people obtain the health services they require without experiencing financial hardship when paying for them.”
While almost every country in the world aspires to this goal, their paths differ. How well resources are pooled and optimized to meet the needs of each country is a major factor that can either accelerate or stymie success.
Globally, over 800 million people spend at least 10 percent of their household income on healthcare through direct out-of-pocket payments (OOPs), pushing millions of people further into poverty each year.
The situation is dire in low-and-middle-income countries like those in Africa, where 27 out of 48 countries are significantly affected by direct OOPs for healthcare services, Business Day reports.
The inclusion of UHC as a goal in African countries’ national health strategies is becoming increasingly critical and important as the continent continues to bear a high disease burden (24 percent globally), has an increasing population, and lacks the health workforce to meet healthcare demands.
A publication by the World Bank contends that countries that meet their UHC targets by 2030 will eliminate preventable maternal and child deaths, improve resilience to public health emergencies, reduce financial hardship associated with illness, and lay the groundwork for long-term economic growth.
The World Bank has identified four pillars that support UHC: health financing, service delivery, inputs (drugs, human resources, etc.), and health sector governance.
The private sector, with its financial and innovative capacity, can play a cross-cutting role in expanding the scope of all these pillars and improving care quality.
CHAI Country Director and Senior Global Director for Universal Health Coverage, Prof. Yogan Pillay stated, “Partnering with governments in the region will contribute to strengthening healthcare systems towards the achievement of universal health coverage.
“This new funding will help support primary healthcare and improve access to sexual and reproductive health services within a rights-based approach.”
The partnership will bring together governments, civil society, healthcare providers, and patients to swing back the scales of inequality in global health.
It is worth noting that a new National Health Insurance Authority (NHIA) Act was signed into law in Nigeria in May 2022.
The Act creates and empowers the NHIA to ensure health insurance coverage for all Nigerians through a mandatory mechanism in collaboration with state health insurance agencies.
Through this Act, efforts to combat high levels of poverty caused by OOPs for healthcare by providing health insurance to all Nigerians by 2030 are now more achievable than ever before.
Kenyan government also allocated KES6 billion (US$52M) to the National Hospital Insurance Fund (NHIF) for the Universal Health Coverage (UHC) program in a bid to scale-up the Universal Health Coverage with a call to citizens to register for the National Health Insurance Fund.
With public health epidemics and pandemics such as the COVID-19 pandemic highlighting the importance of UHC, there is an urgent need in Africa for appropriate health financing strategies that ensure financial risk protection and support sustainable health services toward UHC attainment.