World Health Day 2019

Helgi Jonsson's (Trans-European Division Health Ministries director) special message on World Health Day 2019: "When we have it, we don't think so much about it."

Olivia (name has been changed) was in full labour when she arrived at the hospital. She was rushed into the emergency room. After a quick examination, the doctor and nurse realised that both her life and the life of her unborn baby were in danger, severely in danger. In just a few short minutes a skilled medical team were with her, transporting her to the best medical centre in Slovenia. In less than 40 minutes Olivia was inside a delivery room, surrounded by the best experts for maternal health. Her tiny baby boy was born ten weeks premature and both mother and baby faced life-threatening health problems. The baby was rushed to the neonatal unit, while the young mother’s life was saved by emergency surgery. They both survived due to the excellent primary and secondary care system inside this European country.

That was twenty years ago. Yet, even today, where you live still dramatically affects your access to essential health services. Developed primary health care and universal health coverage has saved many lives. On the other hand, a lack of primary health care and high health costs has resulted in many lost lives. It still matters where you are born and where you live. Access to primary health care is too often a matter of life and death.

Today, on World Health Day, global humanity is “celebrating” health and wellbeing. It is time for health for all! Health is both a human right and human responsibility. Everyone should have the information, means, and access to the services they need to take care of their own health and the health of their families. The sad fact is that at least half of all people in the world do not receive the health services they need. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health.

Unsafe and lowquality health care ruins lives and costs the world trillions of euros every year.

To make good health for all a reality, we need:

• individuals and communities who have access to high quality health services so that they take care of their own health and the health of their families. It is also vital that people have access to quality health education and the possibility to improve their health through responsible behaviours and lifestyle changes.
• skilled health workers who are able to provide quality, people-centred care. Health workers should also place a stronger focus on the prevention of non-communicable diseases, infectious diseases and mental disorders.
• policy-makers committed to investing in primary health care.

Primary health care should be the first level of contact within the health system, where individuals, families, and communities receive most of their health care — from promotion and prevention to treatment, rehabilitation, and palliative care — as close as possible to where they live and work. At its heart, primary health care is about caring for people and helping them improve their health or maintain their wellbeing, rather than just treating a single disease or condition.

Primary health care covers the majority of health needs throughout a person’s life including services such as screening for health problems, vaccines, information on how to prevent disease, family planning, treatment for long and short-term conditions, coordination with other levels of care, and rehabilitation. Primary health care is a cost-effective and equitable way of delivering health services and helping countries make progress towards universal health coverage.

Quality, accessible primary health care is the foundation for universal health coverage.

Universal health coverage means that all people have access to the quality health services they need, when and where they need them, without financial hardship. We know universal health coverage is possible, we just need to make it happen!

Health inequity

There is ample evidence that social factors, including education, employment status, income level, gender, and ethnicity have a marked influence on how healthy a person is. In all countries – whether low-, middle or high-income – there are wide disparities in the health status of different social groups. The lower an individual’s socio-economic situation, the higher their risk of poor health.

• At least half of the world’s population still does not have full coverage of essential health services.
• About 100 million people are still being pushed into extreme poverty (defined as living on 1.90 USD or less a day) because they have to pay for health care.
• Over 800 million people (almost 12% of the world’s population) spent at least 10% of their household budgets on health care.
• Every day at least 16,000 children die before their fifth birthday of pneumonia, malaria, diarrhoea, and other diseases. Children in sub-Saharan Africa are 14 times more likely to die before the age of five than children in the rest of the world. Furthermore, children from rural and poorer households remain disproportionately affected.
• Life expectancy varies by 34 years between countries. In low-income countries, the average life expectancy is 62 years of age, while in high-income countries, it is 81 years. A child born in Sierra Leone can expect to live for 50 years while a child born in Japan can expect to live 84 years.
• Health inequities have a significant financial cost to societies. The European Parliament has estimated that losses linked to health inequities cost around 1.4% of gross domestic product (GDP) within the European Union – a figure almost as high as the EU's defence spending (1.6% of GDP). This arises from losses in productivity and tax payments, and from higher welfare payments and health care costs.
• Maternal mortality is a key indicator of health inequity. Maternal mortality rates show the wide gaps between rich and poor, both between and within countries. Developing countries account for 99% of annual maternal deaths in the world. Women in Chad have a lifetime risk of maternal death of 1 in 16, while a woman in Sweden has a risk of less than 1 in 10,000.
• Persistent health inequities slow down development. Close to 1 billion people in the world live in slum conditions, representing about one quarter of the world's urban population.

WHAT IS ADRA DOING? ADRA believes that all people, everywhere, deserve the right care, right in their community. Everyone should have good health, well-being and access to the health care they need, when they need it, right in the heart of community. Primary health care is a critical foundation for universal health coverage. We support access to universal health coverage along with personal responsibility toward ourselves, our communities, and the planet. In 2017 ADRA provided assistance and support in the area of health to almost 3 million people.

Moteeb is a ten-month-old child from Yemen who lives in a camp for internally displaced people in Al Hazm District, Al-Jawf. His mother died just a month after his birth due to postnatal complications since the family could not afford the cost of transportation to the nearest health facility to seek medical care. ADRA implements its Comprehensive Integrated Response Against Malnutrition (CIRAM) Project in the region where Moteeb was taken care of and treated. Moteeb was restored to health after five months of treatment by the local ADRA team. ADRA’s project in Yemen aims to reduce malnutrition and provide primary health care to more than 30,000 newborns and children under five.

WHAT CAN WE DO? Everyone has a part to play to help achieve good health for all. Stand up for justice, exercise compassion, show love.

1. LEARN. Learn more about health, injustice, and inequity in the area of health, including access to primary health care and universal health coverage.

2. BE RESPONSIBLE. Take good care of your health and the health of your family; practice a responsible, healthy and balanced lifestyle.

3. ACT. Stand up for justice and raise awareness about access to primary health care and universal health coverage:

a) Use your own voice to demand good health services in your community and around the world.
b) Engage in constructive conversations seeking solutions toward access to primary health care and universal health coverage with a broad range of people, who are essential to ensure it.
c) Collaborate with grassroots organisations and champions for universal health coverage to explore solutions towards quality primary health care for all.
d) Make necessary noise to ensure your local and global communities’ needs are taken into account.
e) Share stories of affected individuals and communities without access to primary health care.
f) Support projects, activities, and efforts that provide access to health care.
g) Share posts and messages with your own networks, share materials and join conversations on issues related to the access to primary health care and universal health coverage. The primary hashtag that we are using is #HealthForAll