By Prof. Francis Omaswa
We as humans are by nature empathetic, social and capable of collaborating in mutuallysupportive ways for the individual and common good. Naturally, we are saddened when we see human suffering. Likewise, we are cheered when we witness success. Yes, we also have in us negative non-cohesive tendencies such as selfishness and greed, jealousy and aggression. Ultimately, however, the common good tendencies predominate. This is the reason why we have collectively overcome vices such as ending slavery and apartheid. Indeed, negotiating and adopting the Sustainable Development Goals (SDGs) is an example of the success of our cohesive tendencies. How is this interplay currently impacting the achievement of Universal Health Coverage (UHC)?
Previously, health was classified as a cost without economic returns. However there is sufficient evidence that proves that investing in health has high economic and social returns.
Leading economists such as Sir Paul Collier, Professor of Economics and Public Policy at Oxford University and formerly Chief Economist at the World Bank regrets that for the last 40 years, they have been teaching wrong economics of greed and profit. There is now need to unlearn that wrong teaching and replace it with teaching that links economics to humanity, empathy and the social cohesiveness. This is well articulated in his book “The future of capitalism”
So, what are the practical implications of all this for UHC? The first message is that health and wellbeing should now be reclassified as central to economic and social growth and political action. It is the primary goal of all the SDGs. The unlearning of the discredited economics teaching needs to be deliberately embarked upon so that there is change of behavior in the ministries of finance, other related agencies and sectors. This will need deliberate and purposeful work with clearly defined measurable outcomes.
Secondly, we must work to advocate for societies and communities that value social cohesion. We must embed health in the routine governance of society so that people are encouraged and supported to appreciate their individual and collective participation as both a duty and right, as part of the empathic human social beings. This will be achieved through people centered Primary Heath Care with strong community health systems as the foundation for UHC; starting now with the available resources.
UHC is not new. In fact, it is a renaming of Health for All movements articulated 40 years ago. Through existing national policies and strategies, Uganda has already been implementing UHC and has the structures in place for operationalization. . These include well defined Community Health system with Village Health Teams (VHTs), Health Unit Management Committees, District Health Management teams and intersectoral structures. For instance, at the village level, VHTs are expected to maintain HMIS Form 095 as the village health registers for all households. The VHT undertake oversight on immunization coverage, pregnancy monitoring, and community case management for common illnesses. These also include monitoring waste management pit latrine coverage, access to safe water sources, among others. Why are these not being implemented to scale?
As Uganda celebrates this UHC day on 12 December, 2019, this is a call to us all in to take individual and collective action to implement existing policies and strategies using the resources available to us now. An additional call goes to all those in leadership positions including cultural, religious and political to take responsibility within your communities. All these should familiarize themselves with HMIS Form 095 which is very rich. The population should also be familiar with these instruments and hold duty bearers to account. The writer is the Executive Director of the African Center for Global Health and Social Transformation (ACHEST)