Universal health coverage: the challenges that SOCIEUX+ and global partners address through peer-to-peer cooperation

The International Universal Health Coverage Day, celebrated annually on December 12th, reminds us that “everyone everywhere deserves access to quality essential health services without suffering financial hardship”. In reality, the right to health protection is not yet universally applied. Barriers to access to healthcare remain, in the form of out-of-pocket (OOPs) payments on medical services, limitations in the range and quality of available health provision, physical distance and long waiting times, which translate into opportunity costs, such as lost working time, that may affect the capacity of the poorest (but not only) households to care for their health. Nowadays, around two third of the global population is covered by at least a partial health scheme. Those who meet more limitations are rural people and the poorest households. While coverage has increased, adequacy is still not secured, and OOPs are prevalent in many contexts. Needless to say, the COVID‑19 pandemic has further revealed the need to invest in healthcare services.

Since its inception SOCIEUX+ has carried out a significant number of technical, peer-to-peer cooperation actions relating to health insurance, access to health, health insurance packages, rehabilitation, and disabilities in health. In total, 16 actions have been undertaken in 11 different countries -Thailand, Armenia, Tanzania, DRC, Togo, Lao PDR, Zimbabwe, St. Lucia, Cambodia, Mali and Azerbaijan-, mobilizing 29 different experts from all over Europe, providing around 700 days of peer-to-peer expertise. Health systems’ financing, risk-pooling and management, rights-based entitlements, and quality in the provision of health services are key stakes on which partner institutions worldwide have solicited SOCIEUX+.

Three examples shall illustrate the kind of challenges SOCIEUX+ and global partners have intended to tackle through peer-to-peer work on technical matters:

  • In Democratic Republic of the Congo (DRC), the action, which is currently ongoing, is aimed to assess the feasibility of introducing a universal health insurance scheme in the Kongo Central province. The feasibility study, which will be the overall result of the Action, focuses on a few key areas: the type, quality, and scope of the demand of health services by the local population; a forecast of the financial balance and the performance of the system, and a reflection over the contribution mechanism; the system’s design: the essential functions and the operational needs, in terms of staff, capacities, infrastructures and services, and community-awareness (SOCIEUX+ 2020-06).
  • In Togo, the Partner requested SOCIEUX+ to improve the “tools for the job” related to the provision of health services. In this purpose, conventional frameworks with medical service providers have been designed, while a comprehensive set of medical procedures to be included in the health coverage have been identified and classified (SOCIEUX+ 2017-39).
  • In Azerbaijan experts mobilized by SOCIEUX+ have accompanied the Ministry of Health in undertaking strategic changes to their post-soviet health system, particularly with regards to health-financing arrangements, including performance-based capacities to assess the provision of insurance-covered medical services (SOCIEUX+ 2015-23).

Universal health coverage remains a key objective for governments and social security institutions worldwide. Pursuing equity in access to quality services, ensuring political leadership based on an enabling regulatory environment, promoting responsive and resilient health systems, and sustaining public financing are among the set of UHC Commitments launched on the occasion of the UHC Day 2020. SOCIEUX+ and its partners remain committed in doing their part towards their realization.

Gian Luca Portacolone

SOCIEUX+ Social Protection Coordinator