3 Elements needed for UHC in Africa

Dear Reader,

The momentum towards Universal Health Coverage (UHC) is growing within Africa as an important public policy agenda. UHC means ensuring that all people have access to needed health services of sufficient quality and ensuring that the use of these services does not expose the user to financial hardship (WHO, 2013).

Given the complexity of UHC, countries have used various approaches to expand UHC in Africa. However, there are 3 important elements that should be taken into account in order to increase the likelihood of achieving UHC:
P1: The Poor should not be left behind
Evidence from African countries shows that social health insurance strategies tend to leave out the poor (Fenny, Yates, & Thompson, 2018). It is critical to ensure that no one is left behind in the roadmap towards UHC. This is particularly important for the poor subpopulation since health expenditure is an important factor in poverty alleviation. It is the government’s duty to ensure that UHC strategies are structured to include the poor as part of their role to improve health equity.

P2: Preventative and Primary healthcare
Given the narrowing fiscal space and reduced donor funding available, it is important to create sustainable ways to achieve affordable healthcare for all. Therefore, there is a need to prioritise services covered so that affordable basic care that responds to the needs of the population can be provided to the masses. A focus on primary healthcare is the most cost-effective way to ensure that more people have access to basic healthcare. This takes into account the needs of African populations and promotes early treatment before people develop NCDs or other diseases which are more expensive to treat. In the same vain, strategies to promote population health can reduce the burden of healthcare costs and create a more productive and healthy population.

P3: Private Sector involvement in Universal Health Coverage
According to the International Labour Organisation (ILO), the private sector can support national UHC initiatives by:
  • Substitution where government initiatives are not effective or are overburdened;
  • Creating innovations that can be scaled to national level;
  • Partnership in order to leverage the key insurance functions which are better performed by the private sector; and
  • Supplementing government benefits.
This is only possible through increased collaboration between stakeholders to align priorities towards common goals.

Fenny, A. P., Yates, R., & Thompson, R. (2018). Social Health Insurance Schemes in Africa leave out the poor. Royal SOciety of Tropical Medicine and Hygiene, 10(1).
WHO. (2013). Arguing for Universal Health Coverage. World Health Organization.


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