Worldwide over 30 middle-income countries are responding to the need for Universal Health Coverage following the inception of the global Universal Health coverage movement. In 2005, this movement led the World Health Assembly to call on countries to develop their health systems, so that all people have access to affordable service.

This truncation of the expression shares experiences from 12 Francophone countries on the transition from scheme to system including setbacks in achieving universal coverage. This evaluation was conducted by the Alliance for Health systems and policy Research in collaboration with Institute of Tropical Medicine. Unfortunately, it was also revealed that in most countries, there were gaps in population coverage for health services as well as overlaps in coverage. This was evidenced by certain populations having  benefits from multiple health financing schemes.  For instance  Civil servants with health insurance   still opted to give  birth in health facilities  that offer a fee exemption for deliveries. There was also lack of coordination between funding bodies and health services providers in vertical programs which posed a question for sustainability and bridging of coverage gaps in many countries. Universal coverage in many countries was low because of heavy dependence on external financing. As a result there was increased fragmentation not only in terms of number of schemes but also in governance for health financing.  

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In view of the aforementioned challenges in the 12 countries, it was recommended that vertical schemes should be emerged and those that could not be emerged should be closed. This was a major recommendation which entailed  the need for the numerous stakeholder including funders, private actors, health ministers, public agencies, professional associations and the multiple programs to meet at one table and make decisions.  Even with this  proposed solution at hand, not only one solution exists for moving towards universal coverage since each countries problems are different.

Based on Knowldege Translation evidence, the only solution that can be  applied to all countries wanting to make significant progress towards universal health coverage is; governments  and Ministries of Health, must develop significant, operational capacity to collect information, to analyze it, and to use it to guide decision-making. Knowledge management and the ability to analyze the situation - its strengths, constraints, opportunities, and threats – will be necessary conditions to achieve Universal Health Coverage. 

While many of us testify that achieving universal health coverage is complex and challenging, we would love to share your views and experience from your own countries.  Discussion are platforms are open on our website and on the various public health platforms on which our blogs are posted.

We welcome bloggers to contribute articles at any time of the year. Our focus is currently on three themes i.e.; service delivery (maternal child health), Health Financing and Community Governance. To join the writing team, please email the secretariat at ktnet.musph.ac.ug and copy Angela Kisakye [email protected]

Acknowledgements

Harmonization for Health in Africa

References

1. http://www.healthfinancingafrica.org
2. UNICO Studies Series 25 The Impact of Universal Coverage Schemes in the Developing World: A Review of the Existing Evidence Ursula Giedion, Eduardo Andrés Alfonso, Yadira Díaz: The World Bank, Washington DC, January 2013