How to manage

Healthcare in UHC?
So Yoon Kim, M.D., Ph.D.
Director, Asian Institute for Bioethics and Health Law,
Yonsei University, South Korea
Contents

What is UHC?

Facts about healthcare services

People-centred approach: Health system attributes

Integrated people-centred healthcare services (IPCHS)

Reference
What is UHC?
• Universal health coverage is a global priority for WHO, and
the linchpin of the health-related SDGs. It’s the one target
that, if achieved, will help to deliver all others.
• For healthcare and coverage to be truly universal. It requires
a shift from health systems designed around diseases and
health institutions towards health systems designed for
people, with people.
Three dimensions to consider when moving
towards universal coverage

https://www.who.int/health_financing/strategy/dimensions/en/
Facts about Healthcare services

https://apps.who.int/iris/bitstream/handle/10665/255311/WHO-HIS-SDS-2017.9-eng.pdf;jsessionid=84A0EA719B48B85E78C5B79D695F6F96?sequence=1
A people-centred approach is needed
for: (Health system attributes)
Equity in access
Quality
Accountability
Efficiency
Resilience

https://apps.who.int/iris/bitstream/handle/10665/255311/WHO-HIS-SDS-2017.9-eng.pdf;jsessionid=84A0EA719B48B85E78C5B79D695F6F96?sequence=1
Equity in access
• For everyone, everywhere to access the quality health
services they need, when and where they need them.
• Action domains for UHC:
• Financial protection
• Service coverage and access
• Non-discrimination
Quality
• Safe, effective and timely care that responds to people’s
comprehensive needs and is of the highest possible standard.
• Action domains for UHC:
• Regulations and regulatory environment
• Effective, responsive individual and population-based services
• Individual, family and community engagement
Accountability
• Care is coordinated around people`s needs, respects their
preferences, and allows for people’s participation in health
affairs.
• Action domains in UHC:
• Government leadership and rule of law for health
• Partnerships for public policy
• Transparent monitoring and evaluation (M&E)
Efficiency
• Ensuring that services are provided in the most cost-effective
setting with the right balance between health promotion,
prevention, and inpatient and outpatient care, avoiding
duplication and waste of resources.
• Action domains for UHC:
• Health system architecture to meet population needs
• Incentives for appropriate provision and use of services
• Managerial efficiency and effectiveness
Resilience
• Strengthening the capacity of health actors, institutions and
populations to prepare for, and effectively respond to, public
health crises.
• Action domains for UHC:
• Public health preparedness
• Community capacity
• Health system adaptability and sustainability
Relationship between health systems building
blocks, attributes and action domains leading to
UHC

https://apps.who.int/iris/rest/bitstreams/1134103/retrieve
Integrated people-centred health
services (IPCHS)
• Integrated people-centred health services means putting
people and communities, not diseases, at the centre of health
systems, and empowering people to take charge of their own
health rather than being passive recipients of services.

https://www.who.int/servicedeliverysafety/areas/people-centred-care/ipchs-what/en/
The Framework on Integrated people-
centred health services (IPCHS)
• In 2016 the World Health Assembly adopted the Framework
on Integrated people-centred health services (IPCHS),
giving WHO the official mandate to work with Member States
and other key stakeholders to support implementation of the
Framework.

https://apps.who.int/iris/bitstream/handle/10665/255311/WHO-HIS-SDS-2017.9-eng.pdf;jsessionid=84A0EA719B48B85E78C5B79D695F6F96?sequence=1
The Framework on Integrated people-
centred health services (IPCHS)
• The vision is a future where:
• All people have equal access to quality health services, supporting
the achievement of UHC
• Services are produced and provided in a way that meets people’s
life course needs and respects their preferences
• Services coordinated across the continuum of care
• All health workers are motivated, skilled and operate in a supportive
environment
https://www.who.int/servicedeliverysafety/areas/people-centred-care/ipchs-what/en/
Reference
• Reforming Health Service Delivery for UHC, WHO
• https://www.who.int/health_financing/strategy/dimensions/en/
• https://www.who.int/servicedeliverysafety/areas/people-
centred-care/ipchs-what/en/
• Universal Health Coverage: Moving Towards Better Health
https://apps.who.int/iris/rest/bitstreams/1134103/retrieve