Universal Health Coverage (UHC)

About the House

University Health Coverage (UHC) is a priority of the global health policy to increase access to, and quality of, essential health services. Underpinning this priority is the drive to conform to the United Nations Sustainable Development Goal 3: Good health and well- being that was adopted by the United Nations in 2015 and declared an urgent global goal.

The World Health Organization (WHO) defines UHC as “ensuring that all individuals and communities receive the health services they need without suffering financial hardship’ including ‘health promotion prevention, treatment, rehabilitation, and palliative care” (WHO 2019). UHC is therefore a sound and solid commitment by any government to improve the wellbeing of all its citizens and promote health security and social cohesion. Zambia is committed to achieving UHC through the primary health care approach and is a signatory to multiple International, Regional and National commitments. While significant strides have been made in realising the commitment, Evidence has shown that there isn’t much research that has been done on UHC in Zambia to inform policy and programming. PASGR is responding to this gap by establishing a community of practice around UHC that will enhance evidence-informed decision making (EIDM) around UHC as a policy issue of interest. The community of practice is synthesizing the already existing evidence as well as generating new evidence through research/rapid studies to enhance uptake of research evidence into inclusive policy and programmes in Zambia.

House' Approach

Through the Utafiti Sera approach, PASGRs’ innovative research-to-policy framework that supports meaningful engagement of multiple stakeholders in the research process and provide safe spaces for stakeholder engagements and knowledge exchange on the national policy issue of interest. The Utafiti Sera framework provides platforms for co-creation and networking among stakeholders thereby removing traditional barriers between researchers, policy makers, communities, and beneficiaries. PASGR recognizes that strong and sustained collaborations among researchers, practitioners, decision-makers and citizens (policy beneficiaries) are central to finding solutions to dynamic policy problems. The House through collaborations and stakeholder convenings is enhancing co-creation and co-production of knowledge through the house forums and interactions to promote knowledge translation.

Through this house, PASGR is amplifying the significance of evidence-informed decision making in UHC by creating safe spaces and platforms for policy dialogue and debates, policy actor engagement, and structured dialogues. Through these spaces the research-policy community have the opportunity to listen, engage, and talk to policy actors including from the government ministries and agencies, private sector, civil society organisations and policy beneficiaries in a manner that transcends the power imbalances that have existed before in the policymaking terrain.  The house activities allow for meaningful and equitable participation of diverse actors in the evidence-informed decision making (EIDM) process through systematic engagements and deliberations.

PASGR is consolidating efforts across Zambia for knowledge transfer and documentation with the aim of understanding the available evidence and finding locally viable and scalable solutions to specific policy problems within the UHC sector. The House is composed of a diverse pool of stakeholders, ranging from state, non-state, and international actors with varying interests in UHC in Zambia.

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Objectives of the House

The overall objective of this house is to strengthen the capacity of the research-policy community to enhance uptake of research evidence around UHC into inclusive policy and programmes. Specifically, the house is driven by the following objectives;

  • To sustain a robust constituency of policy actors and a community of practice around UHC;
  • To map and synthesize available evidence or generate new evidence through a rapid studies/research on UHC to fill existing knowledge gaps and inform policy uptake;
  • To strengthen the capacity of house members on packaging and production of information, communications and uptake materials to accelerate research evidence uptake.

Country of Focus – Zambia

Cities of Focus/Counties – Lusaka and all other major cities in Zambia.

Host Organisation – Centre for Reproductive Health and Education (CRHE)

Policy Issue

Universal Health Coverage (UHC) has become a central focus in the global health agenda, prioritizing the reduction of health inequalities and improving access to health services. UHC is a multi-dimensional concept encompassing population coverage, service coverage, and financial protection. It also integrates equity and quality into its definition. The aim is to ensure that everyone receives the necessary health services, including initiatives to promote better health, prevent illness, and provide treatment, rehabilitation, and palliative care of sufficient quality. Importantly, these services should not impose financial burdens on users. The goal of UHC is to ensure that all individuals can access promotive, preventive, curative, rehabilitative, and palliative health services of adequate quality, without facing financial hardship.

Zambian government is dedicated to achieving universal health coverage (UHC) through a primary health care approach. This commitment is evident in the various reforms implemented to increase access to and utilisation of health services for all citizens. Notable examples include the decentralization of health service planning and delivery, as well as the introduction and subsequent abolition of user fees in rural, peri-urban, and all primary healthcare facilities nationwide.

To compliment the government efforts, the House is enhancing evidence uptake on universal health coverage in Zambia through the Utafiti Sera approach, that facilitates a continuous and equitable participation of diverse actors.

Since it’s inception early this year, the house has conducted a mapping and synthesis exercise on existing studies and rapid studies on UHC in Zambia to fill knowledge gaps and inform research evidence uptake. The house has also conducted a scooping review to assess Zambia’s policy reform progress towards UHC within the framework of the WHO building blocks. This review focuses on identifying potential challenges and opportunities for advancing UHC. From the review and synthesis of key elements of the 2022–2026 National Health Strategic Plan goals, it was evident that leadership and governance remains the critical for the successful implementation of UHC in Zambia. Leadership and governance are pivotal in ensuring the efficient and effective management of the health sector. In the context of UHC, leadership is synonymous with stewardship, while governance encompasses the systems and structures that facilitate sector coordination, participation, transparency, and accountability. Leadership and governance is the main policy priority for the House.

House Resources/Outputs

Newspaper and Media Mention

Convening/Activities

Co-creation policy-driven stakeholder engagements to enhance the evidence uptake is the major focus of the house activities. To achieve this, the house organizes convening and forums where researchers and policy makers get to interact and engage in knowledge sharing on policy gaps, best practices and desired changes.

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