PAHO’s Strategy for Universal Access to Health and Universal Health Coverage Carlos Ayala Cerna, MD, MPH Health Systems and Services Advisor PAHO/WHO Belize *Title of the Presentation

OBJECTIVES The need for the changes View of the progress The Strategy for Universal Access to Health and Health Care Coverage

The needs……….. *Title of the Presentation Everyday……….

Pressure for Change on Health Services Changes in demand Changes in supply Broad social changes Demographics Epidemiology The public’s expectations Technology and knowledge Workforce Financial pressure Globalization Government reforms Sectoral reforms Health Services

Malaria-VBD Maternal and Child Health HIV/AIDS MoH Social Security Traditional Medicine Private- low complexity NGOs Primary Level Municipalities Secondary Level Universities Occupational hazards Private- high complexity Tertiary Level Our reality now……..fragmented services

Segmented contributions……….

Joachim P. STURMBERG and Carmel M. MARTIN Rethinking general practice – Part 1: Far from equilibrium disease-centered and econometric- oriented health care and general practice/family medicine Asia Pacific Journal of Family Medicine Volume 5 Issue 2, 27 March The consequence……… current model

Alma Ata 1978 Renewed PHC 2005 Reforms based on PHC WHR 2008 The progress……..

Strategy for Universal Access to Health and Universal Health Coverage Strategic line 1: Expanding equitable access to comprehensive, quality, people- and community-centered health services Strategic line 2: Strengthening stewardship and governance. Strategic line 3: Increasing and improving financing, with equity and efficiency, and advancing toward the elimination of direct payment that constitutes a barrier to access at the point of service. Strategic line 4: Strengthening intersectoral coordination to address social determinants of health.

Objective 1: Integrated Health Services Based on Prim ary Health Care for Improved Health Outcomes Objective 2: Strengthen the Organization and Manage ment of Health Services Objective 3: Achieveing greater equity, cost effectiveness and efficiency in allocation and use of health resources (Improved Health Financing to achieve Universal Health Coverage Objective 4: Strengthen Capacity For Human Resource For Health Planning To Meet Present And Future Health Sector Needs Objective 5: Strengthening Of The Belize Health Information System To Support Evidence – Based Planning In The Provision And Delivery Of Health Care. Objective 6: Development Of Quality Improvement Framework To Ensure Stakeholder Accountability Objective 7: Efficient and Effective Health Infrastructure Development

What is the difference now ? Policy guidance to countries A political expression of the commitment of countries. Repositions the Organization in health and development Goes beyond Universal Health Coverage, and addresses issues of Access UN mandate

At the end……….