Achieving Universal Health Coverage by 2030: The Health Financing and Social Protection Challenges

Algemeen

As the world struggles to recover from the COVID-19 pandemic, with only nine years to go to 2030, there is still a long way to go reach Universal Health Care (UHC). 44% of the world population remains without a scheme for health protection, with the figure deteriorating in LIC (83%). In several African and Asian countries coverage of essential services remain at a worrying level with less than two thirds of their population having adequate access to the needed and suitable care. More than 2,5% of the global population impoverish due to out-of-pocket payments, with the number of people remaining or falling into poverty because they cannot pay for or access health care even higher. The COVID-19 pandemic has been a wake-up call as well as a stress-test for the universal health care and universal social protection. Numerous governments all around the world launched or broadened social protection schemes to mitigate the impact of the lock-down measures. A renewed interest for the need of a global fund for social protection grew at international level. However, what the pandemic also demonstrated was the dangers of the fragmentation and segmentation in risk-pooling, the uneven and unfair distribution of risks and benefits among populations, the necessity of covering the informal sector workers and displaced people, the constant renegotiation between the societal values (equity, solidarity, deservingness …) and economic evaluation when designing schemes to reach universal care and protection during times of shrinking fiscal space.

This advanced short course will acquaint students with the state-of-art on the debates on and insights in health financing and social protection approaches to achieve UHC, and understand how social protection and health are interrelated. During three weeks frameworks for the analysis of UHC and USP policies are introduced, with special attention for the Health Financing and Social Protection functions. This analytical frameworks integrate different institutional, financial, human and socio-political dimensions inherent in such policies. Emphasis is put on the role of contextuality (historical evolution, global policy, conditionalities (health system, tax-base …), path-dependency), values (equity, solidarity, empathy), politics and technicalities (coverage, resource mobilization, pooling, purchasing, targeting) in defining the multiple paths and making the political choices towards UHC. The different analytic frameworks will be illustrated by means of case studies of health financing and social protection interventions and reforms in low and middle income countries.  

The course integrates inputs from a wide range of disciplines and areas of expertise, and uses a diversified pedagogical approach combining participatory classroom teaching and guided readings, case study presentations, peer-to-peer support, class room exercise, a debate and an actor play.

Eventually, the course participants will have internalised the concepts and components of UHC, health financing and social protection and the analytic frameworks and will be able to critically reflect on these concepts, which will allow them to participate in the analysis, development and progressive realisation of fair health financing and social protection mechanisms for UHC in their country.