A new universalism? Universal health coverage and debates about rights, solidarity and inequality in Kenya

Muinde, Jacinta Victoria S.; Prince, Ruth J.

doi:10.1016/j.socscimed.2022.115258

Cited by 8 publications

(4 citation statements)

References 34 publications

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“…Universal health coverage is considered as a legal concept and humanitarian concept, social (equitable entitlement and enrolment to the social security system), a health economic (financial protection), and a public health concept (comprehensive services versus essential packages) (40). In these contexts, our synthesis shows that UHC has critical values, such as the right to health, social justice or equity in access, solidarity, quality, service coverage, population coverage (inclusiveness), and financial protection (affordability) (9,19,29,(41)(42)(43)(44). Policy actors also identify values, such as quality of care, equity, financial risk protection, and a comprehensive set of services for every one with any health conditions as features of UHC (10).…”

Section: What Is Universal Health Coverage?mentioning

confidence: 95%

Universal Health Coverage – Exploring the What, How, and Why Using Realistic Review

Endalamaw,

Mengistu,

Khatri

et al. 2024

Preprint

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Background: Universal health coverage (UHC) is a critical target in many health system strategies to achieve the ‘good health and wellbeing’. Evidence on the meaning and scope of UHC and the strategies required to achieve it are needed, as variations in its understanding and implementation have risen. We synthesised evidence on the meaning, components, significance, and strategies of UHC. Methods: A review of evidence was conducted based on realist synthesis. We searched PubMed, EMBASE, Scopus, and Web of Science for published materials and websites for grey literature. We have followed some steps: define the scope of the review and develop initial programme theory, search for evidence, data extraction, and synthesis of evidence. Results: Universal coverage, universal health, universal healthcare, universal access, and insurance coverage are used interchangeably with UHC. It is a legal notion that embodies a human rights-based and collaborative approach to ensure fair and comprehensive health care services. Universal health coverage is relevant for three macro reasons: first, it prevents and reduces the impact of diseases; second, it addresses inequality and promotes equity; and third, it is key for global health security. Various mechanisms involved to implement UHC, such as health insurance, social health protection, digital financing systems, value-based care, private sectors, civil societies, partnership, primary health care, and reciprocal health care systems. Conclusions: Universal health coverage is a multifaceted concept that can be expressed by various terms in different contexts. Universal health coverage is a political and ethical imperative that aims to promote health equity and protect human dignity across different levels of society. It is essential in preventing diseases and serving a crucial role in global health security. Practically, UHC is not truly universal, as it does not include all services under its scheme and varies across countries. This requires consistent advocacy, strategic and operational research as well as political will to ensure UHC.

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Section: What Is Universal Health Coverage?mentioning

confidence: 95%

Universal Health Coverage – Exploring the What, How, and Why Using Realistic Review

Endalamaw,

Mengistu,

Khatri

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The government encouraged non-governmental organizations (NGOs), social enterprises and fintech companies to move into the field of UHC, where they promised to expand access to ‘affordable healthcare’ alongside financial protection. In this context, we explored Kenya’s attempts to expand membership of its national health insurer, the National Hospital Insurance Fund (NHIF), to include those outside formal employment, as well as micro-insurance schemes and digital health designs in Kenya and Tanzania (Ameso and Prince, 2022; Muinde, 2020; Muinde and Prince, 2023; Neumark and Prince, 2021).…”

Section: Blurring ‘Social Justice’ With ‘Market Justice’mentioning

confidence: 99%

Blurring ‘social justice’ with ‘market justice’ in recent experiments with healthcare and social protection in the Global South

Prince

2024

Global Social Policy

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More than three decades after structural adjustment programmes were imposed on governments across the Global South, and amid growing recognition that development has largely failed to address poverty, experiments with expanding forms of welfare and social protection have gathered pace, focusing not only on workers and their families in formal-sector employment but also, in rhetoric at least, on 'all citizens'. Cash transfer programmes, basic income grants, social pensions, and universal health coverage (UHC), have all gained currency in the 21st century. Reconfiguring relations between labour and welfare, these offer 'new visions of social security in a world of precarious work' (Kar, 2017: 12) and a recognition of the state's responsibility (Ferguson, 2015) for those facing a 'wageless life', even while they draw them into financial infrastructures of global capitalism (Nilsen, 2021).A large body of research focuses on cash transfer programmes and their ambitions to alleviate poverty, with heated arguments about their potential to generate new forms of citizenship or merely cement existing inequalities (e.g. Ferguson, 2015;Leisering, 2019;Nilsen, 2021). An arena of social policy generating similar disagreement concerns the expansion of 'universal' social protection in the field of health care. Universal Health Coverage (UHC), defined as 'ensuring that all people can receive the quality health services they need without being exposed to financial hardship' (WHO, 2010), has moved up the policy agenda as arguments for a more comprehensive approach -to invest in public health systems and ensure that the poor are included -have gained currency. Below, I discuss how UHC, like other attempts to introduce a 'thin' form of more universal welfare, remains squarely located within neoliberal social policy. I discuss the policy's focus on expanding health insurance coverage to previously un-insured populations, particularly those who have no formal employment, drawing upon research conducted in Kenya and Tanzania.

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“…County A referral hospital Pilot site for universal health coverage (UHC) and thus with advanced coverage of the UHC benefit package among its population (Muinde & Prince, 2022) Serves…”

Section: Study Site Selection Criteriamentioning

confidence: 99%

Exploring the complex realities of nursing work in Kenya and how this shapes role enactment and practice—A qualitative study

et al. 2023

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There is a growing attention towards nursing roles in the contemporary healthcare setting, with debates about nursing roles and why nurses struggle to meet their professional standards (Harvey et al., 2020;Mantovan et al., 2020). The dilemmas and struggles nurses face in meeting individual patient care needs and consequent failure to meet their professional expectations of care are well documented (Gathara et al., 2020;Mbuthia et al., 2021). Nursing in resource-constrained settings is typified by daunting working

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A new universalism? Universal health coverage and debates about rights, solidarity and inequality in Kenya

Cited by 8 publications

References 34 publications

Universal Health Coverage – Exploring the What, How, and Why Using Realistic Review

Universal Health Coverage – Exploring the What, How, and Why Using Realistic Review

Blurring ‘social justice’ with ‘market justice’ in recent experiments with healthcare and social protection in the Global South

Exploring the complex realities of nursing work in Kenya and how this shapes role enactment and practice—A qualitative study

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