The WHO defines universal health coverage (UHC) – and therefore Universal Eye Health – as “ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services”. This means that all people should enjoy access to quality eye health, and out-of-pocket payments should not impede access or cause difficulties.
UHC is of great importance as, in essence, it is grounded in the right to health which includes ensuring access to services without discrimination and progressively realising quality health services for all. UHC will require strengthening health systems and providing access to services for all people particularly those unable to pay for or otherwise unable to access health care. If done right UHC can be, as WHO Director General Margaret Chan has called it, ‘a major equalizer’: “Universal health coverage is one of the most powerful social equalizers among all policy options. It is the ultimate expression of fairness.”
This applies also to achieving Universal Eye Health and, as such, there are a number of elements that governments and other stakeholders should account for. Eye health needs to be integrated into strengthened health systems, with sufficient and well-distributed services and personnel. Services must be comprehensive; that is covering the range of causes of vision impairment from promotion, prevention to rehabilitation and care. It will require elimination of barriers that can affect access for vulnerable sectors of the population including women, people with disabilities, older people, indigenous peoples and people living in rural areas. Finally, point-of-care payment should not prevent access.
Advancing towards Universal Eye Health will require maximising opportunities including the SDG UHC target, and advocating for incorporation of eye health such as surgeries, glasses for children and low-vision services within social insurance and other schemes to progress UHC. This is especially important as financing for health is expected to increasingly come from domestic sources. Cataract Surgical Coverage for example, has been recognised within the WHO/World Bank UHC monitoring report as an important indicator for older people’s access to health care, this can support arguments to include Cataract in essential packages. On inclusion of eye health in these schemes it will be crucial to monitor delivery and advocate to ensure that policy translates into practice in a way that progresses towards universal eye health.
Universal health coverage is one of the most powerful social equalizers among all policy options. It is the ultimate expression of fairness
Cataract Surgical Coverage has been recognised within the WHO/World Bank UHC monitoring report as an important indicator for older persons’ access to health care