Harnessing knowledge for the design and implementation of Universal Health Coverage

Health is essential for exercising all other rights and it’s a resource for people to lead individually, socially and economically productive lives. Still health remains an imbalanced space with certain communities marginalised, particularly women and people living in resource constrained settings. The opportunities to participate and exercise voice in health are directed by the provision of health resources and material. Universal Health Coverage (UHC) places people and communities at the center through the provision of promotive, preventive, curative, rehabilitative and palliative health care services, that such services are of effective and of sound quality, while ensuring that the uptake of these services does not expose people to financial hardship.

Against this backdrop, the South African Medical Research Council with the National Department of Health, hosted a two-day UHC symposium attended by the National Department of Health, representatives from the SAMRC, health researchers, provincial health departments, international non-governmental organisations and front line health workers. The Symposium was held on Thursday, 21 and Friday 22 November 2019 at the Southern Sun OR Tambo International Airport in Johannesburg.

Prof Helen Schneider, Prof Glenda Gray, Minister Dr Zwelini Mkhize and Dr Fareed Abdullah

The SAMRC aims to build a bridge between the body of health systems researchers that conduct high quality research together with decision-makers in government all the way from the Minister of Health and his officials in Pretoria through to the provincial and institutional level leadership and management of the health system with a view to providing decision makers with more evidence and better data on which to make decisions.

The Symposium held in the form of plenaries and parallel sessions, explored topics of health financing, National Health Insurance (NHI), front line health workers, health data information and decision making, maintaining quality under the NHI, leadership and management and supply side regulatory challenges for UHC.

The Symposium helped to elucidate on aspects of the NHI as a broader project to enhance the health system, to unravel the interplay between health systems design and health financing reforms, and managing budget cuts while maintaining quality at provincial level. The collective sentiment was that financial reforms can be tested under the current legislative framework.

Delegates further reflected on issues of systems development and data mining to improve efficiency and quality, developing tools to encourage social accountability at the district level, looking at a whole system approach to enact change for nurturing leadership and management techniques, and developing a body of knowledge on UHC in the South African context to inform policy making. Delegates recognised that there is a dearth of research on regulation in the private health care system, resulting in, for example, an incomplete regulatory environment for medical schemes.

In conclusion, there is a wealth of knowledge, experience and expertise in health systems research in South Africa and continuous dialogue and in depth discussions on UHC is needed. One of the key outcomes would be to bridge the divide between health systems research and policy making.

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View the Universal Health Coverage National Dialogue website