Malawi: Universal Health Coverage Commitment 2019
By Maziko Matemba, Director, Health and Rights Education Programme (HREP)
A healthy living will always be of utmost priority to every individual despite society marginalization and differences. From one age group to the other, from one tribal race to the next, regardless of disability and other experiences, lies a distinct commonality among us all and that is our health and the right to live healthy. We crave access to high-quality services that offer prevention, treatment, rehabilitation, and palliative care, including access to essential medicines and vaccines without facing any financial barriers. We must have accountability on how those services are being delivered to us.
More than half of the population in Africa experiences inadequate access of medicines and other quality medical interventions and technologies. Many nations in Africa are fighting against a high burden of disease and there are alarmingly high mortality rates, especially in rural areas. Within the African context millions of people die every year from preventable diseases holding 24% of the global health morbidity and world highest under-five mortality with one child death out of 13 children under the age of five. In terms of communicable disease, 70% of people living with HIV worldwide live in countries in Africa. There is a 25% incidence rate of Tuberculosis deaths in Africa when it holds just 16% of the world’s population.
Children, youth, women and other vulnerable people are being pushed into extreme poverty because our health systems currently require pay higher prices for good health care with over 800 million spending at least 10% of our household budgets into paying for health care. If accessing good quality health services requires paying high fees, then what happens to the minority in both the urban and rural areas whose earnings cannot even cover half of the fee? A high number of people living in the rural and township areas opt to go to community health care centers or district hospitals since the services are defined as free but do they get the exact health care that they needed or the only advantage is that the services are free?
Civil society and community members are raising the needs for government accountability. We declare how much our health systems need strengthening to address the many disparities and inefficiencies that need fixing starting from the top levels of management to the bottom. The supply chain is one major element causing health system leakages. Policymakers must establish measures to eliminate the theft of medical equipment and drugs, especially in the public sector. The supply chain must be monitored to ensure that all health facilities are equipped with proper and adequate medical equipment.
Comprehensive primary health care (PHC) should be delivered and placed at the center efforts to reduce all incidences that cause burdens of diseases including sexual and reproductive health and rights, non-communicable diseases and adolescence health. Shaping PHC priorities must engage a wide range of stakeholders to address issues like the social, economic, commercial and environmental determinants of health.
Most of the African countries, including Malawi, should invest more in human resources. Low health budgets contribute to persistent shortage of health personnel, despite availability of a well-trained health workforce. A proactive approach is needed to help health facilities recruit trained medical personnel and improve their compensation. Under the same factor of expenditure our nations should increase domestic expenditure and financing for health in order to moving towards a 5% of the annual GDP as government health care expenditure to achieve the required SDG target of 3.8.1 with a concrete plan of ensuring removal of direct cash payments as part of urgent measures for it is everyone’s right to living healthy and having access to full primary health care and effective health systems with an excellent provision of good health personnel’s.
Let’s build on the momentum and commitment taking shape around the UN High-level meeting on Universal Health Coverage and moving towards improved primary health care and health systems is critical to meeting essential health needs.
