ILO strategy towards universal access to health care
Updated by Sven Nef on 12.06.2015
Core elements of the ILO strategy on rationalizing the use of pluralistic financing mechanisms
The ILO proposes that access deficits be measured by utilizing detailed national health surveys, as well as regional disaggregated analyses of formal legal coverage by each health financing subsystem. This involves taking stock of all existing social health protection mechanisms within the country and analyzing which portion or sector of the population they cover. This would yield an approximation of the coverage gap and access deficit, thereby providing guidance to the national coverage plan. More…
The national coverage plan aims to provide a coherent design of pluralistic national health financing coverage and delivery systems consisting of subsystems, such as national tax-based services and social health insurance schemes, private insurance schemes etc. Aiming at universal coverage, these would operate within a clearly defined scope of competence and cover defined subsections of the population. More…
Capacity building in this context consists primarily of training; upgrading capacities in designing, implementing and monitoring; and knowledge development - e.g. through research and exchange of experiences.
Building administrative capabilities through training and the establishment of efficient structures and procedures is one of the key preparatory activities for a sustainable social health protection. The successful implementation of a reform, along with effective monitoring, good governance and reliable delivery of service, are dependent on well-trained, effective and committed staff. More…
Countries use various means of resource generation, risk pooling, health care delivery and financing to develop a model that best fits their economic development, political situation, and social and cultural values. Read examples from Egypt, Kenya, Senegal, Sierra Leone, Rwanda, and Uganda.
There is no single right financial model for providing social health protection or one single pathway towards achieving universal coverage. Countries use various means of resource generation, risk pooling, health care delivery and financing to create dynamic systems that evolve over years, often contingent upon historical and economic developments, social and cultural values, institutional settings, political commitment and leadership.
The most promising approach to attain universal coverage within a realistic time frame is to coordinate and rationalize the use of pluralistic financing mechanisms. Effective social health protection coverage can be achieved through a combination of national health services, social health insurance, community-based insurance and mandated private health insurance that respects existing coverage and financing arrangements, and can be adjusted to the specific social and economic context of each country.
Decisions on key aspects of social health protection should be based on broad social dialogue that includes social partners and representatives of patients, healthcare workers, healthcare providers and the government.
Successful social health protection systems and policies should consider three levels:
Additional information: Extending social security to all – A guide through challenges and options (section 3.2)