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Towards Universal Health Coverage...

We're supporting universal health coverage through research and technical assistance in four key areas: strengthening health systems, improving financing for health, responding to Covid-19, and supporting community health workers.

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Universal health coverage (UHC) ensures all people, everywhere, can get the quality health services they need without financial hardship. In many countries, inadequate health coverage means high rates of avoidable death, ill health and poverty: at least half of the world’s population lacks access to essential health services, and out-of-pocket expenses for health care drive almost 100 million people into poverty each year.

Health coverage is affected by a range of factors within the health system and beyond – including weak basic health infrastructure; shortages of skilled health workers and medicines; socioeconomic conditions and gender norms that impede access to care and drive ill-health; and underinvestment, particularly in primary health care.

UHC day is a call for rapid and increased work to make health systems equitable, resilient, and capable of meeting everyone’s needs.

Our health practice has supported progress towards UHC through research and technical assistance across countries and health system areas. Below, we highlight resources related to three key areas of current work.

Strengthening health systems

Access to high quality, equitable health care depends on strong health systems.This requires adequate hardware, including health workers, funding and information systems, and supportive health system software, such as management processes and norms among health system actors. Strong governance at national and local levels underpins effective health management and service delivery.

Covid-19 has highlighted again the importance of investing in strong basic health systems – robust foundations are needed to manage shocks such as disease outbreaks and other emergencies. However, resilience also requires specific capacities for emergency preparedness and response, such as surveillance systems and surge capacity, and capacities to adapt around ongoing or recurrent stresses. The importance of resilience is particularly evident in fragile countries affected by conflict and other shocks, where progress towards UHC is often slowest.

Our work on health system strengthening spans a range of areas – including research, evaluation, and technical assistance on national and sub-national governance, performance management, health planning and data use, financial systems, health workers, community engagement, and health system resilience.

Improving financing for health

To achieve universal health coverage, countries need to invest more in health and optimise health spending. Health financing refers to raising and pooling funding for health, and strategically purchasing health services to ensure that everyone has access to the health services they need without suffering financial hardship. Health financing mechanisms should be designed to consider efficiency, effectiveness, equity, and sustainability.

The double health and economic shock caused by the Covid19 pandemic has strained health financing systems. Donors and national governments alike are prioritising health spending to combat the pandemic, but they face fiscal space constraints during this period of economic recovery that could threaten gains made in critical health areas, particularly maternal and child health, HIV, TB, and malaria, and achievement of the health-related Sustainable Development Goals. Improved efficiency in health spending and innovative health financing approaches are needed given this context.

Our work on health financing includes health insurance and financial protection; strategic health purchasing (including performance-based financing, capitation and diagnosis-related group funding models); public financial management; evidence generation and analytics (such as fiscal space analysis, costing); policy development, implementation, and institutionalization; and capacity development. We use a multidisciplinary and multisectoral approach to health financing that results in successful reforms with lasting impact.

Responding to Covid-19

Covid-19 has affected health systems in myriad ways. As well as changing health care needs, and requiring new strategies for treatment and prevention, Covid-19 and the associated public health measures have constrained the ability of health systems to provide routine care – affecting supply chains, adding to workloads and requiring funding that would have supported other essential health services. Concerns about Covid-19 infection,  risks of quarantine, and financial and mobility constraints resulting from lockdowns have also reduced community willingness and ability to access care.

We have been supporting government and development agencies to understand the effects of Covid-19 on health and health systems, to evaluate responses, to support the design and implementation of strategies to address Covid-19, and support wider health system resilience for future emergencies. Examples include working with the government of Ethiopia to strengthen public health emergency management capacity through Building Resilience in Ethiopia (BRE), examining the effects of Covid-19 on essential health services and ways to maintain service continuity, researching women’s roles in strengthening community and household resilience, examining lessons from early government responses across countries, providing advice for governments through epidemiological modelling, and identifying lessons from strategies for Covid-19 vaccine rollout

Community health workers

Community health workers play a key role in UHC. They have been increasingly recognised as a cornerstone of effective primary health care, and as supporting delivery of a range of preventive and curative health services. CHW provide a crucial link between the formal health system and the communities they serve, helping to enhance access and equity. However, it is also increasingly recognised that CHW need support to optimise their role, including support with skills, resources and management to enable effective service delivery, and support for CHW motivation and wellbeing. The role of CHW has been highlighted again during Covid-19, with CHW playing critical roles in areas such as surveillance and community awareness, but sometimes lacking the required support in areas such as protective equipment and experiencing high workloads.

We have worked with partners to support an effective CHW role through a range of research and evaluations, including examining progress with health programmes designed to strengthen CHW services, operational research to strengthen nutrition services provided by CHW, analysing effective approaches to CHW supervision, and documenting CHW experiences during Covid-19 to identify ways they can be better supported.

Get in touch with our health experts here:

Tata Chanturidze  leads the Health and Nutrition Practice and   is a Principal consultant in Health Systems Governance and Financing at OPM . Being a Medical Doctor, with an MPH from Emory University, USA, she brings 20 years’ experience in health sector policies and reforms, governance, service organisation and delivery, health financing and …

Kate Gooding

Senior Consultant

OPM United Kingdom

Kate is a research and evaluation specialist in the health team's monitoring and evaluation hub. She has broad global health and international development experience, and particular expertise in qualitative methods and theory-driven evaluation.

Ruhi Saith

Senior Consultant

OPM India

Ruhi Saith is a medical doctor from India, with a PhD in Medicine from Oxford University and a Master’s degree in Public Health from the London School of Hygiene and Tropical Medicine. She works in Public Health, including broader determinants of health like nutrition and WASH . She has more than 20 years experience in the development …

Vimal Kumar

Principal Consultant

OPM India

Vimal Kumar has more than 30 years' work experience in the corporate, and international development sectors. He has managed large-scale and complex procurement and logistics projects. His key skills are strengthening procurement and logistics system across its components and strengthening the capacity of organisation and staff across supply chain.
Louise is a Principal Consultant within OPM’s Health and Nutrition portfolio. She has a background in mathematics and over two decades of experience in management consulting and operational delivery across health and life sciences, public sector, and health insurance, with a particular focus on health financing across both the public and private …
Nikita has been working with OPM for four years. She works extensively on public health, nutrition and sanitation projects. Her expertise is in M&E and qualitative research and has been part of a range of impact and process evaluations, operational research related projects based in India as well as Africa. Selected publications: …
Mahwish Haydee

Mahwish Hayee

Pakistan Health Lead

OPM Pakistan

Mahwish Hayee is a medical doctor, with a Master's degree in Public Health from Kings College London, and a PhD in Public Health from Lancaster University. She works in Public Health, health systems strengthening projects, and quantitative research. She has more than 15 years' of experience in the field of public health.
Daniel is a Senior Project Manager in the health practice at OPM. He has 13 years of experience in project and programme management of development initiatives across a range of sectors. He holds a degree in Development Studies from the University of East Anglia, and project management qualifications including PRINCE2, Agile, and Project DPro. He …
Bilal Hakeem is a monitoring and evaluation expert with over 10 years of experience in designing and implementing complex monitoring and evaluation projects for large multi-country health and nutrition programmes in low and middle-income countries. He is skilled in the design and use of quantitative data collection and analysis, data quality …

Cindy Carlson

Senior Principal Consultant, Health Systems Strengthening

Cindy is a Senior Principal Consultant for Health System Strengthening with OPM. She currently is Project Director for the UNAIDS Technical Support Mechanism and supports the Bill and Melinda Gates Foundation funded Bihar Learning and Innovation project. Cindy has over 30 years' experience in public health and development management, working …