Universal health coverage in the African Region

Dr Matshidiso Moeti
WHO Regional Director for Africa

Dr Matshidiso Moeti, WHO Regional Director for Africa

Complex and emerging health challenges in the African Region, linked to rapid urbanization, globalization and public health emergencies of international concern, have coalesced to demand more innovative approaches to the planning and implementation of health services in the African Region and at country level.

Universal health coverage (UHC) aims to provide health care and financial protection to all people in a given country with three related objectives: equity in access – everyone who needs health services should get them, and not simply those who can pay for them; quality of health services – good enough to improve the health of those receiving the services; and financial-risk protection – ensuring that the cost of health care does not put people at risk of financial hardship. It is a powerful concept in public health, and one of the key areas of progress in health in the African Region.

Universal health coverage is one of the strategic priorities of the World Health Organization. When I addressed the 136th Session of the WHO Executive Board in Geneva in January 2015, at the time of my appointment as Regional Director for the African Region, I made the commitment to “work very hard in driving progress towards equity and universal health coverage in our Region”. This commitment is embodied in the Africa Health Transformation Programme 2015–2020: A vision for UHC, a strategy that will guide the work of our Regional Office during the next five years.

Some countries in the Region are already implementing strategies to improve access and coverage of health services, while others have made commitments to take measures towards UHC. As countries in the Region move towards UHC, it is vital to understand the challenges and constraints they are facing, identify skills shortages and capacity-building needs, and also learn from their experiences.

This special issue of the African Health Monitor has a dual objective: firstly, it offers an overview of research on the subject of UHC in Africa; and secondly, it provides wider dissemination of research results presented and discussed in African scientific meetings. All the articles of this special issue originated from presentations made during the African Health Economics and Policy Association (AfHEA) 3rd biennial scientific conference held in Nairobi in March 2014. Eleven of the 188 presentations made at the conference were selected by a joint team of WHO staff and AfHEA members and expanded into full papers for publication in the Monitor. With their focus on UHC, they cover themes such as performance-based financing, equity and quality of care, community-based health insurance and health vouchers, and the impact of allocation of resources in the context of exemption. The articles also describe the achievements and challenges countries face when implementing reforms and introducing policies and strategies towards UHC.

Universal health coverage in the African Region – the subject of this special issue of the Monitor – is a high priority and I call on all policy-makers, researchers, academics and health workers to read this issue and provide suggestions for future work in support of UHC in the Region. I take this opportunity to encourage Member States to implement, monitor and evaluate the progress of UHC in their respective countries, as well as to conduct research to provide evidence and disseminate best practice. Finally, I commend the AfHEA for their initiative in organizing their biennial scientific conference and would encourage WHO partners to provide support to the AfHEA and other African health associations fostering research in public health in the Region.



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