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Explaining universal health coverage to my grand-mother

Dr Marie-Paule Kieny, Assistant Director-General - Health Systems and Innovation

Commentary
30 September 2014

Portrait of Marie-Paul Kieny, Assistant Director-General - Health Systems and Innovation.

It is often said that the best ideas are those you can explain clearly and understandably to your grandmother.

So when we talk about universal health coverage, or people-centred care, or integrated service delivery, would my grandmother understand?

"Chère grand-maman,

Today I want to tell you about my work at WHO and about the steps we are taking to progressively change the life of all people in the world. I want to talk to you about universal health coverage, people-centred care and integrated service delivery.

With universal health coverage, you need no longer worry that illness will eat into your modest savings or bankrupt your family. You need not be concerned that you won’t be able to get the health services you need, or that they might be of poor quality. You won’t need to fear that the choice of the right doctor could be a question of life or death.

With people-centred care, when you go for an appointment at a health centre, you will be respected as a person – not simply treated as a medical case.

As you keep telling me, you’re not a spring chicken any more. Your body hurts in more than one place. But at your age, you have learnt enough about that body and the way you live your life to deserve to have a say in what sort of care will work for you.

You’ll be able to stop racing through town to see all those specialists who give you different opinions – and new pills – as they look at your different health issues in isolation, or sometimes in contradiction.

Finally, you will be looked at as a whole person - a decision maker with a responsibility for your own health.

With integrated service delivery, the nurse or your doctor will also talk to you about your diet (tss tss tss, I know you love sugar!) and confirm that you should exercise more… A healthy lifestyle will be key to your wellbeing so you can continue to host us all for the many birthday parties that lie ahead of you.

I hope that within the next 20 years, universal health coverage will enable all future generations to obtain affordable, quality person-centred and integrated health care – wherever they live.

Your granddaughter,
Marie-Paule"

The health system needs to adjust to you, not vice versa

In some countries where universal health coverage has already been achieved, through integrated service delivery, starting new national programmes can be done quickly and affordably.

"To ensure that quality and affordable health coverage is available to you and your family, we need to think more about your needs, give you the knowledge and power to own your health."

Dr Marie-Paule Kieny, Assistant Director-General - Health Systems and Innovation

Let’s say a country sees that its population is becoming more overweight, diabetes is on the rise as is heart disease. Rather than creating new siloed national programmes, first line care givers can be trained to not only treat communicable diseases, but ask questions on what you are eating, how you are feeling, do you exercise, and work with you to find a healthier lifestyle.

New systems of accountability are put in place so you and your care givers know what standards of quality to expect and to work together to make sure they happen.

As your current generation of adults age around the world, a larger percentage of people will be past retirement age. To meet this rising demand across the world, 40-50 million new health-care workers of all types will have to be trained and employed.

Given the scale of the need, many of the existing approaches to health care will be too expensive, too wasteful and duplicative and too ineffective at prevention to control costs and guarantee quality.

To ensure that quality and affordable health coverage is available to you and your family, we need to think more about your needs, give you the knowledge and power to own your health in partnership with your health professional, and see you as a whole person and not just a collection of vertical conditions.

The health system needs to adjust to you, not vice versa.