Framework for health systems development towards universal health coverage in the context of the sustainable development goals in the African Region: report of the Secretariat

ABSTRACT

1. The 2030 Agenda for Sustainable Development was adopted to guide global development, with healthembodied in the third Sustainable Development Goal. Universal Health Coverage underpins theachievement of the health and related SDG targets. Health systems strengthening for universal healthcoverage was identified by WHO as one of the key instruments for the change offered by the 2030 Agenda.2. Member States have made substantial improvements in population health outcomes over the past 25 years.These improvements are reflected in better availability and utilization of services targeted at addressing thepriority disease burdens, matched by an increase in total health expenditure and general governmentexpenditure on health. However, this masks large variations within and across Member States, withimplications for health delivery. In addition, national health systems in the Region are not well aligned withthe changing needs and expectations in facilitating health in sustainable development.3. The Region is experiencing demographic, economic, social, security and environmental changes that placeunique demands on health and related service delivery systems. New/re-emerging health threats arediverting significant human and financial resources away from routine services. The devastating Ebolaoutbreak in West Africa underscored the need for effective and resilient health systems in low-incomecountries.4. This action framework presents the approach Member States need to consider in order to strengthen and realigntheir health systems to ensure that they are able to achieve their health development goals. Itrepresents a foundational plan for Member States to ensure that health is playing its role in facilitatingmovement towards sustainable development.5. The proposed priority actions emphasize the need to ensure the availability and coverage of health andrelated services, increase the population protected from financial risk, enhance health security, improveclient satisfaction and address interventions targeted at other SDGs that impact on health. Key measures formonitoring health system performance such as health system resilience, effective demand for healthservices, equitable and efficient access and quality of care are defined. A scope of investments in healthsystems across health governance, service delivery systems, health workforce, access to medicines andhealth technologies, health infrastructure, sustainable financing for health and health information systems isalso outlined.6. The Regional Committee examined and adopted the actions proposed in this framework