COVID-19 (coronavirus): Universal health coverage in times of crisis

Health means many things to different people. The World Health Organization (WHO) defines it as a state of complete physical, mental and social well-being and not merely the absence of infirmity or disease. The importance of health cannot be over-emphasized. You need to be healthy to be productive and provide for your essential needs. You are responsible for your health. This is supported by your health system which is not limited to hospitals and healthcare workers. The third WHO’s sustainable goal is; Ensure healthy lives and promote well-being for all at all ages. To achieve this, WHO came up with Universal Health Coverage (UHC) to ensure health for all is achieved by 2030.

UHC has four main components that are essential but not known to many. One, a strong, efficient well run health system. Second, affordability of the health service. Third, access to essential medicines and technologies to diagnose and treat. Last, sufficient capacity of well-trained and motivated healthcare workers. This four in totality encompass what is referred to as UHC. Next you hear politicians talk about UHC, make sure you can check all the four above boxes. The COVID-19 pandemic has found most of the health systems not able to cope with it. So what is the UHC context in the COVID-19 pandemic?

In the advent of the pandemic, you witnessed a huge influx of patients to hospitals. This came in the backdrop of an already stretched health system worldwide. Our weak systems were exposed that you wonder if a health system was present. Strong health systems in UHC entails people centered integrated care (including services of malaria, TB, HIV, non-communicable, maternal and child health). The integrated care is anchored on prevention as opposed to curative. It emphasizes early disease detection. We need proper referral systems and a functional primary healthcare.

Health services are expensive and yet it is a right for all. You have heard the common saying, “You are one hospital bill from poverty”. Health services have remained to be in the reach of the rich. This led to the introduction of the component of affordability. Health insurance is expensive to the common man. Governments are encouraged to work on policies to cushion this. Public insurance companies are not able to cater for essential services while private companies are making a kill. The pandemic has forced many to seek healthcare. As long as it remains expensive, most might lose the opportunity for what is their right.

Have you visited a hospital, seen a doctor, after prescription of a drug, it is out of stock? Or you need to have an x-ray done but the closest one is 4 hours’ drive away? Think of getting these answers during this pandemic and maybe that drug or x-ray would have saved your life. Availability of essential drugs and services is paramount to the realization of UHC. Strong working health systems ensure availability of both and proper referral systems. Next time you go to vote ask yourself what the candidate has promised on health reforms.

Sufficient capacity of well-trained and motivated healthcare workers is key. You can read more on staffing and how to overcome the challenges during the pandemic on my previous posts https://meshrn.blogspot.com/2020/06/to-task-shift-or-task-share-during_1.html.

UHC is a great tool in the fight against the pandemic. All the four components are integral. If you get sick, you want to have a hospital near you, which has essential drugs and services. You want it affordable and find sufficient and motivated healthcare workers. UHC must tick all those boxes.



  1. Basic right yet it has become a privilege.When citizens realize the power of the vote a lot can be achieved with willing and able leadership in the realization of UHC. This is a good read as always thought provoking

  2. Our health system is still far from meeting the UHC criteria… Although NHIF helps with affordability, it's still a struggle forost people when it comes to covering major treatments.

  3. I always take home something out of these blogs. Health coverage should indeed benefit all at the minimum cost and not make people poor.

  4. NHIF is supposed to play the centre stage in the affordablity of healthcare however the policy makers are hell bent for it to only help the reach. however it has come along way to where it is now, and there many lobby groups making their voices heard on the same. many of the private insurance companies are after money thus ensure that most services can only be affordable through them.

  5. Thank you for reading. COVID-19 has exposed our health systems to show how weak they are. It also gives an opportunity for the health systems to improve and wake up from slumber.

  6. our hope is that by highlighting this falls by the elected leaders will we make better choices of leadership to ensure we get the best. Thank you for reading.

  7. Thank you for reading. If we leave them to the leaders alone to ensure it is done then it will not be achieved. we must all do our bit, but the greatest responsibility lies with them. Ours is to provide knowledge that will otherwise help the masses make better decisions at the ballot. Our hope is that it will be achieved.

  8. Thank you Mesh for this read! As we strive to achieve UHC the concern should be whether everyone has access to the needed health services of acceptable quality without anyone facing any financial hardship as a result. Again, Must tick all the boxes.

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