From MDGs to SDGs, UHC is possible in Ghana
It’s September 2000, leaders of 189 countries gathered at the United Nations (UN) headquarters and signed the historic Millennium Declaration, in which they committed to achieving a set of eight measurable goals. The goals ranged from halving extreme poverty and hunger to promoting gender equality and reducing maternal and child mortality, by the target date of 2015. The eight Millennium Development Goals (MDGs) failed to consider the root causes of poverty and overlooked gender inequality, as well as the holistic nature of development. The goals made no mention of human rights and did not specifically address economic development.
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Commenting on the effect of the MDGs, UN Secretary General, Ban Ki-moon said, “The MDGs helped to lift more than one billion people out of extreme poverty, to make inroads against hunger, to enable more girls to attend school than ever before and to protect our planet.” However, the progress, the secretary general acknowledged, has been uneven — a problem the upcoming Sustainable Development Goals (SDGs) seek to address.
Sustainable Development Goals
The SDGs are a new universal set of goals, targets and indicators that the UN member states will be expected to use to frame their agenda and political policies over the next 15 years. The SDGs follow and expand on the MDGs. Unlike the MDGs which were put together by a team of experts, the SDGs are a summation of consultations conducted in countries across the globe among different stakeholders. The 17 SDGs range from ending poverty to achieving gender equality and empowering all women and girls and ensuring healthy lives and promoting well-being for all at all ages by the target date of 2030. The SDGs which will be adopted at the end of this month and will become applicable from January 2017.
Current health sector in Ghana
Over the years, the health situation in Ghana has been characterised by significant inequalities over the years. Although the health status of the general population may be improving, the health of the less endowed is improving more slowly than the rest of the country. Financial and geographical access to health services remain a challenge and the health sector acknowledges this (Ministry of Health Mid-Term Plan 2014-2017).
The National Health Insurance Scheme (NHIS) has a national coverage rate of only about 41 per cent, leaving about 59 per cent resorting to the cash and carry system or alternative sources of health care. The NHIS was set up to allow Ghanaian citizens to make contributions into a fund so that in the event of illness, Ghanaian contributors could be supported by the fund to receive affordable health care. According to the National Health Insurance Authority’s (NHIA’s) 2010 Annual Report, the main challenge facing the scheme is late release of funds and fraud in the system.
Why Universal Health Coverage (UHC)
Universal Health Coverage (UHC), championed by the World Health Organisation (WHO), is ensuring that all people can use the preventive, curative, rehabilitative and palliative health services they need, which is of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
The goal of the UHC is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. This requires a strong, efficient, well-run health system, a system for financing health services, access to essential medicines and technologies; and a sufficient capacity of well-trained, motivated health workers.
Any country that has achieved the UHC has the following characteristics: Equity in access to health services; the quality of health services good enough to improve the health of those receiving services; financial-risk protection.
SDGs: A wonderful opportunity to achieve UHC?
Goal three of the SDGs is specifically on health (ensure healthy lives for all ages). The target urges all countries to achieve UHC at every stage of life, with particular emphasis on primary health services, including mental and reproductive health. This is to ensure that all people receive quality health services without suffering financial hardship. Countries are required to implement policies that will create the enabling social conditions that promote the health of their citizens and help individuals to make healthy and sustainable decisions related to their daily living.
Ghana will need to resource the NHIS to make it the vehicle to achieving UHC. It is welcome news that the government has put together a seven-member technical review committee to review the operations of the NHIS. It is the hope of Civil Society Organisations (CSOs) that this review will propose and bring on board the needed structure and financial sustainability to make the NHIS more robust, efficient and effective. Issues of human resource for health, availability of essential drugs and equipment and completion of ongoing health facility infrastructure development are begging for attention.
Conclusion
Though the targets set for the Health MDGs (4, 5 & 6) were all not achieved, the SDGs present Ghana with yet another opportunity to work towards improving the health sector through ensuring UHC. There is the need for a strong political commitment in the form of domestic resources to help achieve the objectives set in the Ministry of Health’s Mid-Term Development Plan (2014-2017), the SDGs and Ghana’s 40-Year Development Plan.
The Universal Access to Health Care Campaign (UAHCC) believes that this is the best time for Ghana to achieve UHC which will help address the health inequalities and save the numerous preventable deaths recorded each year.
The writer is the National Campaign Coordinator of the Universal Access to Healthcare Campaign, a national advocacy campaign advocating UHC in Ghana.
Email: [email protected]
