Health for all: sustainable systems in an urbanizing world
15 de diciembre de 2016
On the occasion of the third annual Universal Health Coverage Day, the New York Academy of Medicine, International Society for Urban Health, and NCD Alliance co-hosted an event exploring the interlinkages between urbanizing systems and health, and how implementation of UHC can help deliver healthy populations and cities in an evolving environment.
Moderated by Dr. Jo Bufford, President of the New York Academy of Medicine, the event explored the complementary role of universal health coverage and health systems strengthening with intersectoral action among health, urban planning, and other sectors to create healthy communities and promote health in all policies.
Dr. Nata Menabde, Executive Director of the WHO Office at the United Nations, delivered a keynote address, highlighting how achieving UHC is a means to achieving many other Sustainable Development Goals (SDGs), including those on poverty, nutrition, gender equality, reduced inequalities, decent work and economic growth, and sustainable cities.
“It is grossly unfair and unjust that people fall into poverty due to catastrophic expenditure on health. UHC is one of the greatest social equalizers” –Dr. Nata Menabde
Dr. Menabde discussed the need for strong health systems that are prepared to serve rapidly ageing populations, adolescents, and provide mental health care – all aspects of urbanizing systems that are rapidly growing. Strong, prepared health systems can help prevent pandemics and are better able to respond to health emergencies. Implementation of UHC in all countries is a priority for WHO, as it provides access to quality essential health services, safe, effective, and affordable essential medicines and vaccines, and protection from financial risk.
Following Dr. Menabde’s address, Dr. Lola Adedokun, Director African Health Initiative at Doris Duke Charitable Foundation, spoke about a case study of strengthening health systems in Africa by improving primary health care service delivery, data for decision-making, and community engagement efforts. The program aimed to catalyze a shift in thinking from single disease programs to strengthening health systems and primary healthcare in sub-Saharan Africa. The African Health Initiative demonstrated that a comprehensive service package delivered at the primary health care level helps achieve UHC and improves health outcomes.
“Catalyzing improvements in health systems means strengthening communities, improving the quality of data, translating research to inform policymakers, and building the capacity of practitioners.” – Dr. Lola Adedokun
Health systems strengthening is a vital component of any success UHC package, and is an initiative the New York City Department of Health and Mental Hygiene (NYC DOHMH) has undertaken. Dr. Oxiris Barbot, First Deputy Commissioner at NYC DOHMH, presented several NYC health initiatives aimed at bridging public health and health care to advance health equity in New York City.
“A multisectoral approach for improving health that draws on other sectors to more fully address the root causes of inequities is essential.” –Dr. Oxiris Barbot
New York City’s child mental health initiative aims to bridge the gap between health care and the school community by increasing mental health literacy in school staff and students and better utilizing behavioral health services. The initiative brings together public health, health care delivery systems, schools, and communities to improve health outcomes for children. Comprehensive service delivery with the community at the center is a key component of effective UHC packages.
Finally, Dr. Sue Henshall, Special Advisor to the CEO of the Union for International Cancer Control, spoke about the need for partnerships to help strengthen and deliver resilient health systems. In many low- and middle-income countries, the strain on existing health infrastructure is already showing, where systems are not equipped to deliver care for growing populations in urbanizing areas. UICC has engaged with civil society and non-traditional partners outside the health sector to improve the quality of the health workforce, cancer registries and data surveillance, and reducing fragmented health services.
“The question is not whether we should partner, but how we partner where there is a shared purpose and trust.” –Dr. Sue Henshall
All speakers emphasized the importance of creating and supporting innovative partnerships, something that the non-communicable disease (NCD) agenda has pursued. The multisectoral nature of NCDs pushed the global health and development community into better collaboration with relevant private sector, resulting in a mix of population-based and individual level healthcare interventions to reduce exposure to common risk factors.
This event approached the case for universal health coverage from a different perspective by examining the need to strengthen health systems in a rapidly urbanizing world. Engaging the patient voice and developing multisectoral partnerships, particularly with actors outside the health sector, is critical for improving health outcomes. Rapidly urbanizing systems present new challenges for which many countries, regardless of development status, are unprepared. Comprehensive UHC packages delivered at the primary care level and that unite fragmented health systems will not only result in healthier populations, but also help us achieve the Sustainable Development Goals.