Achieving Universal Health Coverage (UHC) by 2030 will require innovative interventions that blend an understanding of a community’s characteristics and contextual issues to create solutions with long-lasting effects.
To do so, we need to think beyond the traditional lens of health care delivery to consider both the social factors and implications on population health. This was one of the key takeaways of the UbuntuPlus Co-Creation Mission, organized by Chestrad Global, from November 1 – 4 in Ilesha, Ile-Ife and Lagos, Nigeria.
UbuntuPlus is Chestrad’s commitment to telling Africa’s own stories of diversity, gender equity and youth inclusion through co-created interventions that integrate concepts of African humanity, such as Ubuntu, Omoluabi and Ajoje.
Nneoma Ekwem and I were invited to attend and represent VillageReach at the mission. We had the opportunity to learn more about UbuntuPlus and to share VillageReach’s Community Insights to Action (CITA) Framework. We developed the framework to ensure that the needs and preferences of under-reached communities are at the center of the design and delivery of responsive primary health care (PHC).
At the mission, we engaged communities in guided conversations, gaining insights on citizen-led development; understanding issues affecting access to health and other services, brainstorming initial solutions and providing feedback to community leadership and government as inputs in designing responsive systems.
Citizen-Hubs for Economic Empowerment and Health Promotion
During these discussions, I learned how community livelihood was impacted by COVID-19, pushing people into extreme poverty, especially those who rely on daily sustenance from small businesses.
Communities took it upon themselves to build a path to economic recovery through people groups (citizen-hubs), which served as a resource center for economic empowerment and health promotion, demonstrating the concept of Ubuntu, or “I am what I am because of who we all are.”
With the support of Chestrad, citizen-hubs have since been able to improve the scale and scope of support to an even larger volume of recipients. They will now benefit from telehealth services in collaboration with the Access to Basic Medical Care (ABC) Foundation.
The community conversations also revealed that while health is at the center of development, achieving a healthy status is dependent on access to quality health care and affordable health care. Poverty is an important denomination in health care.
In a small group session I led, one woman said, “There are no medicines in the nearest health center to my house, and it takes up the whole day to access health care, meaning I will have to neglect my business.”
Another woman said, “I need to be able to go to a health center and not worry about money to pay for health services.”
One man said, “Men have health needs, too, but this comes secondary to the drive for livelihood.”
People should not have to be pushed into poverty to access quality health care. The PHC system of the future must be more responsive, flexible and resilient to meet individual needs.
Keeping the Community at the Center of Intervention Design and Implementation
Reflecting on our conversation, it was clear to me that we often neglect a critical stakeholder—service users—in designing health interventions, and, as a result, our health systems remain inequitable and unable to deliver on health goals.
Building systems with the service user at the center implies that, for different populations, different approaches will be needed to deliver health services, including the location and staffing of service delivery points and other health infrastructure.
It was also clear that population health will benefit from multisectoral collaboration because health does not happen in a vacuum. Opportunity costs are associated with meeting health needs, and great educational and economic benefits are associated with staying healthy.
VillageReach believes in radical collaboration with governments, the private and social sectors to scale and sustain equitable PHC delivery solutions. Multisectoral collaboration is a natural step.
It is imperative that we work together, embracing the Ubuntu spirit of “I am what I am because of who we all are” as governments and communities, to bring ourselves closer to Universal Health Coverage.