Universal Health Coverage - A Tool to Fight Health Inequity Battles: The Need from Aspiration to Decisive Action in African Countries

Abstract

Background: Universal Health Coverage (UHC) is considered an effective tool to reduce the current healthcare provision inequities observed both within and across countries. UHC helps by creating dynamic systems for health that usher access to good quality healthcare for all. It holds the center stage in the post-2015 Sustainable Development Goals (SDGs) agenda. Advancing towards UHC in African countries requires simplified actions in the three broad dimensions of UHC: population coverage, quality and type of services covered, and proportion of the costs covered. 

Methods: We reviewed data from 51 African countries on their: current health budgets, out-of-pocket payments as a percentage of total expenditure on health, government total healthcare expenditure on public health services as a percentage of GDP, and population health status indicators required to assess progress towards achieving UHC. World Bank (2015) and UNDP (2015) datasets that measure the well-being of a nation and are available online were used for the analyses. 

Results: We found high health inequities and poor population health status, high out-of-pocket payment (>75% of private healthcare expenditure), and low government healthcare expenditure on public health (<4% GDP) for the majority of African countries. This shows the low commitments of the countries to promoting and achieving health equity. 

Conclusions: The three dimensions of UHC are broad and complex, but justifiable for people at the centre health systems. In African countries, implementing UHC need innovative workable strategies to demystify and simplify the dimensions based on the each country’s context. One-size-fits-all philosophy may not work.