Health systems strengthening
Resilient and equitable health systems are the foundation of thriving societies, ensuring that no one is left behind in accessing essential care, regardless of their income, identities, location or status.
In 2015, 193 UN Member States adopted the Sustainable Development Goals (SDGs). In doing so, they committed to ensure healthy lives and promote well-being for all, at all ages, by 2030 (SDG3). They promised to deliver this by achieving universal health coverage (SDG target 3.8), including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all.
Health is a fundamental human right. Everyone, everywhere should have access to the health services and medicines they need. Nobody should face financial barriers or risk falling into poverty when paying for health services out of their own pockets.
Despite these commitments, progress is largely off track. 4.5 billion people – more than half of the world’s population – still lack access to essential health services. What’s more, over the last 20 years, financial protection has worsened, with 2 billion people experiencing financial hardship and 1.3 billion people pushed into poverty due to health expenses.
Many governments have neglected foundational investments in health systems, resulting in insufficient access to affordable health services and quality products, well-trained and well-paid health workers, and health information systems, among others.
Health: It’s on the government
To achieve universal health coverage and health security, governments must invest in equitable and resilient health systems that are tailored to the needs of their country and their populations. These efforts must be based on the principles of universality, equity and the right to health. But although governments have the main responsibility to realize the right of health, they alone cannot deliver health for all. Social participation is critical for health systems to respond to the needs of people and communities, particularly those in vulnerable and marginalized situations. More inclusive governance for health also provides the basis for creating trust in public health policies and programmes.
Our joint vision for health systems strengthening
Resilient and equitable health systems are the foundation of thriving societies, ensuring that no one is left behind in accessing essential care, regardless of their income, identities, location or status. Improving health systems performance requires national, regional and global action in health financing, service delivery and governance. Our Healthy systems for universal health coverage - A joint vision for healthy lives paper proposes a joint vision for health systems strengthening to achieve UHC. It outlines health system performance dimensions and policy entry points to promote UHC through health systems strengthening, including principles to guide action.
Strengthening health systems, with a focus on equity and resilience, is crucial for UHC and health security and contributes to wider socioeconomic progress. There is an urgent opportunity for more and better-directed investment in the foundations of health systems and an integrated approach based on primary health care that leaves no one behind.
A primary health care approach
Building equitable and resilient health systems that are centered on people's needs and protect them from impoverishing health spending is best achieved through an integrated approach based on primary health care. With its focus on putting people at the centre, primary health care is the most effective way to ensure that health policies and services respond to people’s health needs throughout their lives, particularly for vulnerable groups including women and girls.
Primary health care can deliver 90% of essential health services needed to achieve UHC and can prevent or delay the need for more costly treatment. It is also critical for the prevention, preparedness and response of health emergencies, including those of pandemic nature, as it helps maintain access to essential and routine health services while building some of the core health systems functions needed to detect, assess and report public health events.
