Research and universal health coverage

The report summarized its three key messages as follows:1. “Universal health coverage, with full access to high-quality services for health promotion, prevention, treatment, rehabilitation, palliation and financial risk protection, cannot be achieved without evidence from research. Research has the power to address a wide range of questions about how we can reach universal coverage, providing […]

The report summarized its three key messages as follows:
1. “Universal health coverage, with full access to high-quality services for health promotion, prevention, treatment, rehabilitation, palliation and financial risk protection, cannot be achieved without evidence from research. Research has the power to address a wide range of questions about how we can reach universal coverage, providing answers to improve human health, well-being and development.
2. All nations should be producers of research as well as consumers. The creativity and skills of researchers should be used to strengthen investigations not only in academic centres but also in public health programmes, close to the supply of and demand for health services.
3. Research for universal health coverage requires national and international backing. To make the best use of limited resources, systems are needed to develop national research agendas, to raise funds, to strengthen research capacity, and to make appropriate and effective use of research findings.”
‘Why universal health coverage?’ and revealed that in 2005, all WHO Member States made the commitment to achieve universal health coverage. The commitment was a collective expression of the belief that all people should have access to the health services they need without risk of financial ruin or impoverishment. Working towards universal health coverage is a powerful mechanism for achieving better health and well-being, and for promoting human development. It further explained that the two facets of universal health coverage are: the provision of, and access to, high-quality health services; and financial risk protection for people who need to use these services.
The report attempted to answer the most important question of ‘Why research’ and what questions need to be answers to ensure universal health coverage. It observed that ‘Scientific research has been fundamental to the improvement of human health. Research is vital in developing the technology, systems and services needed to achieve universal health coverage. On the road to universal coverage, taking a methodical approach to formulating and answering questions is not a luxury but a necessity.’ In this report, research is the set of formal methods that turns promising ideas into practical solutions for improving health services, and consequently for improving health. The goal of the report is to identify the research questions that open the way to universal health coverage and to discuss how these questions can be answered.
It further observed that many recent advances have been made in health service coverage and in financial risk protection as shown, for example, by progress towards the United Nations
Millennium Development Goals (MDGs). Despite this progress, the gap between the present coverage of health services and universal health coverage remains large for many conditions of ill-health in many settings. For instance, nearly half of all HIV-infected people eligible for antiretroviral therapy were still not receiving it in 2011, and an estimated 150 million people suffer financial catastrophe each year because they have to pay cash out-of-pocket for the health care they need. The focus of this report is on the research needed to provide wider access to essential services of this kind, and how to create the environment in which this research can be carried out.
 It also identified research questions of two kinds. ‘The causes of ill-health differ from one setting to another and so too must the necessary health services, including mechanisms for financial risk protection. The first group of questions therefore asks how to choose the health services needed in each setting, how to improve service coverage and financial protection, and consequently how to protect and improve health and well-being.’
These questions throw up a wide range of topics for research. Research is needed to find out how to improve the coverage of existing interventions and how to select and introduce new ones.  The most pressing research questions have been identified for many specific health topics, such as maternal and child health, communicable diseases, and health systems and services. Although there are notable exceptions, less effort has generally been given worldwide to establishing and publicizing national research priorities, to assessing the strengths and weaknesses of national research programmes, and to evaluating the health, social and economic benefits of research.
The second group of questions asks how to measure progress towards universal coverage in each setting for each population, in terms of the services that are needed and the indicators and data that measure the coverage of these services. Many specific indicators, targets and data sources are already used to measure the coverage of specific health interventions. The metrics used to monitor progress towards the MDGs track, for example, access to antiretroviral therapy, births attended by skilled health personnel, and immunization coverage. The report provided exciting observation which shows that research is likely to be most productive when it is conducted within a supportive national research system. Countries are expected to set research priorities, to develop research capacity, to define norms and standards for research, and to translate evidence into practice.
It also observed that ‘with regard to strengthening capacity, effective research needs transparent and accountable methods for allocating funds, in addition to well-equipped research institutions and networks. However, it is the people who do research – with their curiosity, imagination, motivation, technical skills, experience and connections – that are most critical to the success of the research enterprise.’
 
All comments to Dr Aminu Magashi at [email protected]