Impact Story

Mutual learning and accountability for universal health coverage

Published on 9 July 2019

Ensuring everyone in the world has access to decent healthcare is the concept behind universal health coverage. This ambition is part of the Global Goals, but has been on international agendas since 1978, when the Alma-Ata Declaration identified primary healthcare as key to attaining health for all people.

‘Abbie Trayler-Smith/H4+Sia Sandi, a student midwife from The School of Midwifery in Masuba, examines a pregnant patient while on placement at the Makeni Regional Hospital. Her training is being funded by H4+ (made up of UNAIDS, UNFPA, UNICEF, UN Women, WHO, and the World Bank), formed to implement the UN Secretary General’s Global Strategy for Women’s and Children’s Health and progress the health-related Millennium Development Goals (MDGs). In Sierra Leone, the H4+ is working on fundamental programmes to strengthen health systems, in particular reproductive, maternal, newborn and child health care, including the implementation of new training policies for midwives’. © Abbie Trayler-Smith/H4+/Panos Pictures

With 2018 marking the 40th anniversary of Alma-Ata, IDS has been leading calls for policymakers, academics and service deliverers to look beyond the technical aspects of health to achieve universal health coverage. In their work on healthcare over the past year, IDS researchers have emphasised the importance of mutual learning between and across countries, disciplines and sectors, while strengthening mechanisms of accountability.

Members of the IDS Health and Nutrition Cluster, as co-hosts of the Health Systems Global (HSG) secretariat, have, since 2016, played a central role in coordinating and managing HSG’s growing global membership of more than 1,800 members in 120 countries. The Cluster was at the forefront of the highly successful HSR2018 – the Fifth Global Symposium on Health Systems Research – in Liverpool in October 2018. IDS was an active member of a consortium of UK partners that co-convened the event alongside Health Systems Global (HSG), the World Health Organization, and the Alliance for Health Policy and Systems Research. The event was the largest of its kind and was praised for fostering interconnections across research and policy.

HSR2018 – success in numbers

  • 2,247 delegates from 146 countries
  • 125 parallel sessions
  • 451 poster presentations from academics across the world
  • 283 scholarship recipients
  • 62,391 unique visitors to HSR2018 website (July 2017 to October 2018)
  • 7 million users of #HSR2018 hashtag during Symposium

IDS had a strong presence at HSR2018. Researchers from the K4D programme facilitated learning for DFID’s health cadre. The Impact Initiative programme coordinated sessions to support ESRC-DFID researchers to engage their research with health policymakers, researchers and activists attending the conference. IDS alum Professor Asha George was also appointed Chair of the Board of Health Systems Global at the Liverpool Symposium.

Over 2019, HSR2018 outcomes include cross-institutional engagement around the Alma-Ata Declaration, the World Health Assembly and the UN General Assembly; a new coalition to advance implementation research and delivery science; and planning for HSR2020 in Dubai.

Accountability for health equity

To achieve universal health coverage, health resources must reach the people most in need – often those most marginalised in society. Putting the universal framing of development into practice, IDS explored different ways to strengthen accountability as a means to promote health equity.

The Unequal Voices project, comparing experiences of implementing pro-equity health reforms in Brazil and Mozambique, ended in 2018 with a successful series of policy events in both countries. Project staff engaged with decision makers including Mozambique’s Minister of Health, representatives from the World Bank, the municipal health secretariat in Sao Paolo, and the district indigenous health office in the remote Rio Negro region of the Amazon.

The project’s principle investigator, Alex Shankland, worked with Tom Barker and Laura Bolton of IDS and a team led by Professor Stephen Peckham of the University of Kent to study the same issues in the NHS in England, commissioned by the Brazilian Ministry of Health Research and Training Agency, Oswaldo Cruz Foundation (Fiocruz). This contributed to the key aim of supporting mutual learning not only between Brazil and Mozambique, but between countries of the South and the UK.


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