How will private healthcare evolve under UHC?

Dr Rufaro Chatora, WHO country representative

However, in which ever way, shape or form it manifests itself, universal health coverage (UHC) is inevitable. It forms part of the United Nations’ sustainable development goals. “To promote physical and mental health and well-being and to extend life expectancy for all, we must achieve universal health coverage and access to quality healthcare. No one must be left behind. This places UHC as the target that underpins and is key to achievement of other Goal 3 targets.”

Set of goals

According to Dr Rufaro Chatora, World Health Organisation (WHO) country representative says UHC provides a set of goals rather than tell us how to organise a health system. “This is logical as each country faces different challenges in organising its health system when all people have access to quality health services.

“Universal health coverage is a journey not an event, and even some of the richest countries struggle to maintain and extend their levels of coverage, quality and financial risk management.”

Some of the challenges government face are weak regulation, which affects the levels of care including inappropriate care by unqualified providers. The government’s response has been to prohibit or ban inappropriate private practice, or control providers through legislation or self-regulation, he says.

Potential role

Currently, the private sector provides about 50% of health services. And in low to medium income countries, it comprises corporate hospitals, independent sole practitioners and retail pharmacists.

The private sector can therefore fill the gap in service coverage because they are usually located in communities, do better in responsiveness and tend to respond to market opportunity.

“Service providers in the private sector can assist with addressing common problems such as complementary services in prevention, the primary, secondary and tertiary care continuum, and encourage improvements in service and quality through training, accreditation or subsidies, or engage directly using public funds, as well as partner with government on stewardship on training and licencing,” he says

“The central issue is often financial risk protection. Hence it’s better to think of the intermediate objectives of UHC. These are equity in resource distribution, efficiency and transparency and accountability. It now becomes easier to define specific actions, for example in pooling, that will result in equity in resource distribution, and these may contribute to utilisation based on need and financial protection. It is important to remember that there usually are several causes contributing to the same problem,” Chatora says.