Looking back to pave the way forward toward health for all

This year’s Universal Health Coverage (UHC) Day comes just weeks before the start of a new decade. As global advocates come together to ask world leaders to keep the promise of health for all, we’re reflecting on country-led progress from the past ten years that holds important lessons for the path forward.

• Sri Lanka: Keeping a finger on the pulse of a population’s evolving health needs: In 2013, the Sri Lankan government began a partnership with the World Bank to strengthen primary health care to address malnutrition and the increasing impact of non-communicable diseases (NCDs) on a rapidly aging population. In a five-year period, they equipped and trained 4,000 clinics to provide quality maternal and child health services and dramatically increased the availability of NCD treatment in the vast majority of primary health care facilities across the country. After seeing such great success, the World Bank renewed its support in 2018 for the Ministry of Health’s next phase of ambitious primary health improvements, focusing on the detection and management of NCDs, which are the cause of 87% of deaths in the country.
• Rwanda: Spending on what matters to speed up progress toward health for all: Rwanda has proven that strong political leadership to make important policy decisions and drive resources to address key drivers of quality primary health care – combined with an approach that recognizes the importance of community involvement -- can pay off in a big way. Building on a program built in the previous decade, by 2015, the country drastically reduced the financial burden of health services by implementing an innovative community-based health insurance scheme, helping to cover 88% of its population – the highest enrollment in Sub-Saharan Africa. Because of this and investments in other strategic tactics, Rwanda has seen major progress in improved health outcomes.
• Argentina: Bolstering the health workforce to create a stronger health system: In 2011, Argentina began collecting data through its flagship health program to better understand and support health providers – the people who form the backbone of primary health care delivery. The country used its findings to bolster providers’ motivation and capacity to do their jobs well. This helped boost retention and satisfaction, ultimately paving the way for the health workforce to become real partners in linking communities to the health system and in improving the quality of service delivery.  
• Ghana: Unlocking the power of data for scaling up health system improvements: In the early 2010s, Ghana faced difficulties scaling up the widely successful pilot of its Community-Based Health Planning and Services (CHPS) program, which uses community health workers to reach rural and poor populations who have historically been left behind by traditional health programs. The country invested in a new data collection intervention to pinpoint weaknesses and identify solutions to the problems that were holding back efforts to improve the quality of health care services nationwide. Today, CHPS now reaches more than 4,576 communities across all of Ghana’s 216 districts and serves as a blueprint for how countries can use data to scale up primary health care improvements.

Achieving UHC will look different everywhere, but these examples show us what’s possible when countries and development partners focus on primary health system improvements grounded in quality data collection and use, strong policy leadership, and a deep understanding of peoples’ and communities’ needs. At PHCPI, we’re committed to helping countries use tools like the Vital Signs Profiles to create the roadmaps we need to make the next 10 years a banner decade for health for all.