Universal health information is essential for universal health coverage.

Universal access to health information is a human right and essential to achieving universal health coverage and the other health-related targets of the sustainable development goals. The COVID-19 pandemic has further highlighted the importance of trustworthy sources of health information that are accessible to all people, easily understood and acted on. WHO has developed Your life, your health: Tips and information for health and wellbeing, as a new digital resource for the general public which makes trustworthy health information understandable, accessible and actionable. It provides basic information on important topics, skills and rights related to health and well-being. For those who want to learn more, in-depth information can be accessed through links to WHO videos, infographics and fact sheets. Towards ensuring access to universal health information, this resource was developed using a structured method to: (1) synthesise evidence-based guidance, prioritising public-oriented content, including related rights and skills; (2) develop messages and graphics to be accessible, understandable and actionable for all people based on health literacy principles; (3) engage with experts and other stakeholders to refine messages and message delivery; (4) build a digital resource and test content to obtain feedback from a range of potential users and (5) adapt and co-develop the resource based on feedback and new evidence going forward. As with all WHO global information resources, Your life, your health can be adapted to different contexts. We invite feedback on how the resource can be used, refined and further co-developed to meet people's health information needs.

Achieving universal health coverage and sustainable development goals by 2030: investment estimates to increase production of health professionals in India.

BACKGROUND: COVID-19 has reinforced the importance of having a sufficient, well-distributed and competent health workforce. In addition to improving health outcomes, increased investment in health has the potential to generate employment, increase labour productivity and foster economic growth. We estimate the required investment for increasing the production of the health workforce in India for achieving the UHC/SDGs. METHODS: We used data from National Health Workforce Account 2018, Periodic Labour Force Survey 2018-19, population projection of Census of India, and government documents and reports. We distinguish between total stock of health professionals and active health workforce. We estimated current shortages in the health workforce using WHO and ILO recommended health worker:population ratio thresholds and extrapolated the supply of health workforce till 2030, using a range of scenarios of production of doctors and nurses/midwives. Using unit costs of opening a new medical college/nursing institute, we estimated the required levels of investment to bridge the potential gap in the health workforce. RESULTS: To meet the threshold of 34.5 skilled health workers per 10 000 population, there will be a shortfall of 0.16 million doctors and 0.65 million nurses/midwives in the total stock and 0.57 million doctors and 1.98 million nurses/midwives in active health workforce by the year 2030. The shortages are higher when compared with a higher threshold of 44.5 health workers per 10 000 population. The estimated investment for the required increase in the production of health workforce ranges from INR 523 billion to 2 580 billion for doctors and INR 1 096 billion for nurses/midwives. Such investment during 2021-2025 has the potential of an additional employment generation within the health sector to the tune of 5.4 million and to contribute to national income to the extent of INR 3 429 billion annually. CONCLUSION: India needs to significantly increase the production of doctors and nurses/midwives through investing in opening up new medical colleges. Nursing sector should be prioritized to encourage talents to join nursing profession and provide quality education. India needs to set up a benchmark for skill-mix ratio and provide attractive employment opportunities in the health sector to increase the demand and absorb the new graduates.

Prevention and treatment of infectious diseases in migrants in Europe in the era of universal health coverage.

Some subpopulations of migrants to Europe are generally healthier than the population of the country of settlement, but are at increased risk of key infectious diseases, including tuberculosis, HIV, and viral hepatitis, as well as under- immunisation. Infection screening programmes across Europe work in disease silos with a focus on individual diseases at the time of arrival. We argue that European health-care practitioners and policy makers would benefit from developing a framework of universal health care for migrants, which proactively offers early testing and vaccinations by delivering multi-disease testing and catch-up vaccination programmes integrated within existing health systems. Such interventions should be codeveloped with migrant populations to overcome barriers faced in accessing services. Aligning policies with the European Centre for Disease Prevention and Control guidance for health care for migrants, community-based preventive health-care programmes should be delivered as part of universal health care. However, effective implementation needs appropriate funding, and to be underpinned by high-quality evidence.

Building back better children's surgical services toward universal health coverage: Perspectives from Bangladesh and Zimbabwe.

Introduction: This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Children's surgical services are crucial, yet underappreciated, for children's health and must be sufficiently addressed to make and sustain progress toward universal health coverage (UHC). Despite their considerable burden and socioeconomic cost, surgical diseases have been relatively neglected in favor of communicable diseases living up to their inauspicious moniker: 'the neglected stepchild of global health'. This article aims to raise awareness around children's surgical diseases and offers perspectives from two prototypical LMICs on strengthening surgical services in the context of health systems recovery following the COVID-19 experience to make and sustain progress toward UHC. Approach: We used a focused literature review supplemented by the perspectives of local experts and the 6-components framework for surgical systems planning to present two case studies of Bangladesh and Zimbabwe. The lived experiences of the authors are used to describe the impact of COVID-19 on respective surgical systems and offer perspectives on building back the health system and recovering essential health services for sustainability and resilience. Findings: We found that limited high-level policy and planning instruments, an overburdened and under-resourced health and allied workforce, underdeveloped surgical infrastructure (from key utilities to essential medical products), lack of locally generated research, and the specter of prohibitively high out-of-pocket costs for children's surgery are common challenges in both countries that have been exacerbated by the COVID-19 pandemic. Discussion: Continued chronic underinvestment and inattention to children's surgical diseases coupled with the devastating effect of the COVID-19 pandemic threaten progress toward key global health objectives. Urgent attention and investment in the context of health systems recovery is needed from policy to practice levels to improve infrastructure; attract, retain and train the surgical and allied health workforce; and improve service delivery access with equity considerations to meet the 2030 Lancet Commission goals, and make and sustain progress toward UHC and the SDGs.

Impact of health insurance coverage on health care utilization during COVID-19 pandemic: A propensity score matched survey analysis in a target region in India.

BACKGROUND: Health insurance is considered as a mechanism to accelerate the progress towards universal health coverage and ensure financial risk protection for households throughout the country. There is a growing body of evidence reporting that the health insurance coverage can significantly improve the access and utilization of healthcare services. Hence, we attempted to determine the impact of health insurance on the utilization of healthcare services during COVID-19 pandemic. METHODS: A community-based cross-sectional study was conducted in rural Tamil Nadu. The primary data collection was conducted during November 2021. We employed a multi-stage stratified random sampling technique. Propensity score matching analysis was performed using radius matching method at 0.05 calliper to estimate the following parameters: average treatment effect (ATE), average treatment effect on treated (ATT), and average treatment effect on untreated (ATU). RESULTS: In total, 2390 participants were included. Almost two-third belonged to 18-45 years with almost equal distribution of males and females. Only 13.6% were covered by health insurance. Healthcare utilization was significantly higher among participants with health insurance (55.2%) compared to participants without coverage (42.5%). The ATT values in intervention and control group were 0.55 and 0.46 (p < 0.001). Similarly, the ATU values in intervention and control group were 0.42 and 0.51. The ATE value was 0.08. CONCLUSION: Our study shows that the health insurance coverage had significant impact on utilization of healthcare services during COVID-19 pandemic. Further longitudinal research exploring the effect of different forms of health insurance for improving access and utilization of healthcare services can be undertaken.

Diet Therapy and Public Health.

A major threat to the achievement of the Sustainable Development Goals and Universal Health Coverage continues to be malnutrition [...].

Pattern of OPD utilisation during the COVID-19 pandemic under the Universal Coverage Scheme in Thailand: what can 850 million records tell us?

BACKGROUND: Out-patient department (OPD) is a crucial component of the healthcare systems in low- and middle-income countries including Thailand. A considerable impact of coronavirus disease 2019 (COVID-19) pandemic and its control measures, especially the lockdown, on utilisation of OPD services was expected. This study thus aims to estimate the pattern of OPD utilisation during the COVID-19 pandemic in Thailand including overall utilisation and within each sub-groups including diagnostic group, age group, and health region. METHODS: This study was a secondary data analysis of aggregated outpatient data from patients covered under the Universal Coverage Scheme (UCS) in Thailand over a 4-year period (2017-2020). Interrupted time series analyses and segmented Quasi-Poisson regression were used to examine the impact of COVID-19 on the overall OPD utilisation including the impact on each diagnostic group, age groups, health regions, and provinces. RESULTS: Analysis of 845,344,946 OPD visits in this study showed a seasonal pattern and increasing trend in monthly OPD visits before the COVID-19 pandemic. A 28% (rate ratio (RR) 0.718, 95% confidence interval (CI): 0.631-0.819) and 11% (RR 0.890, 95% CI: 0.811-0.977) reduction in OPD visits was observed during the lockdown and post-lockdown periods, respectively, when compared to the pre-lockdown period. Diseases of respiratory system were most affected with a RR of 0.411 (95% CI: 0.320-0.527), while the number of visits for non-communicable diseases (ICD-10: E00-E90, I00-I99) and elderly (> 60 years) dropped slightly. The post-lockdown trend in monthly OPD visits gradually increased to the pre-pandemic levels in most groups. CONCLUSIONS: Thailand's OPD utilisation rate during the COVID-19 lockdown decreased in some diseases, but the service for certain group of patients appeared to remain available. After the COVID-19 lockdown, the rate returned to the pre-pandemic level in a timely manner. Equipped with a knowledge of OPD utilisation pattern during COVID-19 based on a national real-world database could aid with a better preparation of healthcare system for future pandemics.

Universal health coverage in Pakistan: is the health system geared up to take on the challenge?

BACKGROUND: There is a strong and wide consensus that Pakistan must pursue universal health coverage (UHC) attainment as the driving force for achieving sustainable development goals by 2030. Nevertheless, several institutional and socioeconomic challenges may hinder the progress toward UHC. MAIN BODY: It is important that the health system of Pakistan must be transformed to strengthen all three dimensions of UHC i.e. maximizing the population covered, increasing the range of services offered, and reducing the cost-sharing. To make UHC dream a reality in Pakistan, there are some pre-requisites to meet upfront: a) budgetary allocation for health as percentage of GDP must be increased; b) health system's readiness especially in the public sector ought to improve in terms of human resource and availability of essential services; c) safety nets for health must continue regardless of the change in the political regimes; d) decrease the reliance on donors' funding; and e) accountability to be ensured across the board for service providers, managers, administrators and policymakers in the health system. CONCLUSION: COVID-19 pandemic has revealed some major gaps in the health system's capacity to deliver equitable healthcare, which is a cornerstone to achieving the UHC agenda. The priority-setting process will need to be aligned with the SDGs to ensure that the agenda for action towards 2030 is comprehensively addressed and successfully accomplished preferably before, but hopefully not beyond the targeted dates.

The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal.

BACKGROUND: In its pursuit of solutions for universal health coverage (UHC), Senegal has set up two departmental health insurance units (UDAMs) since 2014. Few studies on the resilience of health systems in Africa have examined health insurance organisations. This article aims to understand how these two UDAMs have been resilient during the COVID-19 pandemic and the restrictive measures imposed by the State to maintain services to their members and reimbursements to healthcare providers. METHODS: This study was a multicase study with multiple levels of analysis using a conceptual framework of resilience and analysis of organisational configurations. Empirical data are derived from document analysis, observations for 6 months and 17 qualitative in-depth interviews. RESULTS: The results identified three main configurations concerning (1) safety and hygiene, (2) organisation and planning and (3) communication for sustainable payment. The UDAM faced the pandemic with resilience processes to absorb the shock and maintain service to their members. The UDAM learnt positive lessons from crisis management, such as remote work or the ability to support members in their care in hospitals away from their headquarters. They have innovated (transformative resilience) with the organisation of electronic payment and the use of social networks to raise funds and communicate with members. Strengthening their effectiveness after the shock of the departure of the donors in 2017 contributed to the adaptation and even transformation from the pandemic shock of 2020 and 2021. The study shows that leadership, team dynamics and adaptation to contexts are drivers of resilience processes. CONCLUSION: Both UDAMs adapted to the shocks of the pandemic and government measures to maintain the services of their members and their organisational routine. This resilience confirms that UDAMs are one of the possible solutions for UHC in the Sahel.