By Sophie Nyongesa
World Health Day, celebrated annually on 7th April, is an initiative of the World Health Organization (WHO) with the aim of raising awareness about the overall health and well-being of people; each year drawing attention to a specific public health concern to persons all over the world. The theme for this year “Building a fairer, healthier world” emphasizes on the call for action to eliminate health inequalities as part of a global campaign in bringing people together in building a fairer and healthier world. This theme highlights the WHO’s constitutional principle that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.
Universally, the majority of people are struggling to make ends meet with some grappling to get by with less than a dollar a day in income, poor housing conditions, lack of equal opportunity to quality education, fewer employment opportunities, experiencing greater gender inequality, and little or no access to safe environments, clean water and air, food security and health services. The World Health Organization states that this leads to unnecessary, avoidable illness, and premature death, and injustice that harms our societies and economies.
Although all countries have been hit hard by COVID-19, the WHO states that its impact has been seen to be harshest on those communities which were already vulnerable, who are more exposed to the disease, less likely to have access to quality health care services and have more likely experienced adverse consequences as a result of measures implemented to contain the pandemic. For instance, pregnant women in Kenya opted to deliver from home while others missed their antenatal care visits due to the fears of contracting COVID-19 during their visits to health facilities. Moreover, Gender Based Violence against women and girls increased as they spend more time at home with potential or known abusers while the government- imposed restrictions made it harder for survivors to report abuse, seek help and medical attention, and for service providers to respond efficiently.
COVID-19 has also undercut health gains, pushed people into poverty and food insecurity and amplified gender, social and health inequalities. Health inequalities are not only unjust and unfair, but they also threaten the advances made to date, and have the potential to widen rather than narrow equity gaps. However, on the brighter side, World Health Organization states that health inequalities are preventable with strategies that place greater attention to improving access to quality health care, especially for the most vulnerable and marginalized groups. These strategies include;
- The provision of Universal Health Care of sound quality based on the principles of Primary Health Care. This would include the provision of equitable, accessible, appropriate, affordable services focused on health promotion, disease prevention and multi-sectorial social development in which citizens are active participants.
- Promoting health equity in policies and programmes – placing responsibility for action on health and health equity at the highest level of government ensures its coherent implementation across all policies. This requires that ministries of health adopt a social determinants approach and develop a framework across all of its policy and programmatic function.
- Fair financing – Public financing for the social determinants of health is fundamental to the promotion of health and prevention of disease. Strong public sector leadership and adequate budgets are the foundations of an equitable health system.
- Political empowerment- democratic participation in a full and unrestricted manner is a very important aspect in creating an equitable society. Inclusive social practices enable civil society organizations to promote political and social rights in a way that improves health equity.
- Good global governance – good governance strengthens the coherence of action across sectors and stakeholders, increasing the capability and ensuring joint action and accountability on health and non- health sectors, public and private sectors and citizens, for a common interest of improving health on equal terms.
Adopting a whole government approach to tackling the root causes of inequalities and increasing investment in primary health care is key in meeting today’s challenges of ensuring health for all and to building resilient health systems for the future. These includes deliberately investing significant portion of government resources, including from national budget on the marginalized populations to improve their socioeconomic and health outcomes as well as coming up with integrated solutions that have positive impact on several Sustainable Development Goals including those related to food, health, climate and more so SDG 10 on reduced inequalities.
Furthermore, leaders should ensure that communities are at the forefront in decision-making processes as we strive to move forward to a just and equitable world that promotes the achievement of all the Sustainable Development Goals. Additionally, we should urge leaders to monitor health inequities, and to ensure that everyone is able to access quality health services depending on their health needs.
A coordinated approach is needed that brings together governments at all levels while adopting rights approaches based on the needs of communities to address the root causes of inequities and to implement solutions within and beyond the health sector can result to a just and equitable world. This will go hand in hand with ensuring an equitable supply of health products including vaccines, testing kits and equipment. We must therefore strengthen national and international mechanisms that aid in the establishment of sustainable solutions to socio-economic problems while creating equitable access to the highest quality of healthcare, only then will it be possible to build a fairer and healthier world!