Evans T, Chowdhury A, Evans D, Fidler A, Lindelow M, Mills A, et al. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Admin Pol Ment Health. Address In the last step, the percentage of each dimension of the health system control knob framework was calculated based on the frequency of factors. 2018;13(5):112. Cairo: World Health Organization. Health Syst Reform. Iran J Epidemiol. Soltani S, Takian A, Akbari Sari A, Majdzadeh R, Kamali M. Financial barriers to access to health Services for Adult People with disability in Iran: the challenges for universal health coverage. Article Med J Islam Repub Iran. All authors have contributed significantly, and that all authors read and approved the final version of the manuscript. The state of health in Pakistan and its provinces and territories, 1990 ER SH. We are proud to join Japan and the Republic of Korea in this partnership to achieve Universal Coverage in Ghana, the U.S. And though the shortage will be felt worldwide, Asia and sub-Saharan Africa are predicted to be the hardest hit. Universal Health Coverage (UHC) is an ambitious goal in health service with sustainable development goal (SDG). The study indicated that the most number of identified factors were within the Regulation and Supervision control knob (33 factors). Grbich C. Qualitative data analysis: an introduction: sage; 2012. 2021;20(1):114. 2020;13(sup2):1791414. Since 2000, dozens of countries,including Canada, Saudi Arabia, Rwanda, Cuba, Indonesia, and Kenya, have begun to implement reforms to establish UHC. BMC Health Serv Res. 2014. 2019;1:1. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation and palliative care. Therefore, considering these factors, countries can identify their strengths and weaknesses in this path and design the necessary and planned measures in this direction to accelerate the achievement of UHC. The importance of this dimension best highlights when we consider its direct impact on three goals of UHC including, financial protection, population coverage, and service coverage. Policymakers and managers can use this framework as a useful and practical tool in achieving UHC, depending on the goals of their countrys health system [24]. It covers all essential, quality health services - from health promotion to prevention, treatment, rehabilitation, and palliative care - across the life course. 2013;16(12):7368. Doshmangir L, Sajadi HS, Ghiasipour M, Aboutorabi A, Gordeev VS. Hakim Res J. Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow destroying their futures and often those of their children. On May 19, 2022, the National Health Insurance Authority Bill was signed into law: it makes health insurance mandatory for all citizens and legal residents. Significant cost efficiencies can be achieved and most (90%) essential UHC interventions can be delivered through a PHC approach. 2017;27. When autocomplete results are available use up and down arrows to review and enter to select. The publication language was restricted to English and Persian. Please contact us at contact@globalcitizen.org if you would like to re-activate your account. Google Scholar. Depiction Health. Funding. All study reports, including reviews, case studies, reports, and original studies that were related to affecting factors the achieving of UHC in Iran were included in the study. Payment for health care and perception of the national health insurance scheme in a rural area in Southwest Nigeria. 2019;33:65. Ethiop J Health Sci. Ambassador to Ghana, Virginia Palmer, noted. Universal health coverage (UHC) has been identified as a priority for the global health agenda. Chu A, Kwon S, Cowley P. Health financing reforms for moving towards universal health coverage in the western pacific region. 2015;351. Regional Office for the Eastern Mediterranean; 2017. For data analysis, the content-analysis method was applied, which is a method to identify, analyze and report patterns (themes) within the text. Med J Islam Repub Iran. The industrys low wages and long hours may deter others from entering the field or motivate them to move to areas with potential for higher pay and away from the frontlines, causing a shortage of health care workers who serve a critical function on the ground. The influential factors for achieving universal health coverage in Iran The lessons that countries are currently learning from the COVID-19 pandemic all underscore that investing in health for all is not optional. The maximum score of articles was 24 and the minimum score was 8. Fried ST, Khurshid A, Tarlton D, Webb D, Gloss S, Paz C, et al. 2004. Schwab Foundation for Social Entrepreneurship, Centre for the Fourth Industrial Revolution. All articles after extraction from the databases using the keywords mentioned were evaluated by two authors using the Critical Appraisal Skills Program (CASP) checklist. Cookies policy. On financial hardship, people living in poorer households and in households with older family members (those aged 60 and older) are more likely to face financial hardship and pay out of pocket for health care. Organization WH. Introduction. In this framework, 4 main themes (governance and financial team, integrated service delivery team, health workforce development team, and essential medicines and technologies team), 16 dimensions, and 46 indicators have been introduced [81]. 2015;385(9974):123047. Marnani AB, Teymourzadeh E, Bahadori M, Ravangard R, Pour JS. Take action here with Global Citizen and Johnson & Johnson to make sure everyone can get the health services they need no matter who they are, where they live, or what their income. 2013;13(1):18. Data collection was continued until data saturation. Universal Health Coverage | WHO | Regional Office for Africa Bull World Health Organ. 2020. Universal health system and universal health coverage: assumptions and strategies. Because the factors act as a role model for health system managers to have due policy-makings. Thailand: World Health Organization; 2019. This not only means individuals may be discouraged from getting preventative treatment like vaccines, but also means they will wait until their lives hang in the balance to seek medical attention. Determining and prioritizing indicators of public health coverage in Iran: a qualitative study. This study was part of a Ph.D. Thesis supported by Iran University of Medical Sciences (Thesis NO: 19114, ethical code: IR.IUMS.REC.1399.674). 2014;7(1):25856. 2019;6(3):5462. Responded validity was used to ensure the rigor and accuracy of the results. Appendix 3- Identification affecting factors to achieving UHC trough systematic review in Iran. To observe ethical issues in this study, all experts involved in the study were asked to fill out an informed consent form to participate in the FGD, semi-structured interview, and expert panel. But WHO is not alone: WHO works with many different partners in different situations and for different purposes to advance UHC around the world. Even where there is national progress on health service coverage, the aggregate data mask inequalities within countries. Universal Health Coverage (UHC) has been introduced as a viable solution to promote, restore, and/or maintain the health of the population in countries [1, 2]. In my experience, most countries do not know what the structure of their health system is or how it works. Prior to the COVID-19 pandemic, there was worldwide progress towards UHC. 2019;2(4):2835. The first step was to decrease OOP payments, extending insurance coverage, and improving the quality of health services in target populations Second step was about providing all services, drugs, and equipment needed by the inpatient wards, and the third one was about updating the tariffs on medical services [18,19,20]. Lancet. Eight hundred two factors were extracted through systematic review and 96 factors through FGD and interviews (totally, 898). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. We, therefore, appreciate Congress' focus on opportunities to close the remaining coverage gaps and achieve comprehensive health coverage for every American. Given the importance of these factors, the researchers did not rule out these cases. Lagomarsino G, Garabrant A, Adyas A, Muga R, Otoo N. Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia. The delivery of these services requires health and care workers with an optimal skills mix at all levels of the health system, who are equitably distributed, adequately supported with access to quality assured products, and enjoying decent work. No country can afford to stand alone during a pandemic. 2013;91(11):85363. Bredenkamp C, Evans T, Lagrada L, Langenbrunner J, Nachuk S, Palu T. Emerging challenges in implementing universal health coverage in Asia. PLoS Med. Koohpayehzadeh J, Azami-Aghdash S, Derakhshani N, Rezapour A, Kalajahi RA, Khasraghi JS, et al. Med J Islam Repub Iran. Naghdi S, Moradi T, Tavangar F, Bahrami G, Shahboulaghi M, Ghiasvand H. The barriers to achieve financial protection in Iranian health system: a qualitative study in a developing country. 2020. 2017;36(8):144351. For more details, review our .chakra .wef-12jlgmc{-webkit-transition:all 0.15s ease-out;transition:all 0.15s ease-out;cursor:pointer;-webkit-text-decoration:none;text-decoration:none;outline:none;color:inherit;font-weight:700;}.chakra .wef-12jlgmc:hover,.chakra .wef-12jlgmc[data-hover]{-webkit-text-decoration:underline;text-decoration:underline;}.chakra .wef-12jlgmc:focus,.chakra .wef-12jlgmc[data-focus]{box-shadow:0 0 0 3px rgba(168,203,251,0.5);}privacy policy. University of Nairobi; 2018. 2019;22(10):592605. US signs pact to support Ghana achieve Universal Health Coverage Successful implementation and monitoring of the implementation of this control knob will be crucial for any country to reach UHC [101, 102]. The WHO has also introduced some frameworks and models for this purpose [80]. Ehsani-Chimeh E, Sajadi HS, Majdzadeh R. Iran towards universal health coverage: the role of human resources for health. 2015;93(3):64854. All UN Member States have agreed to try to achieve universal health coverage (UHC) by 2030, as part of the Sustainable Development Goals. If you need to access the old Global Health Observatory data, you can do it here. Ciencia Saude Coletiva. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Health Policy Plan. Some people have old fashioned, and inefficient vehicles that consume lots of fuel and break down often. The extracted factors were merged and categorized by round table discussion. Arch Public Health. Lancet. The four phases (systematic review, FGD, and semi-structured interview, merging Factors, and Expert Panel) of study and their results. Although all countries pursue the same goal, the method and timings are different based on the structure and available resources of the countries as well as the unique factors affecting countries [9]. Appendix 1- Complete search strategies for databases. In this phase, finalized affecting factors in phases 1 and 2 (160 factors through systematic review and 64 through FGD and semi-structured interviews), after elimination and merge duplicate and similar factors in round table discussion were reduced to 171 factors. Most (90%) of essential UHC interventions can be delivered through a PHC approach, potentially saving 60 million lives and increasing average global life expectancy by 3.7 years by 2030. coverage of essential health services (SDG 3.8.1); and. Q&A: How to achieve universal health coverage in Africa CAS Ghana journalists urged to use Right to Information Law to get information, Enterprise-wide risk assessment critical for business survival Bank of Ghana. In the SDGs, progress on UHC is tracked using two indicators: Detailed data is provided in the WHO Global Health Observatory Data Repository for UHC. (Ethical approval code: IR.IUMS.REC.1399.674). Arani AA, Atashbar T, Antoun J, Bossert T. Irans health reform plan: measuring changes in equity indices. Published Date - 09:50 PM, Thu - 20 July 23. Riazi-Isfahani S, Moradi-Lakeh M, Mafimoradi S, Majdzadeh R. Universal health coverage in Iran: health-related intersectoral actions. Due to the limitations in financing policies in different countries, these factors can act as leverage to improve financing policy-making and solve economic problems affecting this area. Prioritising these three areas will enhance Pakistan's ability to achieve universal health coverage, meet its Sustainable Development Goals, and improve the overall health outcomes. Without them, it will be difficult for countries to achieve UHC. Dehnavieh R, Haghdoost AA, Majdzadeh R, Noorihekmat S, Ravaghi H, Mehrolhasani MH, et al. The phases of the study (all four phases) and their results for a better understanding of the readers are presented in Fig. Moreover, the introduction of such factors results in the accurate, transparent, and accountable form of resource allocation which is a bottleneck in health systems. Ahmadnezhad E, Murphy A, Alvandi R, Abdi Z. Google Scholar. Mehrolhassani M, Najafi B, Yazdi Feyzabadi V, Abolhallaje M, Ramezanian M, Dehnavieh R, et al. Having a health system is like having a car. Economic consequences of outsourcing in public hospitals in Iran: a systematic review. Mousavi SM, Sadeghifar J. While governments can, and should, play a leading role in the global UHC movement, to make the dream of UHC for all a reality, governments, nonprofits, and businesses must work together to create and invest in robust health systems. Also, we created another column in this framework to categorize some factors that were not included in the health system control knobs columns. Your privacy choices/Manage cookies we use in the preference centre. It talks about concepts of Universal Health Care and Healthcare As An Optional Public Service" (HOPS) framework for UHC. It is intended to be a key reference document for the International Health Partnership for UHC 2030 (UHC2030), as well as a broader resource for the global community to inform collaboration on the HSS and UHC agenda. Glob Health Action. The initial purpose of healthcare systems around the world is to promote and maintain the health of the population. Doshmangir L, Bazyar M, Rashidian A, Gordeev VS. Iran health insurance system in transition: equity concerns and steps to achieve universal health coverage. Observation report of Islamic republic of Iran's National Institute of Health Research. We tried to provide a comprehensive and practical exploration of factors effective in achieving UHC. In order to create your account we need you to provide your email address. An examination of the legal, Policy and Institutional Framework for Universal Health Coverage in Kenya. All data generated or analyzed during this study are included in this published article in Additionalfiles1 and 2. Yip W, Fu H, Chen AT, Zhai T, Jian W, Xu R, et al. Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. 2012;47(3):31634. Universal health coverage in Iran. How to Achieve Universal Health Coverage? Sajadi HS, Majdzadeh R. From primary health care to universal health coverage in the Islamic Republic of Iran: a journey of four decades. Commonly, governments use a combination of health financing mechanisms for financing, while LMICs rely more on OOP payments, social health insurance, international donor, and allocations from national budgets [95, 96]. Also, it can affect justice in access to health services and make the path clear or uneven to UHC for every country [98,99,100]. 2020;19(1):112. Arch Iran Med. In a study entitled the challenges and opportunities to achieving UHC in Nepal, the factors such as using Constitutional provision, global support, and progress on the health insurance act, decentralization of health service to the grass-roots level, were introduced as an opportunity to move towards UHC. Health financing for universal coverage and health system performance 2018;32:100. The UHC service coverage index (SDG indicator 3.8.1) increased from 45 in 2000 to 68 in 2019, with the fastest gains in the WHO African Region. Google Scholar. Glob Health Action. Dr. Beracochea is a leader in global health, and aid effectiveness in development assistance. How a universal health system reduces inequalities: lessons from England. Dehghani M, Mesgarpour B, Akhondzadeh S, Azami-Aghdash S, Ferdousi R. How the US sanctions are affecting the Health Research system in Iran? Sustainable universal health insurance coverage barriers in Iran: 2007. Bill & Melinda Gates Foundation. Introduction. gcse.type = 'text/javascript'; Community participation in health services development, implementation, and evaluation: a systematic review of empowerment, health, community, and process outcomes. East Mediterr Health J. 2021;24(1):6883. COVID-19 Pandemic: An Opportunity for Universal Health Coverage Article Certainly, combining and integrating the strengths of these frameworks and covering the weaknesses of each of them would be very helpful. This study, by presenting the factors and classifying them in the framework of control knobs, facilitates the recognition of these factors according to their nature and the main area for countries and provides the basis for measures to correct and cover weaknesses in the health system of countries. The required data were gathered by searching on 1 August 2020 and the search was updated on April 18, 2021, in the following databases: PubMed, EMBASE, Scopus, ProQuest, ISI Web of Science, Cochrane Library, Science Direct, and hand searching through Google Scholar search engine.
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