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Currently, there has been an increasing push for nations to meet Universal health coverage to strengthen their healthcare system by improving equality and access to healthcare services. After public health improvement and epidemiological transition UHC has been addressed as the third Health transition in the world. Fundamental health and development corporations including the World Bank Group, Oxfam, WHO, Rockefeller Foundation, International Labor Corporation, United Nations Children Fund and the Gates Foundation, have taken multiple initiatives to promote UHC. This coverage mainly aims to maintain community and individual health access and quality of service without experiencing financial hurdles. The UHC concept is closely linked to the sustainable development goal 3 frameworks and the right to health that mainly in to maintain all individuals’ healthy lives and nurtures their well-being. For example, SDG 3.8 focuses on reaching UHC, including quality basic healthcare services access, and economic risk protection, access to inexpensive important medicines, vaccines, effective, safe and quality for all (WHO, 2022). Along with that SDG 1 that focuses on "ending all forms of poverty everywhere," can be in jeopardy without UHC as near about 90 million individuals are improvised each year due to health costs (The World Bank, 2022). Additionally, the right to health is glorified in “the Articles of the WHO Constitution in 1946 and professed by member states in Article 25 of the United Nations Universal Declaration of Human Rights of 1948 and the International Covenant on Economic, Social and Cultural Rights of 1966” (Uhc2030, 2023). This research is mainly focused on the UHC's role in maintaining population health right including a specific concentration on SDG3. Focusing on the UHC definition and its connection with his right historical rights in international agreement exploration, WHO constitution, Alma Ata declaration and sustainable development goal helps to provide information on the UHC's role in health rights promotion.
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According to the WHO, universal health coverage is demonstrated as all individuals have full access to standard health services that they require where and when they require them without any financial struggle. The crucial health service continuum full context comes under the UHC umbrella from health prevention to promotion, rehabilitation, palliative care and promotion. On the other hand, health rights are demonstrated as a community and individual inherent right to appreciate the most elevated achievable mental and Physical health standards (Who, 2023). This right mainly focuses on protection by identifying global Legal equipment including the “International Covenant on Economic Social and Cultural Rights, the Convention on the Rights of the Children, and the Universal Declaration of Human Rights.”
In order to deliver on this commitment WHO set a standard for the corporation in that they reveal that nations need to possess efficient, equitable and strong healthcare systems that are significantly connected with their serving society. In order to get there primary Health Care is cost efficient and the most effective way. Each nation possesses different initiatives to achieve the goal of UHC and focusing on population-specific requirements and resources they choose what to cover. PHC investment maintains population can get quality health services as well as resources by addressing their requirement in an integrated method (OHCHR, 2020).
Overall UHC poses three fundamental dimensions as
-health service access to all who require service not only for those who can provide payment for the service
-it helps to protect against financial risk which means individuals need not fall into debt while paying for healthcare services or treatment.
- it has to provide quality services that are effective and adequate
Many people across the world cannot get treatment care and prevention services during their requirement and to that they are allowed to gate quality Health Services as it is their basic human right. Overall the characteristic of UHC depends on fair axis and equity in health (Ncbi, 2018).
There is world's 7.3 billion population does not possess health coverage and they do have not full access for getting quality Health Services. Additionally world's 12% population which is 800 million people utilise households 10% budget for bearing health expenditure. Near about 180 million population expanded their housing budget on health. The increasing rate number is around 5% per year in that women are the most affected segments (WHO, 2022). During the pandemic outbreak the right to health and healthcare equity got attention within the global conversation that highlights universal healthcare is significant in developing an additionally resilient healthcare system and providing a healthy life to all.
Beyond individuals in health UHC has a high contribution to equality, economic growth, human dignity, ending property and social inclusion. The UHC aim is demonstrated in the United Nations 2030 commitment as a sustainable development goal part in goal 3 that mainly concentrates on individual health which is also called target 3.8 (UICC, 2022).
SDG 3.8 growth is significantly followed by the collaboration of the World Bank and the World Health Organisation via a global monitoring report that was revealed every 2 years. The measures of the target are crucial health service coverage which is SDG indicator 3.8.1 and protection to financial risk which is SDG indicator 3.8.2. As per the SDG indicator 3.8.1, service coverage index measures individuals' capability within a nation to fully access crucial Health Services. The index is measured as 16 equally weighted indicators Geometric mean concentrating on four fundamental healthcare areas such as infectious diseases such as malaria and tuberculosis, maternal reproduction and health of newborn children, service access and capacity for instance hospital professional number or bed number per capita and non-communicable disease such as diabetes and hypertension (Worldbank, 2023).
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The SCI provided ranks of Nations on a 0 to 100 scale. A higher score means greater service coverage while a lower score means that there is a need to improve the area (See Appendix 1). After the pandemic outbreak health service coverage possesses inequality that remains the same instead of convergence and global progress. About 193 nations and 31 countries pose the highest number while 93 countries possess 60-79 scores that demonstrate high SCI scores (WorldBank, 2019). On the other hand, there are 54 countries with medium scores and 16 countries with low scores of 20-39. However, no nation has extremely low service coverage that is below the 20 SCI score.
Additionally, the financial protection that is mentioned in SDG indicator 3.8.2 is calculated as the population living fair in the household in that OPP (out-of-pocket) expenditure goes beyond 25% or 10% of the total household budget.
Kharas, McArthur and Ohno, (2019) Stated that the UHC is largely accepted in multiple countries to boost their health system development and promote individual well-being. In this aspect, developed nations such as Canada, Israel, New Zealand, Australia and Japan have incorporated this service in multiple forms. Canada and Australia collaborate between the Government and federal government in state territories and provinces to implement UHC. Besides that, some countries such as Germany included alternative initiatives to UHC considering national taxation or local taxation. Some low and middle-income nations particularly Sub-Saharan Africa implemented this service to supply adequate services despite their financial constraint, limited health resources and underdeveloped healthcare systems. In those countries due to their financial limitations, people have to pay full payment to access healthcare services whether they have proper financial conditions or not.
The health rights foundation context can be found in United Nations charters like foundational manuscripts which can give health rights as an intrinsic function to supply healthier life to all. This act is developed in 1945 and defines the “equal and inalienable rights of all members of the human family” and “inherent dignity”. as the “foundation of freedom, justice and peace in the world” This principle of Human rights support is basic for the United Nations (Hrlibrary, 2023). On the other hand, the constitution of the World Health Organisation is also firmly connected with the principle of health rights. The constitution was enacted in 1948, 7th of April and first signed in New York in 1946 which held an international health conference. As per the constitution statement health is characterized by a social mental and physical well-being state, not only just information or disease absence. Maximum attainable health standard enjoyment is an individual's fundamental right regarding religion, social condition, economic status, political belief and race. All people's health is basic to the security and peace attended to and heavily relies on complete state and individual cooperation. Any state's achievement within the health security and promotion context is demonstrated as an entire individual's value. Distinct Nation's unequal development in the context of disease maintenance or health and well-being promotion comes under common danger. Child health development is of fundamental significance in that the capability to transform the complete environment to provide a healthy life is crucial for their mental, physical and cognitive development (world health organisation, 2023). Extension of access to psychological medical and relevant awareness to the entire community and individual is crucial to attaining the fullness of health.
The Alma Ata Declaration of 1978 has achieved one of the greatest milestones in public health in the 20th century it has achieved the target that good health for all is identified by Primary Health Care.
The Conference reaffirms that health, which is complete social well-being, mental and physical, state and not simply infirmity or disease absence, is a basic human right and that the achievement of health's highest standard is a considerable essential global social goal for the culmination of that numerous other colonial sectors apart from the health sector and economic sector effort is needed. The gross disparities that exist in people's health status, especially between materialised and developing nations and within countries, are socially, economically and politically inappropriate and, thus, it is a common concern in most countries. People retain the duty and right to experience collectively and individually in health care implementation and planning. Primary health care is fundamental health care founded on socially acceptable, scientifically sound and functional techniques and initiatives that make it universally affordable to engaged people and their families in society and community and nation can sustain at every developmental level of self-determination and self-reliance in a cost (World Health Organisation, 2023). Overall it can be stated that The declaration establishes a foundation for UHC.
On the other hand, the Astana declaration also possesses a link with UHC as the commitment to health rights has been stated by the international community in this declaration in 2018. The Declaration reaffirms responsibility for all human beings' fundamental right to the most increased obtainable health standard enjoyment without discrimination. Called on the Alma-Ata Declaration's fortieth anniversary, the Declaration reaffirms its commitment to entire principles and values, especially to solidarity and justice, and it emphasizes the health and interdependence significance for security, socio-economic and peace development (World Health Organization, 2018). The declaration affirmed that strengthening PHC (primary health care ) is a considerably effective, efficient and inclusive initiative to improving social well-being as well as individuals' mental and physical health and that PHC is a bearable health system's foundation for the Health-Related SDG and UHC. The Declaration confirms that despite significant progress within the last 40 years, the health needs of people across the world are still unmet. For numerous people staying healthy is quite problematic, especially for financially constrained people. The declaration addresses it as economically, politically, socially and ethically unacceptable. It is also your government's responsibility and primary role to protect and promote individuals' health right to get high standard healthcare (Ohchr, 2019). UHC and multisectoral action will be promoted through this enhancing relevant stakeholder engagement and boosting regional society to amplify PHC.
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As a principle, the coverage can ensure all people can fully access quality healthcare services including failure team rehabilitation and curative care. The target of SDG 3 is linked with this right to achieve the goal such as minimizing preventable newborn child death or infectious disease prevention (Ico, 2023b).
The service needs to be accessible and fair for supplying information to enhance individual awareness about their health condition or developing and informing decisions in respect of their own health. The target of sustainable development goals is relevant to substance treatment and prevention and the right to education poses relevance to UHC goals (Ico, 2023).
The service UHC focuses on supplying high-standard healthcare services,s aligning witthe h maximum health attainable standards. In this aspect, SDG 3 focuses on healthcare service standards through professional capacity enhancement that poses relevance to UHC goals (Gov, 2022).
In order to maintain UHC for their people there is a need for significant efforts at the international as well as national level. The government needs to focus on enhancing its investment in healthcare infrastructure by prioritising primary Health care services. A country that poses inadequate healthcare infrastructure needs to invest on a domestic level. In that, they can allocate proper resources for boosting their healthcare infrastructure development while maintaining quality healthcare services. They can also provide training to the community healthcare worker to increase their awareness about UHC's significance in maintaining health rights (UICC, 2022). Besides that, there is also a need to identify social health determinants such as housing education and poverty and to improve this area there is a need to include some policy that prioritises targeting these determinants to achieve health rights. In this aspect, community engagement is also valuable as they can engage in decision development in that they can trailer regional requirements.
On the other hand countries such as low and middle-income countries having limited GDP can make global collaboration for identifying health challenges that go beyond to the national border. In that, WHO has a significant role in coordinating efforts to maintain adequate practices within that country to boost health rights.
The previous country's example demonstrated Health Care expansion has long-term political procedures and is often tied to social welfare growth. It needs political scope, financial resources availability, particularly from an effective tax revenue foundation and a combination of left-wing and strong political leaders or parties. Additionally, low and middle-income nations such as Africa show a connection between morbidity and property. In that country, GDP is also low, which demonstrates the country's financial limitations that create barriers to accessing high-standard health service (McKee et al., 2019). Additionally, the pandemic outbreak adversely influenced Africa and Asian LMIC. In that country, the death of TB patients has increased due to the pandemic minimising TB patient diagnosis management and treatment. It pushed about 90 million people into property. On the other hand, about 368 million children do not go to school and they cannot get school meals due to the pandemic influence on food security. In Nepal, the lockdown minimizes 50% of institutional delivery while in India more than 50% of child immunization service and antenatal care are disrupted (Kodali, 2023). As a result UHC Service also decreased in those countries.
Conclusion: Advancing health through UHC
Universal health coverage shows the key rule depending upon 100 particular frameworks of Sustainable Development Goal 3. To achieve a universal healthcare service that promotes overall. Different types of international agreements are embedded with UHC to promote health and different rights for providing adequate quality of services and maintaining equality for all including financial constraints. USC and the rights of health involve different types of domestic investment with proper strategy and cultivating society interaction which promotes international cooperation through legal frameworks. UHC principle alignment with SDG3 helps to provide a healthy nation that leads to universal health growth by supplying sufficient access to all.
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