P4H is a response to the global challenge that some 100 million people are pushed into poverty each year because of costs incurred in paying for health care out of pocket (OOP) at the time of need while many more are too poor even to seek health care. It is estimated that 1.3 billion people – more than a fifth of the world’s population – do not have sufficient access to health services at all; for an even greater number, in the absence of any form of income support, sickness or disabling injury entail severe financial penalties. There is need to raise more awareness about this global challenge and to enhance and scale up support to partner countries in their efforts to move closer to UHC/SHP. The launch of P4H as the global network for social health protection is an important landmark ushering in coordinated responses to accelerate countries’ transitions to universal coverage and social health protection.
Challenges of development cooperation
Recognizing that access to quality health care for poor and disadvantaged groups remains a critical challenge, many low- and middle-income countries are now striving to establish UHC/SHP, and turning to external development partners (DP) for help and advice in drawing up and implementing workable policy. Increased global demand for support, coupled with the growing momentum behind UHC/SHP initiatives, has led to a marked increase in the number of actors and investments.
Unfortunately, a lack of coherence, both at the country and DP level often gets in the way of progress. It is not unusual, for example, for different sectors such as health, social affairs, finance, and local government to find themselves pulling in different directions as stakeholders seek to protect or further their interests. At the same time, the different approaches and agendas pursued by DPs can lead to incoherence if not outright interference in support efforts. Such challenges are only compounded by the shifting priorities and frequent staff changes within DPs, some of which also lack the capacity required to fulfil their mandates.
Finally, the support provided frequently fails to recognize the complexity of the issues faced or is packaged as one-size-fits-all solutions that are imposed on countries regardless of their specific needs.