Premium
Revisiting policies to achieve progress towards universal health coverage in low‐income countries: Realizing the pay‐offs of national social protection floors
Author(s) -
ScheilAdlung Xenia
Publication year - 2013
Publication title -
international social security review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.349
H-Index - 28
eISSN - 1468-246X
pISSN - 0020-871X
DOI - 10.1111/issr.12022
Subject(s) - poverty , social protection , economic growth , business , public economics , health policy , context (archaeology) , vulnerability (computing) , health care , sustainable development , social determinants of health , social security , development economics , economics , political science , geography , market economy , computer security , archaeology , computer science , law
Despite progress on extending social health protection coverage, most low‐income countries are still far from achieving universal health coverage and thus key objectives related to improvements in health, such as those aimed at by the Millennium Development Goals ( MDGs ), will almost certainly not be realized by 2015. Principally affected are the most vulnerable populations: the rural and urban poor and workers in the informal economy and their families. It is of particular concern that progress might not only remain limited but even be reversed if policies continue to fail to address the root causes of gaps and deficits in health coverage. This article provides evidence that these causes lie both within and beyond the health sector and are strongly related to poverty and other forms of vulnerability. It argues that sustainable progress towards universal health coverage can only be achieved in an adequate time frame when focusing simultaneously on i) extending health coverage and improving access to needed health care; ii) providing income security through income support to those in need; iii) addressing limitations, or the inability to participate, in income generation from work; and iv) implementing coherent policies within and across the social, economic and health sectors that set priorities on poverty alleviation. Such policies can best be implemented in the context of national social protection floors ( SPF ) that focus on access to at least essential health care and on providing at least basic income security over the life cycle to all in need. Implementing SPFs may result in breaking the mutual linkages between ill health, poverty and other vulnerabilities and achieving sustainable progress towards universal health coverage and other social protection objectives.