High-level Side Event on Innovative Approach to Achieving Universal Health Coverage Inclusive of Mental Health and Disabilities
Introduction:
On the sidelines of the three High-Level Meetings on health issues during the high-level week of the 78th session of the UN General Assembly, Bangladesh together with (Antigua & Barbuda, Bhutan, …….) is organizing a side event titled, “Innovative Approach to achieving Universal Health Coverage Inclusive of Mental Health and Disabilities.” The event is scheduled to take place at 1100 hrs on Tuesday, 19 September 2023 at Conference Room 11, UN Headquarters, New York.
Background:
The 1978 Alma Ata Declaration, focused on primary health care, also perhaps marked the first global emphasis on the need for community-based health care systems. The Declaration emphasized, inter alia, the need for promoting maximum community self-reliance and participation in the planning, organization, operation and monitoring of primary health care. Since then, many UN Member States have made good progress in developing community-based health care models as a key pillar of their primary health care systems. Community-based health services have proven to be crucial in accelerating a number of disease eradication programmes, including through GO-NGO participation.
Today, community-based healthcare model is widely recognised as an effective vehicle for achieving Universal Health Coverage (SDG target 3.8). Universal Health Coverage ensures that all individuals have access to the full range of quality health services they need, when and where they need them, and without financial hardship across the life course. Such an undertaking demands innovative solutions and substantial investment in infrastructure, logistics, management and monitoring of health systems. It also underscores the need for establishing an efficient network of health care systems through public-private partnerships, extending from remote rural areas to low-income urban settings to reach the people’s doorsteps.
Sheikh Hasina Initiative of Community Clinics:
In Bangladesh, Father of the Nation Bangabandhu Sheikh Mujibur Rahman laid out a comprehensive plan to set up health facilities at the local level in a newly independent country. In pursuance of his vision, Hon’ble Prime Minister Sheikh Hasina launched a unique and innovative community clinic-based health system during her first tenure in office in 1998. Discarded by the subsequent governments from 2001-2008, the model was revived with Prime Minister Sheikh Hasina’s return to office in 2009. At present, around 14,500 community clinics are operating all over the country with a targeted catchment of 6,000 people each. The model has considerably improved healthcare delivery at the grassroots due to its low-cost approach and ready service availability, including provision of 30 essential drugs, contraceptives and insulin free-of-cost. The community clinics are designed as one-stop service centres for health, family planning, and nutrition as well as for screening mental health and neurological disorders. The community clinics prioritize preventive care and offer health education and promotional services alongside an efficient referral system. On average, 9.5 to 10 million people visit the community clinics each month, with 80% of them being women and children.
In recognition of the contribution of community-based health care services, the United Nations General Assembly unanimously adopted a resolution titled “Community-based Primary Health Care: A Participatory and Inclusive Approach to Universal Health Coverage” on 16 May 2023. The resolution acknowledges the important role community clinics play in expanding primary health care through partnerships and innovative approaches. It also emphasizes the need for mental and psychological support as well as disability responsive interventions through community-based health care systems. The resolution commends the Sheikh Hasina Initiative in Bangladesh as an exemplary model of community clinics, in promoting primary health care, women’s empowerment, community engagement and mobilization towards achieving universal access to health.
Community Clinics for Universal Health Coverage:
As the world now stands at the midpoint of achieving the Sustainable Development Goals (SDGs), it is crucial for the global health community to leverage successful practices like the community clinic model to accelerate the attainment of Universal Health Coverage by 2030. Fostering partnerships and inclusive approaches thus becomes imperative, involving various stakeholders such as local communities, healthcare professionals and other service providers in the design, execution and oversight of community-based primary health care in a context-specific manner. It may be useful to expand and replicate effective practices and evidence-based interventions, both nationally and internationally, drawing from people-centric health systems that Bangladesh has already demonstrated through its community clinic models.
Objective of the Event:
a) Enhancing awareness about the critical role being played by community clinics in achieving Universal Health Coverage in Bangladesh and other countries;
b) Identification and dissemination of best practices, innovations and lessons learned with community-based primary health care models from different parts of the world;
c) Exchanging views on the resource and technology gaps in implementing and expanding community-based health care, especially in the Global South;
d) Suggesting pathways for community-based health care systems to cater to underserved groups and for optimizing the community-centric networks to respond to future health emergencies;
e) Building international opinion and partnership to strengthen support and technical assistance for scaling up mental health care initiatives and disability-responsive interventions through community-based health care systems.