The philosophical foundations of ‘health for all’ and Universal Health Coverage

Allen, Luke

doi:10.1186/s12939-022-01780-8

Cited by 9 publications

(4 citation statements)

References 33 publications

(33 reference statements)

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“…To be more focused, conceptual and historical developments toward UHC have been presented from the available literature. We fixed the article's content in light of policy and program confusions in various countries ( 15 ), the multiple foundations of UHC ( 16 ), gaps in healthcare equity and excess during historical paradigm shifts ( 17 ), and the current and future challenges on the path of UHC ( 18 ). The future challenges for UHC presented in this article were articulated on the basis of epidemiological, demographic, existing policy discrepancies, and lifestyle factors associated with healthcare ( 11 , 19 ).…”

Section: Methodsmentioning

confidence: 99%

Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review

Ranabhat

Acharya

Adhikari

et al. 2023

Front. Public Health

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The goal of universal health coverage (UHC) from the United Nations (UN) has metamorphized from its early phase of primary health care (PHC) to the recent sustainable development goal (SDG). In this context, we aimed to document theoretical and philosophical efforts, historical analysis, financial and political aspects in various eras, and an assessment of coverage during those eras in relation to UHC in a global scenario. Searching with broad keywords circumadjacent to UHC with scope and inter-disciplinary linkages in conceptual analysis, we further narrated the review with the historical development of UHC in different time periods. We proposed, chronologically, these frames as eras of PHC, the millennium development goal (MDG), and the ongoing sustainable development goal (SDG). Literature showed that modern healthcare access and coverage were in extension stages during the PHC era flagshipped with “health for all (HFA)”, prolifically achieving vaccination, communicable disease control, and the use of modern contraceptive methods. Following the PHC era, the MDG era markedly reduced maternal, neonatal, and child mortalities mainly in developing countries. Importantly, UHC has shifted its philosophic stand of HFA to a strategic health insurance and its extension. After 2015, the concept of SDG has evolved. The strategy was further reframed as service and financial assurance. Strategies for further resource allocation, integration of health service with social health protection, human resources for health, strategic community participation, and the challenges of financial securities in some global public health concerns like the public health emergency and travelers' and migrants' health are further discussed. Some policy departures such as global partnership, research collaboration, and experience sharing are broadly discussed for recommendation.

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Section: Methodsmentioning

confidence: 99%

Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review

Ranabhat

Acharya

Adhikari

et al. 2023

Front. Public Health

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“…This outcome would support the broader goals of proportionate universalism whereby outcomes improve for all, with the greatest gains seen in those with the greatest baseline need. 17 In some cases, the intervention recommended by the left-behind group and selected for testing may be 100% specific for that group -for instance providing SMS reminders in a new language. In this circumstance, we would not administer the intervention to every person who is referred.…”

Section: Types Of Interventionsmentioning

confidence: 99%

Protocol for an adaptive platform trial of intended service user-derived interventions to equitably reduce non-attendance in eye screening programmes in Botswana, India, Kenya & Nepal

Allen,

Kim,

Tlhajoane

et al. 2024

Preprint

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BackgroundOnly 30-50% of people referred to clinics during community-based eye screening are able to access care in Botswana, India, Kenya, and Nepal. The access rate is even lower for certain population groups. This platform trial aims to test multiple, iterative, low-risk public health interventions and simple service modifications with a series of individual randomised controlled trials (RCT) conducted in each country, with the aim of increasing the proportion of people attending.Methods and AnalysisWe will set up a platform trial in each country to govern the running of a series of pragmatic, adaptive, embedded, parallel, multi-arm, superiority RCTs to test a series of service modifications suggested by intended service users. The aim is to identify serial marginal gains that cumulatively result in large improvements to equity and access. The primary outcome will be the probability of accessing treatment among the population group with the worst access at baseline. We will calculate Bayesian posterior probabilities of clinic attendance in each arm every 72 hours. Each RCT will continually recruit participants until the following default stopping rules have been met: >95% probability that one arm is best; >95% probability that the difference between the best arm and the arms remaining in the trial is <1%; or 10,000 people have been recruited. Lower thresholds may be used for RCTs testing interventions with very low risks and costs. The specific design of cluster RCTs will be determined by our research team once the intervention is known, but the population and outcome will be the same across all trials.DiscussionThis APT will be used to identify effective service modifications, driving continuous improvements in access.Ethics and DisseminationThis trial has been approved by the research ethics committee at the London School of Hygiene and Tropical Medicine. Approvals for individual interventions will be sought from UK and local ethics committees. Results will be shared via local workshops, social media, and peer-reviewed publications.Trial Registration:ISRCTN53970958. Registered on 21 September 2023Strengths and LimitationsRandomised control trials are resource intensive and often require lengthy set up periods. The adaptive platform design allows for the evaluation of multiple interventions with a single outcome, governed by a predefined set of criteriaThe study defaults are designed to test multiple low-risk, incremental service modifications in series, and quickly identify those that are just as good as, or superior to the status quo.Our high default tolerance for type I error means that we will often incorrectly identify arms as superior when really there is no difference. This is acceptable when arms confer similar costs and negligible risks.Our default very low type II error rate means that we will very rarely mistakenly identify an inferior arm as being superior.Our trial is embedded within screening programmes and uses automated randomisation, allocation, data collection, and statistical testing to minimise resource requirements.

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“…Reducing ACEs necessitates reducing the number of families in poverty and proportionately increasing income among those at the lower end of the social gradient, particularly for lone mothers, through family benefits or the tax system, for example (85). The Scottish government, which has supported the ACEs approach in the past, recently stated the importance of understanding the impact of child poverty in relation to preventing and addressing ACEs (83).…”

Section: Adverse Childhood Experiencesmentioning

confidence: 99%

How to conduct effective men's health promotion in community pharmacy

2023

Pharmaceutical Journal

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www.localgovernmentlawyer.co.uk/property/313-property-features/41769retrofitting-social-housing. 420. Jennings N, Fecht D, De Matteis S. Co-benefits of climate change mitigation in the UK: What issues are the UK public concerned about and how can action on climate change help to address them? Grantham Institute Imperial College London; 2019. 421. Grantham Research Institute on Climate Change and the Environment. What is "decarbonisation" of the power sector? Why do we need to decarbonise the power sector in the UK? LSE; 2019. Accessed 15 October 2019. Available from http://www.lse.ac.uk/GranthamInstitute/faqs/what-is-decarbonisation-of-the-power-sector-why-do-we-need-to-decarbonise-the-power-sector-in-the-uk/.

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The philosophical foundations of ‘health for all’ and Universal Health Coverage

Cited by 9 publications

References 33 publications

Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review

Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review

Protocol for an adaptive platform trial of intended service user-derived interventions to equitably reduce non-attendance in eye screening programmes in Botswana, India, Kenya & Nepal

How to conduct effective men's health promotion in community pharmacy

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