SPEED Uganda - team continues to contribute to the shaping of the roadmap for Universal Health Coverage

The government of Uganda has committed to work towards achieving universal health coverage (UHC) with essential health and related health services needed for promotion of a healthy and productive life.  This vision is espoused in the goal of Health Sector Development Plan 2015/16-2019 /20. The need to mobilise multisectoral efforts for attainment of UHC objectives in Uganda is increasingly acknowledged. The Ministry of Health with support from African Collaborative for Health Financing Solution (ACS) Initiative convened a meeting on 21^st -22^nd June 2018 at Esella Hotel, Kampala to establish a taskforce to develop a roadmap for UHC in the country. The road map is intended to provide a framework for coherent implementation of policies and strategies towards attainment of UHC goals in the short, medium and long term.

SPEED was nominated to this taskforce in recognition of its pivotal contributions towards evidence-based UHC policy development in the country. The SPEED team represented by  Makerere University  School of Public Health ( MAKSPH),  Economic Policy  Research Centre (EPRC), Uganda National Health Consumer’s Organisation (UNHCO) and National Planning Authority (NPA) presented to this high level committee their views about UHC.

Dr Aloysius Ssennyonjo, the SPEED project manager elaborated how SPEED has conceptualised UHC and related efforts. Highlights of his submission were:

1. The current focus on UHC is on ensuring that  the use health services does not expose the user to financial hardship BUT this perspective is narrow and forgets potential financial hardships to the supply system that needs similar attention.
2. UHC is a goal and not an intervention: “advancing/progressing towards UHC” NOT “implementing UHC”
3. Achieving UHC is NOT a health financing reform NOR health sector issue BUT is a whole of government effort.
4. UHC efforts should be looked at within the frame of SGD3: “Ensuring Good Health & Wellbeing”. The focus on biomedical solutions and healthcare services ignores critical benefits of investing in health promotion and keeping people healthy. The broad perspective on good health and wellbeing makes it easier for other non-health sectors to appreciate the contribution to the UHC agenda

The policy implications for UHC were equally elaborated as below

1. Managing the financial burden to individuals and health system;
2. Increasing the services of good quality provided.
3. Expanding the population groups benefiting from the services;
4. Building resilient systems to sustain coverage
5. Ensuring that different sectors work together in a synergistic and coherent manner for population health.

At this meeting, the NPA presented the UHC Policy paper that had been recently been presented to the Presidential Economic Council and was due for presentation to the Cabinet. This document is one of the products from the SPEED Project. Its development followed several think tank meetings that and incorporated inputs from several stakeholders within government ministries, departments and agencies, civil society organisations and private sector.  The paper has also benefited from inputs at an international conference last year.

The discussions during the two days highlighted other ongoing efforts that should be leveraged to the establishing the situation analysis for UHC progress in the country. These included a) the recently launched UHC Book by the SPEED Project and b) the Midterm review/assessment of the health sector development plan. It was advised that the taskforce should examine all ongoing efforts to support the UHC roadmap development to avoid duplications.

The  members  also pointed out  critical issues which  needs to be streamlined to facilitate  proper movement towards UHC; these included, convening  of  all strategic players in order to develop a unified and jointly agreed road map, agreeing   on the institutional host of UHC efforts with the needed  mandate to  convene different stakeholders beyond health to lead these efforts, the need to avoid previous approaches, which merely focus on financing health care and finally recognizing that UHC is a journey not a project and hence the need for long term strategies which will make an impact on not only systems resilience but population productivity.

The members on the committee included representatives from ministry of Health, Finance Planning and economic Development, Ministry of Local Government, Water and Environment, Agriculture, Health development partners, civil societies, and academia among others.