The theme of World Health Day 2018 is Universal Health Coverage (UHC): Building a future where all people obtain the health services they need without suffering financial hardship.
Access to reliable, timely, practical health information empowers people to protect their own and their families’ health, it empowers health workers to deliver evidence-based healthcare and prevention, and it empowers policymakers to develop evidence-informed policy and health systems. It is also a recognised determinant of the right to health. We argue that universal access to essential healthcare information is a prerequisite for UHC, that it is readily achievable thanks to mobile phone technology, and that it should be included as an objective and/or indicator within the Sustainable Development Goals target for UHC (SDG 3.8.)
Why is access to essential health information important?
Most citizens - and many health workers - in low- and middle-income countries (LMICs) lack reliable, timely, practical information about how to protect their health and what to do in a healthcare situation. The consequences are indecision, delays, incorrect treatment, and failure to take appropriate action especially in low-resource settings where there is a lack of access to trained health workers (who are often themselves not adequately informed).
‘Mobilising’ universal access to essential healthcare information
We are now in a stronger position than ever to accelerate efforts to end this crisis and achieve the HIFA Vision: 'a world where every person has access to the information they need to protect their own health and the health of others'. This is due to the increased ubiquity of mobile phones, particularly in low- and middle-income countries (LMICs). Advances in mobile technology also mean that these devices offer more features, memory and processing power.
Several mobile applications (‘apps’ ) and other services have demonstrated that it is relatively simple to put essential health information literally into the hands of citizens and health workers. Examples include:
- First Aid (Red Cross and Red Crescent)
- Safe Pregnancy and Birth (Hesperian)
- Interactive voice response services, e.g 3-2-1 (Viamo/Human Network International), Mobile Kunji (BBC Media Action)
- HealthPhone (Mother and Child Health and Education Trust)
A call to action
Universal access to life-saving healthcare information can be achieved simply and inexpensively by having one or more such mobile application, configured in a form appropriate to the particular needs of a given country, and in a manner consistent with its wider mHealth strategy, installed on all (or most) mobile phones in that country.
Governments have the power, through appropriate regulatory bodies, to encourage or require relevant telecommunication companies to routinely provide essential healthcare information on mobile phones. Governments can also provide an enabling health policy that supports guided transfer of essential healthcare information for citizens via health facilities and public services. Indeed, governments are ultimately responsible to fulfil their obligations under international human rights law to ensure all their citizens have access to the information they need to protect their health and the health of others.
As we celebrate World Health Day 2018, HIFA calls on the United Nations Development Programme to officially recognise universal access to healthcare information as a prerequisite for UHC. We propose two possible additions to the SDG 3.8 indicators, either of which will help monitor progress towards UHC and provide early signals of progress towards SDG 3 targets (that other indicators might pick up only later):
1. Adding a new high-level indicator for the UHC target SDG 3.8 , suggested wording as follows: “Coverage of essential healthcare information for citizens and front-line healthcare workers”, or
2. Augmenting an existing high-level indicator, SDG 3.8.1, for the UHC target SDG 3.8 suggested wording as follows: “Coverage of essential health services (defined as the average coverage of essential services based on tracer interventions that include [….existing list........] including access to essential healthcare information, among the general and the most disadvantaged population)”.
We also suggest operationalising these high-level indicators through using an additional tracer indicator for SDG 3.8.1 along the lines of : “The proportion (%) of a population with access to essential healthcare information though mobile phones”.
Universal access to essential healthcare information is a highly desirable and feasible goal, and it is readily measurable. We call on UN agencies, governments, mobile network operators and others to work with us to explore next steps towards universal access to healthcare information as a prerequisite for universal health coverage.
Geoff Royston (mHIFA adviser), Martin Carroll (HIFA Steering Group member), and Neil Pakenham-Walsh (HIFA Coordinator)