Universal Health Coverage and Primary Health Care: Choice
UHC is not a new idea, but the packaging of the best ideas that public health has learned over the years. Central to UHC is primary health care (PHC). Simple, novel, and powerful, PHC has revolutionized health care’s efficacy worldwide, offering the most basic package of essential services and products to prevent disease, promote health, and manage illness. Unfortunately, however, much of primary health care is still aimed at treating illness rather than maintaining a person’s health. And, significantly, much of primary health care is not people-centered.
In pursuit of UHC, as outlined within the Sustainable Development Goals (SDGs), countries have made gains, though sometimes in an unbalanced manner. Poorer countries, in particular, have improved the spread of infectious diseases. However, they have made fewer gains in securing the same results in providing reproductive, maternal, child, and adolescent health services. The pace of progress has been far from desirable. Major impediments to achieving UHC are the usual suspects: growing out-of-pocket expenditures, weak health systems, and entrenched gender norms and power relations.
As nations and communities grapple with the idea of UHC, how does family planning fit into the picture? Amos Mwale, Executive Director of the Centre for Reproductive Health and Education in Zambia, emphasizes that “UHC is not just about ‘coverage.’ It is truly about giving people the ‘choice’ and delivering what they want and not just what is available.” Countries that understand that UHC is a means of empowerment cannot afford to ignore family planning, which epitomizes choice and need.
The UHC/family planning nexus provides profound benefits beyond merely improved health and choice. Family planning expands opportunities for education, empowers women, sustains population growth, and accelerates national development. For its part, UHC restores equality, promotes social cohesion, and contributes to meeting a country’s development goals. And family planning plays a vital role in achieving the goals of primary health care.