The Prince Mahidol Award Foundation (PMAF) and the World Health Organization (WHO) hosted the Prince Mahidol Award Conference 2016 on “Priority Setting for Universal Health Coverage from 26th-31st January 2016 at the Bangkok Convention Centre at Central World in Bangkok, Thailand.
The 2016 conference focused on priority setting in the context of Universal Health Coverage (UHC) by discussing important issues, such as exploring how to organize priority setting, linking research and UHC policy, and sharing experiences of priority setting mechanisms between countries. Given her expertise, in the role of Civil Society and consumer perspective Ms. Robinah Kaitiritimba the Executive Director, Uganda National Health Users’/Consumers’ Organization (UNHCO) and a prominent Patients’ Champion in Uganda was requested by the International Organizing Committee and WHO to be on the panel “Priority Setting for UHC: the Civil Society Perspective.” Ms. Kaitiritimba spoke about five priorities for any government engaging in priority setting for Universal Health Coverage in their country:
- Participation: The important question to begin with is “whose priorities?” If this is citizen’s priorities how are they included in determining priorities and ensuring that the objectives for UHC are met. So these should ensure effective citizen’s participation and engagement balancing power relations and ensuring value for money in UHC. There is need for people centeredness in priority setting. Adequate all-inclusive consultation of all stakeholders in the priority setting process ensures that people’s needs and preferences are the main priorities when setting the stage for UHC. For full participation education and empowerment should be considered. Deliberate effort should be made to mobilize citizens and facilitate their meaningful and effective participation. Special consideration should be made for vulnerable and special interest groups including women, children, People with disabilities and adolescents among others. Women and girls are not only the first care givers at family level but they are also marginalized regarding participation and voice, opportunities for education. This category is also economically disempowered even when they provide the greatest labour force in most societies.
- Primary Health Care: All governments should take responsibility for Primary Health Care for all citizens; without discrimination. Governments must address all barriers and social determinants such as water, sanitation, transport and education. Deliberate focus should be put on strengthening systems for Sexual Reproductive Health and Rights and on factors that promote education and enabling opportunities for equal opportunities for all. Disease prevention, including: Non Communicable Diseases (NCDs), childhood and pregnancy related morbidity and mortality as well consideration for the very expensive services such as technology for diagnosis for the most disadvantaged are all important in priority setting. In many societies especially in less developed economies addressing construct discrepancies for gender remain a critical component in setting priorities for UHC.
- Informal sector: The informal sector in less resourced countries is largely unregistered and unregulated. This poses the danger of them being excluded from UHC interventions such as health insurance. This means that health financing will not benefit from the economies of scale and that the interventions will not embrace the health and wellbeing of the entire population. The informal Sector should be considered in all stages of priority setting.
- Private Sector: Priority setting should consider leveraging resources of the Private Sector. These resources include: Skills, Competencies and Technology. This is important because many communities have a tendency to go to the private sector as the first point of contact for health care.
- Health Financing: There are no governments that can afford to pay the entire scope of healthcare for their citizens. So because citizens will bear a percentage cost for UHC it is important that there is adequate thinking which method and mix of health financing will drive quality, equity, efficiency and effectiveness in the process of priority setting for Universal Health Coverage.
In conclusion UHC is a gateway to wellbeing, economic empowerment and it ensures that planning for health will save individuals and families from the bondage of catastrophic spending that has driven many into abject poverty. UHC will also ensure equity and address preventable death and morbidity. Unless the focus of planning and implementation is people centered, we may not achieve the desired objectives and projected outcomes.
Contact Robinah Kaitiritimba at: rkitungi@unhco.or.ug, Twitter: @unhco.
Face book page: Uganda National Health Consumers Organization
Disclaimer: The views expressed in the article are personal views of the author.