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The BMJ and The Harvard Global Health Institute launch special collection

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The BMJ and The Harvard Global Health Institute launch special collection

The BMJ and The Harvard Global Health Institute launch special collection on universal health coverage

Collection will stimulate debate and help fulfil the promise of high quality health for all

The BMJ in partnership with the Harvard Global Health Institute are launching a special collection of articles that will explore how to achieve effective universal health coverage (UHC).

The collection will highlight the importance of quality in UHC, potential finance models, how best to incentivise stakeholders, and uncover some of the barriers to true UHC.

The collection coincides with a panel discussion at the 71st World Health Assembly meeting in Geneva entitled Quality Care: Delivering on the Promise of UHC.

Speaking alongside Health Ministers and representatives from the World Bank, World Health Organization and OECD will be Dr Kamran Abbasi, Executive Editor at The BMJ and Professor Ashish Jha at the Harvard Global Health Institute.

Dr Abbasi said: “The BMJ and The Harvard Global Health Institute share a commitment to drive UHC forward. Through drawing on empirical evidence and examples of success, we hope to stimulate debate and encourage ongoing work in this field to fulfil the promise of health for all via UHC.”

UHC refers to a system which seeks to provide everyone, everywhere with access to essential quality health services without facing financial hardship. It is a key target of the UN sustainable development goals and a top priority for the WHO.

Yet figures show that over half the world’s 7.3 billion people lack access to essential health services.

In an article to launch the series, Jishnu Das, lead economist at the World Bank and colleagues say simply providing more resources is not enough to improve health and that we also need to ensure good quality of care.

In many low and middle income countries, they say access to trained medical staff and facilities “does not guarantee universal access to quality care” and in fact in some countries, “providers without any formal medical training can provide higher quality care than fully trained doctors.”

They add that medical knowledge “often does not translate into high quality clinical interactions” and they call for new approaches “to tackle systems that produce medical professionals who are poorly trained, undermotivated, and underused.”

Such action “has the potential to transform how healthcare is delivered in low income contexts, ultimately improving the lives of billions,” they conclude.

In a linked article, Wilhemina Jallah, Minister of Health of the Republic of Liberia and colleagues say investing in community health workers accelerates universal health coverage.

They describe a program to hire, train, and equip nearly 3000 community health assistants and over 300 nurse supervisors that has led to “remarkable progress” in tackling common childhood diseases and supporting pregnant women. “More countries should adopt similar reforms,” they say.

In a second linked article, Professor Adolfo Rubinstein, Minister of Health of Argentina, outlines how they are building more effective health care coverage in Argentina. Reforms include setting up provincial public insurance schemes, creating a transparent process for setting priorities, reducing disparities in effective coverage, and building a primary care oriented health care system.

“Our ultimate goal is to provide actual rather than aspirational UHC, improving not only health outcomes, but also its distribution among different groups, thereby ensuring better quality health care and equity for every Argentinian,” he concludes.

Finally, Sania Nishtar co-chair of the WHO Independent High-level Commission on non-communicable diseases (NCDs) argues that NCDs must be part of universal health coverage frameworks “as they are the world’s biggest killers and the leading cause of preventable morbidity and disability.”.

Integration “is critical for closing the NCD services gap to address the staggering rates of unnecessary deaths, disability, and illness from NCDs,” she writes. “Never has there been a wider chasm in public health between our knowledge about of the burden of disease coupled with evidence of what works, acts on the one hand, and inaction on the other. We must act to bridge that. Words will not be enough.”

All the articles will be available here: https://www.bmj.com/universal-health-coverage

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