International Universal Health Coverage Day - "Health For All: Time for Action"

14 December 2023
Highlights

The United Nations officially designated 12 December as the “International Universal Health Coverage Day” in 2017, and this year’s theme for the UHC day is “Health For All: Time for Action”.

‘Leaving no one behind’ is a central promise of the 2030 Agenda for Sustainable Development and the best way to achieve this goal is through Universal Health Coverage (UHC), which means that all people – no matter who they are or where they live – can receive quality health services, when and where they are needed, without incurring financial hardship. These include the full spectrum of services from those designed to promote better health, prevent illness, and to ones focusing on providing treatment, rehabilitation and palliative care.

It is noted that progress towards achieving UHC and the Sustainable Development Goals (SDGs) by 2030 appears to be lagging, as indicated by the WHO and World Bank's global monitoring report of 2023 on tracking Universal Health Coverage.  The fact that approximately half of the world's population, or 4.5 billion people, was not covered by essential health services as of 2021 is a stark reminder of the substantial gaps in healthcare access. Additionally, the financial hardship experienced by two billion people in 2019 due to out-of-pocket spending on health, including 344 million people living in extreme poverty, underscores the urgent need for policy interventions to address these issues globally as well as at country level.

 The Sri Lankan health system is also facing severe challenges in its journey towards UHC in the context of the poly-crises in the country. As Sri Lanka moves into its next National Health Policy cycle 2026-2035, the country needs to carefully consider the demographic and epidemiological challenges and how they could be addressed to ensure equitable and quality provision of essential services.

WHO organized an event to mark the International Universal Health Coverage Day on 12 December 2023 in Colombo, with the participation of Dr Ramesh Pathirana Hon Minister of Health, Mr Sisira Jayakody, Hon Minister of Indigenous Medicine, Dr Palitha Mahipala, Secretary Health, other senior officials of the Ministry of Health and other government departments, UN agencies, development partners, academia and civil society organizations. The technical session of the event was focused on one of the key challenges faced by the Sri Lankan health system - care of the elderly. 

Sri Lanka is the fastest aging country in South Asia and the elderly population aged 60 years or more is increasing rapidly and is projected to be doubled by 2041. Aging populations pose unique challenges to healthcare systems, including increased demand for healthcare services, a higher prevalence of chronic conditions, and the need for a more holistic, and person-centered integrated approach. Developing systems for providing good quality long-term care for elderly who can no longer care for themselves without assistance also need to gain utmost importance.

Fostering Healthy Aging, developing, and maintaining the functional ability that enables well-being in older age so that people can take active part in society and enjoy an independent and high quality of life, will reduce dependency and healthcare costs in the future. To ensure Healthy Ageing, investment on PHC is important, and will help to expand disease prevention and health promotion interventions across the life course. Age-friendly environments–housing, transport, outdoor spaces, health and social care and other aspects of the broader community – also fosters Healthy Ageing, enabling older people to be and do what they value.

WHO Sri Lanka has been supporting the Ministry of Health in developing policies in Healthy Aging and community care implementation models and health service framework across life course, integrated with PHC targeted at the elderly population. The Directorate of Youth, Elderly and Disabled (YED) of the Ministry of Health, has adopted the Integrated Care for Older People (ICOPE) package for Sri Lanka with the support of WHO Sri Lanka. This package introduced by WHO in 2017 identified 13 evidence-based recommendations for health and care workers to help develop and carry out person-centered integrated care for older people at the community level. The ICOPE approach embodies the focus on optimizing intrinsic capacity and functional ability as the key to Healthy Aging. In Sri Lanka, primary care physicians and nursing officers have been trained as master trainers and multi-stakeholder advocacy meetings were conducted on the implementation of ICOPE in Colombo, Kandy, Anuradhapura and Matara districts. WHO supported the Ministry of Health on establishing national, provincial and district inter-sectoral committees on Healthy Aging. WHO also supported developing a national public awareness and promotional campaign targeting the improvement of healthy life expectancy of the elderly and training of the grass root level community leaders and youth leaders on Healthy Aging at district level.

Policy discussion on the International Universal Health Coverage Day focused on the areas of ensuring optimal delivery of quality essential health care services responsive to the needs of the older people, strengthening of the social support structures for elders and reaffirming the importance of life course approach to Healthy Aging. Discussions also highlighted the value of adopting affordable, integrated and person-centered service delivery models and comprehensive systems of long-term care, based in the communities. Global best practices which could be adopted to the Sri Lankan context were also highlighted during the session.

Dr Ramesh Pathirana, Hon Minister of Health, in his address thanked WHO and other UN agencies for their immense contribution over a long period of time to uplift the health care standards of Sri Lanka. He emphasized the importance of a multifaceted approach, top down and bottom up, bringing all stakeholders together to address the challenge of the ageing population.

Dr Palitha Mahipala, the Secretary Health addressing the gathering underscored the importance of comprehensive patient centered primary care as the path towards UHC and  highlighted the need for service integration at primary care level.

The WHO Representative to Sri Lanka Dr Alaka Singh reaffirmed WHO’s continued support to the country in strengthening PHC and accelerating progress towards UHC and SDG targets. She also highlighted the importance of better focus on a life course approach to support Healthy Aging and identify evidence-backed policy options.

Further policy discussions are planned over the coming months to identify exact policy options which could practically be implemented in the Sri Lankan context with the support of all stakeholders. Gathering of the key stakeholders on the International UHC day, who are pivotal in driving the UHC agenda in the country represented a decisive moment for Sri Lanka to recommit to its health goals and harness the collective efforts of government and partners to drive a positive change, ultimately leading to improved health outcomes and progress towards UHC and SDG targets.

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