State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited

The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancet's Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan France's model of universal and free public health care to the colonies, and French State imperial humanitarianism crystallised in vertical programmes inspired by Louis Pasteur, while vying with early private humanitarian activism in health represented by Albert Schweitzer. From decolonisation to the end of the Cold War (1960-99), French assistance to newly independent states ...

Multi-country purchasing study

The international research consortium RESYST (Resilient & responsive Health Systems) has examined healthcare purchasing functions in some low and middle-income countries to identify factors that influence the ability of healthcare purchasers and other key actors to take strategic actions. The countries included in the study are: Kenya, India, Nigeria, South Africa, Tanzania, Thailand and Vietnam.

From a universal health coverage perspective, this research project focus on purchasing of services from healthcare providers. This core function of healthcare financing must be designed and undertaken strategically to promote quality, efficiency, equity and responsiveness in health service provision and, in doing so, purchasing facilitate progress towards universal health coverage.

The research examined the relationships between purchasers and other groups of actors involved in purchasing mechanisms, including the government, healthcare providers and citizens, so as to understand the various components of strategic purchasing and the organizational environment within which it operates.

The study makes some ...

Can service integration work for universal health coverage? Evidence from around the globe

Universal health coverage (UHC) is at the heart of the new 2030 Agenda for SustainableDevelopment. Health service integration is seen by World Health Organization as an essen-tial requirement to achieve UHC. However, to date the debate on service integration hasfocused on perceived benefits rather than empirical impact. We conducted a global reviewin a systematic manner searching for empirical outcomes of service integration experimentsin UHC countries and those on the path to UHC. Sixty-seven articles and reports were found.We grouped results into a unique integration typology with six categories – medical stafffrom different disciplines; patients and medical staff; care package for one medical condi-tion; care package for two or more medical conditions; specialist stand-alone services withGP services; community locations. We showed that it is possible to integrate services indifferent human development contexts delivering positive outcomes for patients and clin-icians without incurring additional costs. However, the improved outcomes shown wereincremental rather than ...

Global Learning Laboratory for Quality Universal Health Coverage

Welcome to the Community of Practice for the WHO Global Learning Laboratory (GLL) for Quality Universal Health Coverage (UHC). The GLL is deeply rooted in the five interwoven strategies of the Integrated People Centred Health Services Framework—engaging and empowering people and communities; strengthening governance and accountability; reorienting health services; strengthening coordination of care and creating an enabling environment. The GLL recognizes the key role of people-centred health services in order to achieve the Sustainable Development Goals (SDGs) and UHC.

The GLL highlights the need to focus care on the needs and preferences of people. To this end, the GLL aims to create a safe space to share lessons, experiences and ideas; challenge those ideas and spark innovation on quality within the content of UHC. The GLL is organized around three areas. First, national quality policy and strategy (NQPS) in order to drive quality across all levels of the health ...

IHF 40th World Hospital Congress

The IHF 40th World Hospital Congress will be held 31 October – 3 November 2016 in Durban, South Africa with the theme: Addressing the Challenge of Patient-centered Care and Safety.

The World Hospital Congress of the International Hospital Federation (IHF) is a unique global forum that brings together key drivers of national and international policy, management, financial trends and solutions in healthcare management and service delivery. Through this forum multidisciplinary exchange of knowledge, expertise and experiences are facilitated, together with dialogue on best practices in leadership in hospital and healthcare management and delivery of services.

For further information please click here: IHF 40th World Hospital Congress

Universal Health Coverage’s evolving location in the post-2015 development agenda: Key informant perspectives within multilateral and related agencies during the first phase of post-2015 negotiations

In 2001, technocrats from four multilateral organizations selected the Millennium Development Goals mainly from the previous decade of United Nations (UN) summits and conferences. Few accounts are available of that significant yet cloistered synthesis process: none contemporaneous. In contrast, this study examines health’s evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related agencies. Using discourse analysis, this article reports the results and analysis of a Universal Health Coverage (UHC) theme: contextualizing UHC’s positioning within the post-2015 agenda-setting process immediately after the Global Thematic Consultation on Health and High-Level Panel of Eminent Persons on the Post-2015 Development Agenda (High-Level Panel) released their ...

Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses

Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a “diagonal approach.” We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health ...

Health-system reform and universal health coverage in Latin America

Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens—with defined and enlarged benefits packages—and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and ...

Going Universal: How 24 countries are implementing universal health coverage reforms from the bottom up

This World Bank Group book is an overview of how 24 developing countries have embarked on the long journey to Universal Health Coverage (UHC). This Universal Health Coverage Study Series (UNICO) offers knowledge and operational tools to help countries tackle UHC in ways that are fiscally sustainable and that enhance equity and efficiency, by providing examples and lessons learnt from the UNICO countries (individual case studies may be accessed at http://www.worldbank.org/en/topic/health/publication/universal-health-coverage-study-series). In these countries, which together represent one third of the world’s population, efforts to achieve UHC have mainly focused on fiscal expansion, accountability, and community health workers. The study finds that most of these countries, except for success stories such as Costa Rica and Thailand, are still struggling with establishing functional integrated care networks. However, the report recommends that developing countries should continue to empower their primary sector as gatekeepers ...

World health report 2013: research for universal health coverage.

Overview Universal health coverage ensures everyone has access to the health services they need without suffering financial hardship as a result. In December 2012, a UN resolution was passed encouraging governments to move towards providing universal access to affordable and quality health care services. As countries move towards it, common challenges are emerging -- challenges to which research can help provide answers. The World health report: research for universal health coverage focuses on the importance of research in advancing progress towards universal health coverage. In addition, it identifies the benefits of increased investment in health research by low- and middle-income countries using case studies from around the world, and proposes ways to further strengthen this type of research.