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» » A case for universal health coverage

Taona Tivafire / Tatenda Chamisa (ZiMSA)
Universal Health Coverage #HealthForAll.
Taona Tivafire / Tatenda Chamisa (ZiMSA)
Gogo Sibanda is a resident of Zvikomo village in the deepest part of Zaka. She has problematic hypertension and asthma. The closest health centre is about 12 km away yet she has to go to the health centre every month to collect her medical supplies and her only mode of transport is a bartered scotch-cart and two donkeys. Approximately it takes her three hours to reach the clinic, and her grandson, Tamuka has to lose a day of school every month.
Somewhere across the province, there is Jaden, a 21 year old man living in Flamboyant Street, Rhodene, in Masvingo. He sprained his ankle while playing soccer with his friends. The nearest health centre is some five minutes away from his house. He tells his friends that he wanted to go to Dr Phiri`s surgery, but they insist that he goes to Makurira Memorial Clinic and get his x-rays from one of the diagnostic labs in town.
Health is a basic need for every human being. It is one of the undisputed rights and should be readily available at everyone`s disposal. Primary health care is essentially the provision of healthcare services that are affordable, accessible, applicable, relevant and acceptable to everyone in the community. The 7th of April of each year has been set aside as the World Health Day following the birth of the World Health Organisation (WHO) on the same date in 1948. This year`s theme is Universal Health Coverage. #Health for All.
Universal Health Coverage (UHC) is about ensuring that all people can get quality health services, where and when they need them, without suffering financial hardship. As seen above, Gogo Sibanda clearly is at a disadvantage when it comes to accessibility of healthcare facilities. This is something which is common in Zimbabwe's remote and rural areas. Access to health facilities is so difficult that in some instances, the patients decide to stay with their illness and only visit the clinic when the pain becomes unbearable, and at times it will be too late.
UHC entails access to health workers. Every citizen should be able to use the services of a health worker when they are in need of them. In trying to curb the problem of shortage of health practitioners, the Ministry of Health and other Non-governmental Organisations (NGOs) have implemented the training of village health workers. These are people from the community that live within the community and have been trained to provide information, mobilise people for health campaigns and offer some help to the locals so that they can reach the health facility. This initiative, adapted from countries like Cuba and China, has made primary health accessible to people even in the most remote areas.
The quality of services offered also determines the extent of UHC. Jaden has access to a variety of doctors and other health services like X-rays and scans. On the contrary, Gogo Sibanda only has access to the village clinic, where the doctor visits twice in a month. The quality of services offered is thus way different. Most village clinics are manned by nurses only, and at times they are not enough to carry the load. This affects the way they interact with patients because of burnout and hence the quality of services offered becomes compromised. In big hospitals as well, there is shortage of some required equipment for the provision of the desired health services. Many patients have been told to go back home or to other countries because our hospitals lack some of the equipment. We call out to the Government that they consider improving the quality of health services by ensuring that the hospitals have enough equipment and enough human resources with expertise. Health provision also extends to the medication offered, whether it is relevant, and also whether it is affordable and acceptable to everyone.
But how can we as Zimbabwe achieve UHC. We are already on the right track with the recent introduction of removal of hospital fees for patients under the age of 5, over the age of 65 and for pregnant women. So much more can be done with the aid of a strong will. We should advocate for a health care delivery system which is
·         Of quality
·         Available,
·         Accessible,
·         Equitable  to everyone
UHC is only achieved with a strong political will. It is the policies that are enforced that determine whether #HealthForAll is achieved. The government should come up with policies that are inclusive, from an infant in the deepest parts of the country to a 94-year old in the lavish comfort of the city suburb. UHC ensures that everyone gets the services without any financial hardship. In trying to address this, the government scrapped off payment of health services for patients under the age of 5, the elderly and the pregnant mothers. Though UHC tries to remove the financial burden, it does not mean that every health service procedure should be free, but rather the basic services.
The Bible talks of a perishing people because they lacked knowledge. Another function of UHC is that information is adequately disseminated and it reaches every ear. Every citizen should have the knowledge about the health service system in the country, information on how to access and use the services and also information on health related topics. Information empowers people. Some diseases can be avoided because the people know what to do to avoid them.
So in conclusion, the head of the World Health Orgnisation once said "Universal Health Coverage is the single most powerful concept that public health has to offer". With this concept being implemented in our nation, we can have people like Gogo Sibanda enjoying the accessibility and affordability of health services.
Please note that the names used in this article are fictious. .  
Tatenda and Taona are Third Year Medical Students at MSU and are members of the Zimbambwe Medical Students`Association (ZiMSA).education

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