The right to health is a fundamental human right, enshrined in the Universal Declaration of Human Rights. Yet, millions of people around the world are denied access to affordable healthcare, leading to preventable suffering and premature deaths. This article explores the barriers to healthcare access, discusses strategies to enable affordable healthcare for all, and highlights successful initiatives from around the world.
Barriers to Healthcare Access
Several factors contribute to the lack of affordable healthcare access:
- Financial Constraints: High costs of healthcare services, including consultations, medications, and procedures, can be prohibitive for individuals and families, particularly in low- and middle-income countries. A study published in The Lancet found that out-of-pocket healthcare expenditures pushed 100 million people into poverty in 2015 [1].
- Geographical Barriers: Remote and rural communities often lack adequate healthcare infrastructure and face challenges in accessing healthcare facilities, due to distance, transportation costs, and poor road conditions.
- Sociocultural Factors: Discrimination and stigma associated with certain health conditions, such as HIV/AIDS and mental health disorders, can prevent individuals from seeking care. Additionally, cultural beliefs and practices may influence healthcare-seeking behaviour.
- Shortage of Healthcare Professionals: Many countries, particularly in sub-Saharan Africa and South Asia, face a critical shortage of healthcare professionals, including doctors, nurses, and midwives, which limits access to care [2].
- Inadequate Health Financing: Insufficient government investment in healthcare, coupled with inefficient resource allocation, can lead to underfunded health systems and limited-service provision.
Strategies to Enable Affordable Healthcare
- Universal Health Coverage (UHC): UHC aims to ensure that all people have access to quality health services without facing financial hardship [3]. Key components of UHC include:
- Prepayment and Risk Pooling: Shifting from out-of-pocket payments to prepayment mechanisms, such as health insurance or tax-based financing, helps to pool risks and protect individuals from catastrophic health expenditures.
- Strategic Purchasing: Governments and health insurers can leverage their purchasing power to negotiate lower prices for healthcare services and medications, improving affordability.
- Expanding Service Coverage: Increasing the range of services covered under UHC, including preventive, promotive, curative, rehabilitative, and palliative care, ensures comprehensive healthcare access.
- Strengthening Primary Healthcare: Primary healthcare, the first point of contact with the health system, plays a crucial role in promoting health, preventing disease, and managing chronic conditions. Investing in primary healthcare infrastructure, human resources, and essential medicines can improve access to care, particularly in underserved areas.
- Task Shifting and Community Health Workers: Task shifting involves delegating specific tasks from highly trained healthcare professionals to less specialized cadres, such as community health workers, to expand service delivery and improve access in resource-constrained settings.
- Innovative Financing Mechanisms: Exploring innovative financing mechanisms, such as sin taxes, earmarked taxes, and public-private partnerships, can generate additional resources for healthcare and improve financial sustainability.
- Leveraging Technology: Telemedicine, mobile health applications, and electronic health records can improve healthcare access in remote areas, facilitate patient-provider communication, and enhance health system
Successful Initiatives
Several countries have made significant progress in enabling affordable healthcare access:
- Thailand: Thailand achieved UHC in 2002 through a tax-financed system that covers a wide range of services, including preventive care, chronic disease management, and emergency services [4]. Out-of-pocket expenditures have decreased significantly, and health outcomes have improved.
- Rwanda: Rwanda has implemented a community-based health insurance scheme that covers over 90% of the population, with premiums based on income levels [5]. This scheme has expanded access to care, particularly for the poor, and reduced financial barriers.
- Brazil: Brazil’s Family Health Strategy, a primary healthcare model that emphasizes community participation and health promotion, has improved access to care in underserved areas and contributed to reductions in infant mortality and maternal mortality rates [6].
Conclusion
Enabling affordable healthcare to all humans is a moral imperative and a critical investment in human capital. Through a combination of UHC, strengthened primary healthcare, innovative financing mechanisms, and technology, we can make significant progress towards this goal. The success stories from Thailand, Rwanda, and Brazil demonstrate that it is possible to achieve affordable healthcare access, even in resource-constrained settings. The global community must continue to work together to ensure that every person, regardless of their socioeconomic status or geographical location, has access to the healthcare they need to live a healthy and productive life.
References
- Wagstaff A, Flores G, Hsu J, et al. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet. 2018;391(10120):673-681.
- World Health Organization. Global strategy on human resources for health: Workforce 2030. Geneva: World Health Organization; 2016.
- World Health Organization. What is universal health coverage? Geneva: World Health Organization; 2023.
- Tangcharoensathien V, Pitayarangsarit S, Patcharanarumol W, et al. Universal health coverage in Thailand: successes and challenges. BMJ. 2019;365: l1429.
- Lu C, Chin B, Lewandowski JL, et al. Rwanda’s evolving community-based health insurance scheme: lessons for progress toward universal health coverage. Health Policy Plan. 2012;27(Suppl 1): i31-i40.
- Macinko J, Aquino R, Burlá C, et al. Family health strategy in Brazil: a commentary on successes and challenges. Journal of Public Health Policy. 2017;38(4):450-465.
