IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i1p587-d718177.html
   My bibliography  Save this article

Strengthening the Health System as a Strategy to Achieving a Universal Health Coverage in Underprivileged Communities in Africa: A Scoping Review

Author

Listed:
  • Anelisa Jaca

    (Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa)

  • Thobile Malinga

    (Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa)

  • Chinwe Juliana Iwu-Jaja

    (Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa)

  • Chukwudi Arnest Nnaji

    (Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa
    School of Public Health and Family Medicine, University of Cape Town, Cape Town 8000, South Africa)

  • Joseph Chukwudi Okeibunor

    (World Health Organization Regional Office for Africa, Brazzaville, Congo)

  • Dorcas Kamuya

    (Department of Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Nairobi 43640-00100, Kenya)

  • Charles Shey Wiysonge

    (Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa
    School of Public Health and Family Medicine, University of Cape Town, Cape Town 8000, South Africa
    Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa)

Abstract

Universal health coverage (UHC) is defined as people having access to quality healthcare services (e.g., treatment, rehabilitation, and palliative care) they need, irrespective of their financial status. Access to quality healthcare services continues to be a challenge for many people in low- and middle-income countries (LMICs). The aim of this study was to conduct a scoping review to map out the health system strengthening strategies that can be used to attain universal health coverage in Africa. We conducted a scoping review and qualitatively synthesized existing evidence from studies carried out in Africa. We included studies that reported interventions to strengthen the health system, e.g., financial support, increasing work force, improving leadership capacity in health facilities, and developing and upgrading infrastructure of primary healthcare facilities. Outcome measures included health facility infrastructures, access to medicines, and sources of financial support. A total of 34 studies conducted met our inclusion criteria. Health financing and developing health infrastructure were the most reported interventions toward achieving UHC. Our results suggest that strengthening the health system, namely, through health financing, developing, and improving the health infrastructure, can play an important role in reaching UHC in the African context.

Suggested Citation

  • Anelisa Jaca & Thobile Malinga & Chinwe Juliana Iwu-Jaja & Chukwudi Arnest Nnaji & Joseph Chukwudi Okeibunor & Dorcas Kamuya & Charles Shey Wiysonge, 2022. "Strengthening the Health System as a Strategy to Achieving a Universal Health Coverage in Underprivileged Communities in Africa: A Scoping Review," IJERPH, MDPI, vol. 19(1), pages 1-21, January.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:1:p:587-:d:718177
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/1/587/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/1/587/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Augustine Asante & Jennifer Price & Andrew Hayen & Stephen Jan & Virginia Wiseman, 2016. "Equity in Health Care Financing in Low- and Middle-Income Countries: A Systematic Review of Evidence from Studies Using Benefit and Financing Incidence Analyses," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-20, April.
    2. Winnie Yip & Peter Berman, 2001. "Targeted health insurance in a low income country and its impact on access and equity in access: Egypt's school health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 207-220, April.
    3. World Bank, 2016. "UHC in Africa," World Bank Publications - Books, The World Bank Group, number 26072.
    4. Zoë McLaren & Cally Ardington & Murray Leibbrandt, 2013. "Distance as a barrier to health care access in South Africa," SALDRU Working Papers 097, Southern Africa Labour and Development Research Unit, University of Cape Town.
    5. Samia Laokri & Rieza Soelaeman & David R Hotchkiss, 2018. "Assessing out-of-pocket expenditures for primary health care: how responsive is the Democratic Republic of Congo health system to providing financial risk protection?," ULB Institutional Repository 2013/273019, ULB -- Universite Libre de Bruxelles.
    6. Meike Irene Nakovics & Stephan Brenner & Grace Bongololo & Jobiba Chinkhumba & Olivier Kalmus & Gerald Leppert & Manuela De Allegri, 2020. "Determinants of healthcare seeking and out-of-pocket expenditures in a “free” healthcare system: evidence from rural Malawi," Health Economics Review, Springer, vol. 10(1), pages 1-12, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Martin Rudasingwa & Manuela de Allegri & Chrispin Mphuka & Collins Chansa & Edmund Yeboah & Emmanuel Bonnet & Valéry Ridde & Bona Mukosha Chitah, 2022. "Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia," Post-Print hal-03824643, HAL.
    2. Jaramillo, Miguel & Parodi, Sandro, 2004. "El seguro escolar gratuito y el seguro materno infantil: análisis de su incidencia e impacto sobre el acceso a los servicios de salud y sobre la equidad en el acceso," Working Papers 37732, Group for the Analysis of Development (GRADE).
    3. Hsiao, William C. & Yip, Winnie, 2024. "Financing and provision of healthcare for two billion people in low-income nations: Is the cooperative healthcare model a solution?," Social Science & Medicine, Elsevier, vol. 345(C).
    4. Lenka Benova & Oona M R Campbell & George B Ploubidis, 2014. "Socio-Economic Gradients in Maternal and Child Health-Seeking Behaviours in Egypt: Systematic Literature Review and Evidence Synthesis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-12, March.
    5. Hidayat, Budi, 2007. "Are there differences between unconditional and conditional demand estimates? implications for future research and policy," MPRA Paper 30196, University Library of Munich, Germany.
    6. Clara Delavallade, 2017. "Quality Health Care and Willingness to Pay for Health Insurance Retention: A Randomized Experiment in Kolkata Slums," Health Economics, John Wiley & Sons, Ltd., vol. 26(5), pages 619-638, May.
    7. Zhang, Hui & Yuen, Peter P., 2016. "Medical Savings Account balance and outpatient utilization: Evidence from Guangzhou, China," Social Science & Medicine, Elsevier, vol. 151(C), pages 1-10.
    8. Chaudhuri, Anoshua & Roy, Kakoli, 2008. "Changes in out-of-pocket payments for healthcare in Vietnam and its impact on equity in payments, 1992-2002," Health Policy, Elsevier, vol. 88(1), pages 38-48, October.
    9. Leila Doshmangir & Edris Hasanpoor & Gerard Joseph Abou Jaoude & Behzad Eshtiagh & Hassan Haghparast-Bidgoli, 2021. "Incidence of Catastrophic Health Expenditure and Its Determinants in Cancer Patients: A Systematic Review and Meta-analysis," Applied Health Economics and Health Policy, Springer, vol. 19(6), pages 839-855, November.
    10. Dang, Thang, 2017. "The Multiple Effects of Child Health Insurance in Vietnam," MPRA Paper 78614, University Library of Munich, Germany.
    11. Bart Criel & Maria-Pia Waelkens & Fulbert Kwilu Nappa & Yves Coppieters & Samia Laokri, 2020. "Can mutual health organisations influence the quality and the affordability of healthcare provision? The case of the Democratic Republic of Congo," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-21, April.
    12. Bertone, Maria Paola & Jowett, Matthew & Dale, Elina & Witter, Sophie, 2019. "Health financing in fragile and conflict-affected settings: What do we know, seven years on?," Social Science & Medicine, Elsevier, vol. 232(C), pages 209-219.
    13. Binyaruka, Peter & Martinez-Alvarez, Melisa & Pitt, Catherine & Borghi, Josephine, 2024. "Assessing equity and efficiency of health financing towards universal health coverage between regions in Tanzania," Social Science & Medicine, Elsevier, vol. 340(C).
    14. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
    15. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
    16. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    17. Pavitra Paul & Ulrich Nguemdjo & Armel Ngami & Natalia Kovtun & Bruno Ventelou, 2022. "Do efficiency and equity move together? Cross-dynamics of Health System performance and Universal Health Coverage," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-8, December.
    18. Robert Kolesar & Sambo Pheakdey & Bart Jacobs & Narith Chan & Samedy Yok & Martine Audibert, 2019. "Expanding Social Health Protection in Cambodia: An assessment of the current coverage potential and gaps, and social equity considerations," CERDI Working papers halshs-02018867, HAL.
    19. Carolina Bloch, 2020. "Social spending in South Asia—an overview of government expenditure on health, education and social assistance," Research Report 44, International Policy Centre for Inclusive Growth.
    20. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:1:p:587-:d:718177. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.