Universal Health Coverage Analysis
Universal Health Coverage (UHC ) is a multi-dimensional goal and not easily achievable in low and middle-income countries (LMICs). Ensuring physical access to high-quality health services throughout low and middle income countries is one aspect of this. Rural areas have health systems challenges and needs that differ from urban areas, but need to be effectively addressed to achieve UHC. Improving the quality of health services through systems thinking is a mechanism to achieve UHC.
What is Universal Health Coverage?
The World Health Organization (WHO) defines UHC’s goal as “… to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” (WHO, 2012) . The financing …show more content…
Distance complicates getting supplies, building facilities, hiring and retaining staff, and supervising facilities (Leonard and Masatu 2007). Challenges with service provision in rural areas range from low quality of provider care to lower overall quality of services. As noted by Das, et al (2008) in their study of health provider competence through patient-visit vignettes, both provider competence and visit quality were lower in rural areas than in urban areas. Leonard (2007) found a similar situation in rural Tanzania. In maternal and newborn health, Esan and Fatusi (2014) found lower performance in rural areas than in urban areas in Nigeria. Gauthier (2011) found lower quality in rural health facilities than in urban health facilities in …show more content…
De Savigney and Adam (2009) define systems thinking as:
…an approach to problem solving that views ‘problems’ as part of a wider, dynamic system. Systems thinking involves much more than a reaction to present outcomes or events. It demands a deeper understanding of linkages, relationships, interactions, and behaviours among the elements that characterize the entire system. (pg.33)
Systems thinking holds important relevance to health systems: Atun (2012) argues that health systems are “dynamic complex” systems while Gilson (2014) refers to health systems as “complex adaptive systems”. Each of these terms connote similar important qualities outlined by both authors: health systems contain multiple parts, they change, and the parts are interrelated. This is a context in which single-issue interventions can have limited effectiveness because they fail to take into account the multiple components of the system that impact the intervention (Atun, 2012; Gilson, 2014). In rural areas, health facilities and actors are likely to have less contact with centralized monitoring and training bodies, which may make systems thinking a particularly important point of intervention in rural areas to couch improvements within the complex dynamics of the