During the UN General Assembly high level meeting in 2011, world leaders made commitment to address NCDs. This commitment was re-affirmed in 2014 and 2018. Furthers, the advent of Sustainable Development Goals highlighted the growing commitment towards addressing the burden of NCDs as stipulated in target 3.4 which seeks to, “by 2030, reduce by one third premature mortality from NCDs through prevention and treatment and promote mental health and well-being.” The World Health Organization (WHO) Global action plan for the control of NCD 2013-2020 proposed that countries strengthen their health systems and address NCDs through the people centered PHC and UHC.
Universal Health Coverage (UHC) proposes that everyone access the quality healthcare services they need without exposure to any financial risk. The vast amount of evidence indicates that primary healthcare service is essential and a foundation for a strong health system, offering preventive and basic healthcare intervention including for NCDs. However, this level of service delivery is seemingly least prioritized in terms of funding and purchasing modalities. Some of the reasons for the contrast include the limited financial management capacity, limited or no autonomy and non-strategic payment mechanism. Again, despite the encouraging evidence of the world leader’s commitment to address NCDs, many countries policy response to NCD control are limited. There is variation in implementation of PHC and UHC with fragmented response to NCDs.
In the light of the preceding, SPARC, in partnership with AfroPHC, organized a webinar themed “Exploring UHC Funding/Payment Reforms for PHC in Africa.” AfroPHC is a community of Primary Health Care (PHC) health workers interested in elevating learnings, issues and opportunities for PHC Systems Strengthening and SPARC is an Africa based resource hub aimed at Strengthening Strategic Purchasing capacity in sub-Saharan Africa by connecting existing regional expertise and matching it with country demand to make better use of resources for health. Its vision is to empower countries with knowledge and practical tools to make access to affordable and quality health care a reality for all.
I got a chance, through Stowelink (where I am the Chief Programs Officer) to attend this workshop to represent young people and provide my perspective concerning NCDs integration into PHC financing models. Representing Stowelink at the workshop, I advocated for integration of NCDs services into the primary health care. While recognizing that limited funding options and the increasing financial downtime orchestrated by COVID-19 may be blamed for reversing the gain made in PHC, I strongly advocated for innovative financing for NCDs.
Vast amount of evidence suggests that addressing the growing NCD burden will require substantial re-orientation of primary health care (PHC) including the funding mechanism to alleviate the increasing out-of-pocket expenditure that impede health care access. I submitted that NCDs are becoming/or are already defining challenge of the 21st Century hence the growing body of need for expanding primary healthcare packages to adequately tackle this silent pandemic.
In commenting on the need to increase awareness of PHC workers and PHC financing options, I sobbed that PHC has focused so much on infectious disease with little or no attention to NCDs. As such, I proposed that PHC workers must now be equipped with the requisite knowledge and skills for detecting and managing non-communicable diseases at the primary health care levels. Further, I suggested that regular refresher training on NCDs is critical to for PHC workers as this will also serve to update them on current development/trends around this field.