More than funding needed to implement universal healthcare in developing countries

22 May 2017: As efforts to roll out universal healthcare coverage (UHC) gain momentum, questions remain about how it should be funded in countries with limited resources to achieve the main objectives of providing affordable, equitable access to quality healthcare to all people, reducing out of pocket spending and providing financial protection against catastrophic healthcare costs in a sustainable way.

While funding is critical to achieve UHC, issues such as the escalating burden of non-communicable diseases (NCDs), infrastructure challenges and the dire shortage of healthcare providers in developing countries also need to be addressed to reduce costs and ensure that the required health services can be delivered.

This is according to Dr Stuart Bennet, Director, Healthcare: Head of Operations, Africa of the Abraaj Group’s Growth Markets Health Fund, and one of the speakers at the upcoming Africa Health Exhibition & Congress at Gallagher Estate.

Based in Dubai, the Abraaj Group has been investing in developing markets across the globe for the past two decades, more recently through the US$1Bn Abraaj Growth Markets Health Fund (AGHF). The fund is focused on improving accessibility, affordability and quality of healthcare services, particularly in sub-Saharan Africa and South Asia through investment in healthcare facilities, diagnostics, education and training, via integrated health ecosystems.

“Achieving universal health coverage is not just about government support, having risk pooling and mandatory contributions. Without the necessary infrastructure and enough healthcare providers to provide the required services, people will be reluctant to contribute towards national healthcare insurance funds because they want appropriate and improved quality services and treatments for their contributions,” explains Dr Bennett, adding that his research has shown that Africa will need to increase its number of doctors by around 50% to deliver universal healthcare.

Noting that 10 times more people die of NCDs in low- to middle income countries per year than from HIV, malaria and TB, Dr Bennett stressed that a mind-set shift is needed to divert more money and resources towards prevention to reduce the massive burden treatment of these diseases are putting on health spending.

“Owing to the extreme paucity of awareness of NCDs in low- and middle income countries, people are not realising that 80% of the deaths caused by these diseases globally each year, occur in developing countries,” said Dr Bennett. In most of these countries, patients have to pay out of pocket for treatment of these conditions with dire financial consequences to them and their families. In Kenya alone, it is estimated that up to a million people are pushed below the poverty line as a result of catastrophic health conditions.

Convincing governments to invest in preventative care rather than spending massive amounts of money on treating preventable conditions, could result in significant savings, making more money available to improve the quality and delivery of services to more people while also extending coverage by making contributions to health insurance funds more more people, observes Dr Bennett.

But ensuring sufficient funding will require governments to increase the proportion of GDP spent on healthcare. Currently, the proportion of GDP spent on healthcare in sub-Saharan Africa averages less than 5%, which will probably need to be doubled to extend and improve the delivery of services, says Dr Bennett.

Referring to the role the private sector can play, he emphasises the huge opportunities it offers in terms of building and upgrading infrastructure, as well as providing training and education to both healthcare providers and patients. In Kenya, for example, where Abraaj has invested millions of dollars in healthcare over the past 5 years including hospitals and clinics, it has also introduced an NCD training and screening programme aimed at screening at least 100,000 people by the end of the year. This screening service is provided to patients free of cost, and includes collaboration with the Kenya Ministry of Health to raise awareness and build capacity to identify and treat NCDs in Government facilities as well as in the community.

“While financing mechanisms are important to realise the objectives of universal healthcare coverage, the focus should not be only on putting money in that pot, but also on reducing the size of the pot required to treat patients through interventions aimed at improving health rather than spending exorbitant amounts of money  on treating preventable diseases,” Dr Bennett concluded.

Bennet will be speaking at the Hospital Build conference, which will form part of the 7th annual Africa Health Exhibition & Congress 2017 taking place from 7-9 June 2017 at the Gallagher Convention Centre in Johannesburg, South Africa. More than 9,300 regional and international healthcare professionals and medical experts are expected to attend the event.




Conference cost:  ranges from R150 - R300.  Email:  [email protected],



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