In August, Thanzi la Onse researchers attended the SPEED Symposium on Partnerships, Policy, and System Developments for Universal Health Coverage, organised by the Ministry of Health Uganda and the SPEED Project.
Under the theme ‘Partnerships for Health Improvements across Governments, and Societies at Local, National and Global Levels’, the event aimed to “bring experiences, reflections and evidence (both local, national and international) to guide decisions and strategies at various levels for advancing partnerships for UHC in the context of Sustainable Development Goals (SDGs)”. Over 300 delegates from the East African Community and beyond attended.
Eight members of the Thanzi team were in attendance, each presenting an abstract on research carried out within the Thanzi la Onse programme: Tom Hart, Alan Msosa, Wingston Ng’ambi, Edward Kataika, Kenneth Katumba, Paul Revill, and Pakwanja Twea. Congratulations to Kenneth and Wiktoria on the awards they received for their presentations, recognising the contributions to advancing partnerships.
Reflections from Thanzi
Here, some of the team share their thoughts on the symposium:
“It was very useful to learn how the Ugandan government is explaining the opportunities and limits of UHC to the public to ensure that they are well-informed to constructively support planning health reforms and their functioning. Policymakers also reiterated the importance of inclusive engagement with different stakeholders (including those beyond the traditional health agencies and organisations) to mobilise political will towards supporting UHC as a tool for attaining health for all. The importance of appropriate models for allocating resources and efficient usage of resources came out as critical to the success of a health system.”
“The Ugandan government has, through the Ministry of Health and partners, done a lot of good work in the race towards UHC. However, there are still gaps to be filled: building capacity within the Ministry; more inter-sectoral linkages and on boarding of the private sector; contextualised studies to define the still undefined issues (such as the premiums to be paid); and to refine other details of the UHC plan.”
“Most health coverage programmes are often done without youth involvement, even if the policies and programmes affect them. Any policy and project planning should involve all beneficiaries, including the youth.” The symposium had acknowledged this, including a session for youth titled ‘Nothing For Us, Without Us’, recognising that youth are the future and it is vital to engage this demographic in the drive to achieving UHC.
“Primary health care is not a health sector specific effort nor is it a government only effort. Much emphasis was placed on primary health care as the key vehicle for achieving Universal Health Coverage. However, achieving UHC through primary health care would require a greater focus on leveraging and strategic partnerships and multi-sectoral collaboration. Beyond leveraging these partnerships, the following roles of the Government were seen as key enablers in producing desired results: results tracking; rationalizing ongoing dialogue; explicitly stating and tracking roles in implementation; as well as managing conflicts of interest.”
“Systematic policy analysis will ensure that governments make better decisions. The need for a systematic process of coming up with policy options, analyzing the policy options, and determining the policy outcomes was also highlighted. This should be done to conceptualize and feed into the decision-making process rather than justifying already made decisions. But also understanding that policy analysis should be anchored in proper engagement of relevant stakeholders.”
What next?
Health seeking behaviours are affected by age, type of illness and area of residence, and UHC programmes should consider barriers and facilitators of health seeking behaviour in order to improve health. UHC is possible, but Ministries of Health should move from ‘business-as-usual’ to focused programming coupled with resource allocation. Researchers will certainly play a part here, providing policymakers with the data needed to make decisions based on locally relevant economic evidence. The core objective of Thanzi la Onse is to improve population health and reduce health inequities in Malawi, Uganda, and Southern and East Africa. As such, Thanzi’s interdisciplinary and collaborative work packages will continue to seek to inform resource allocation decisions in the region, working closely with local researchers and policymakers. [box]We must create a collaborative approach to policy and systems development that is co-ordinated, coherent, and effective in the pursuit of UHC.[/box]
Related to our work on politics and governance of health, it was clear to see that realisation of health is a political process involving diverse stakeholders who are constantly negotiating for limited resources to meet the population’s needs to the greatest extent possible. Based on our research in Malawi, we shared our understanding how politics has shaped decision making in health in Malawi in order to stress the importance of considering politics as an important element of UHC delivery.
The message is clear: partnerships between researchers and policymakers are vital. Together, we must create a collaborative approach to policy and systems development that is co-ordinated, coherent, and effective in the pursuit of UHC. There is hope that the symposium will bring relevant and implementable solutions that policymakers can adopt, to ultimately achieve universal health coverage by 2030 (a target of SDG 3: Ensure healthy lives and promote well-being for all ages).
For further information about the SPEED Symposium, please visit: http://speed.musph.ac.ug/speed-symposium-2019/
By: Kath Devlin, Kenneth Katumba, Alan Msosa, Wingston Ng’ambi, Pakwanja Twea | 24th October 2019
