Africa: Cape Verde Gives Pointers on Achieving Universal Health Coverage

WHO Africa Director Dr Matshidiso Moeti, President of Cape Verde Jorge Carlos Almeida Fonseca and the Cape Verde Minister of Health Dr Arlindo Narscimento do Rosario at the opening of the 2nd WHO Health Forum.
29 March 2019

Praia — After three days of intense work and great debates, the second Africa Health Forum came to an end in Cape Verde. The conference was the follow up meeting to the first Africa Health Forum held in June 2017 in Kigali, Rwanda which committed to putting people first, promoting synergies and coordinating and engaging all stakeholders behind the goal of achieving universal health coverage while leaving no one behind.

Under the theme "Achieving Universal Health Coverage and Health Security: The Africa We Want To See", the second gathering's aim was to seek new ideas and solutions to achieving universal health coverage and good health in the sustainable development of the continent.

The forum highlighted the need for strategic partnerships, effective engagement and coordinated joint actions for better management and mitigation of the urgent and ever changing health needs for African populations.

"We must recognize the specific needs of the region and prioritize innovative service delivery approaches that will result in a long-term impact and lead to our common goal of quality health care for everyone, everywhere," Dr Matshidiso Moeti, WHO Regional Director for Africa, said during her closing remarks.

"The key areas for deliberations during the forum will take it to the next level, optimizing multi sectoral partnerships for effective collaboration to improve health outcomes, insuring health security and promoting innovation for the achievement of Universal Health Care", said Minister of Health and Social Security, Dr Arlindo Nascimento do Rosário.

Cape Verde as one of the few countries to achieve universal health coverage, unveiled a list of recommendations that countries should follow as the next steps that Member States especially, but also NGOs, development partners and private sector stakeholders should take to heart to deliver the health care systems that Africa needs and deserves.

For countries to take UHC to the next level member states should:

- intensify and continue to implement the UHC strategy as an effective way to guarantee the right to health for all without financial constraints thereby contributing to the social wellbeing of their populations and to the achievement of the sustainable development goals

- continue to strengthen national health systems focusing on the primary health care strategy as the preferred pathway to achieving UHC as reiterated on the Alma-Ata declaration of 1978 on primary health care

- ensure active community participation in deciding and monitoring the effect of health initiatives

- mobilise additional funds and improve the quality of efficiency and investment to accelerate and intensify efforts focused on universal health care

- governments and partners should actively monitor the range of health services that are available in each health group in countries to ensure that citizens enjoy greater access to the services they need for their health and wellbeing

- prioritise initiatives from communities, facilities and districts to build the resilience of health systems to ensure sustained provisions of essential services

- support the expansion of health promotion, disease prevention, curative, rehabilitative and palliative interventions particularly for the population that are currently left behind. Proactively support the generation of data and statistics needed to monitor progress towards universal health care in member states and make adjustments as necessary.

- move away from payment at the point of use because it is associated with iniquities and financial barriers to access services.

On the need to optimize multi-sectoral partnerships for effective collaboration to improve health outcomes, member states should:

- promote inter country dialogue and private partnerships including with inter-organisational services, the private sector, development centres and regional economical communities, local authorities, research institutions and academia

- strengthen public private partnerships for health and wellbeing at all levels of government and across key partner key agencies to enhance health promotion policies, prevention policies and actions

- engage with and ensure the meaningful participation of the citizenry including the young, women and other vulnerable groups in the development of health policies affecting their health and wellbeing

- support local and community structures to address the determinants of health and health inequalities to ensure that no one is left behind. Invest in gathering and using the strategic information needed for advocacy, planning and monitoring of programs of adolescent and youth health. Work to reduce policy barriers that limit access for young people and other vulnerable groups to health and information services.

- governments and partners should continue to promote health in all policies and support cross sectoral and inter-sectoral policy coherence and actions in order to address the determinants of health and to improve health and wellbeing of the population

- empower the health sector to effectively engage and support the other sectors to incorporate health and policies in their processes.

The WHO and of the UN system should:

 - work with member states, development partners and financial institutions to harmonize and integrate policies, strategies and high impact, interventions while expanding efforts to reach vulnerable populations and improve equity

- support member states in mobilising funding and improve the quality and efficiency of investment to strengthen multi-sectoral community engagement and scale up new innovative tools and approaches, engage heads of states in championing a systematic and coherent multi-sectoral agenda for addressing the key demands of health in their countries

- support private and public sector investments in health promotion and primary prevention, provide evidence based guidance that supports health insurance choices and interventions while applying the WHO frame work of engagement with none state actors.

On the need to enhance engagement private sectors for UHC and health security through evidence based actions, member states should:

- put in place an enabling policy environment and instruments that regulate the engagement and role of the private sector in UHC and health security

- create an institutionalized forum for ongoing dialogues between health sector partners and the private sector.

On the need to ensure health security: member state, WHO and other agencies of the UN system and partners should:

- promote full implementation of the international health regulations of 2015 and strengthen cross border collaboration

- propose a mechanism with clear actionable steps for improving collaboration and coordination for public health emergencies, preparedness response in global health security at national regional and global level taking in to account the one health approach

- define the roles and responsibilities of the different stake holders at WHO, The Africa CDCs, International and national NGOs, international agencies, bilateral funders, academia and researchers in supporting countries to fast track the achievement of health security

- in his closing address, José Ulisses de Pina Correia e Silva, Prime Minister of the Republic of Cabo Verde, said universal health coverage and health security are challenges to be overcome. "With strong political and civic awareness, engaged leaderships, good partnerships for development, favourable conditions for investment and for private activity in the health sector and better regulation, we will overcome these challenges".

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