HEALTH COVERAGE FUNCTION OF SUSTAINABLE DEVELOPMENT GOAL THREE

Öz

In the twenty-first century, the resources of the world and the services it provides to society have diversified over time, but not all individuals in society can benefit from these resources and services fairly. It is known that inequalities that exist in all areas of life from the past to the present have negative consequences. Inequalities in access to health service delivery negatively affect the health level of the whole society, especially vulnerable groups. Reducing inequalities in health and delivering health services to the entire society without leaving a single person behind are the keys to achieving the goal of a more healthy and sustainable world. “Sustainable Development Goals” were adopted in 2015 with the aim of eliminating inequalities in all basic areas, especially health. In the direction of the third of these goals, it is aimed to achieve "Universal Health Coverage". Health systems, which have a key role in the delivery of health services, have a major role in accessing universal health coverage. Health systems should be structured to provide primary health care to everyone and protect individuals from financial risks while benefiting from the service. This study; In direction of the goal number three within the scope of the Sustainable Development Goals, it is aimed to include the "Achieve to Universal Health Coverage" and the function of health systems in this direction.

Anahtar Kelimeler

• Health coverage
• Sustainable Development Goals
• health systems
• equity

SÜRDÜRÜLEBİLİR KALKINMA HEDEFİ ÜÇ’ÜN SAĞLIK KAPSAYICILIĞI İŞLEVİ

Öz

Yirmi birinci yüzyılda dünyanın, kaynakları ve topluma sunduğu hizmetler zamanla çeşitlenmekte ancak toplumdaki bireylerin hepsi bu kaynak ve hizmetlerden adil bir şekilde yararlanamamaktadır. Geçmişten bugüne hayatın her alanında var olan eşitsizliklerin, olumsuz sonuçları olduğu bilinmektedir. Sağlık hizmet sunumundan yararlanma konusundaki eşitsizlikler de başta savunmasız gruplar olmak üzere toplumun tamamının sağlık düzeyini olumsuz etkilemektedir. Sağlık alanında var olan eşitsizlikleri azaltmak ve bir kişiyi bile arkada bırakmadan sağlık hizmet sunumunu tüm topluma ulaştırmak, daha sağlıklı ve sürdürülebilir bir dünya hedefine erişimin anahtarıdır. “Sürdürülebilir Kalkınma Hedefleri” 2015 yılında sağlık başta olmak üzere tüm temel alanlardaki eşitsizlikleri ortadan kaldırmak amacıyla oluşturulmuştur. Bu hedeflerden üçüncüsü doğrultusunda da “Evrensel Sağlık Kapsayıcılığına” erişilmesi amaçlanmaktadır. Evrensel sağlık kapsayıcılığına erişimde sağlık hizmet sunumunda kilit konumda olan sağlık sistemlerine büyük görev düşmektedir. Sağlık sistemleri temel sağlık hizmetlerini herkese ulaştıracak şekilde yapılanmalı ve hizmetten yararlanırken bireyleri mali risklerden korumalıdır. Bu çalışmada; Sürdürülebilir Kalkınma Hedefleri kapsamında yer alan üç numaralı hedef doğrultusunda “Evrensel Sağlık Kapsayıcılığına Erişim” ve bu doğrultuda sağlık sistemlerinin işlevinin ele alınması amaçlanmaktadır.

Anahtar Kelimeler

• Sağlık kapsayıcılığı
• Sürdürülebilir Kalkınma Hedefleri
• sağlık sistemleri
• hakkaniyet

Kaynakça

1. 1. UN | Peace, dignity and equality on a healthy planet [Internet]. [cited 2021 Nov 29]. Available from: https://www.un.org/en
2. 2. WHO. Millennium Development Goals (MDGs) [Internet] 2018. [cited 2021 Nov 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(mdgs)
3. 3. UN. Millennium Development Goals Report 2015 | Latest Major Publications -United Nations Department of Economic and Social Affairs [Internet]. [cited 2021 Nov 29]. Available from: https://www.un.org/en/development/desa/publications/mdg-report-2015.html
4. 4. UN. Transforming our world: the 2030 Agenda for Sustainable Development | Department of Economic and Social Affairs [Internet]. [cited 2021 Nov 28]. Available from: https://sdgs.un.org/ 2030agenda
5. 5. UN. Goal 3 | Department of Economic and Social Affairs [Internet]. [cited 2021 Dec 2]. Available from: https://sdgs.un.org/goals/goal3
6. 6. WHO. The Global Action Plan for Healthy Lives and Well-being for All [Internet]. [cited 2021 Nov 28]. Available from: https://www.who.int/initiatives/sdg3-global-action-plan
7. 7. UN. The Sustainable Development Goals Report 2021 [Internet]. United Nations. 2021. Available from: https://unstats.un.org/sdgs/report/2021/The-Sustainable-Development-Goals-Report-2021.pdf
8. 8. UN. Progress towards the Sustainable Development Goals Report of the Secretary-General [Internet]. United Nations Economic and Social Council. 2021. Available from: https://undocs.org/en/E/2021/58

9. 9. UNICEF. Vaccination and Immunization Statistics - UNICEF DATA [Internet]. 2021 [cited 2021 Dec 4]. Available from: https://data.unicef.org/topic/child-health/immunization/
10. 10. Goal 3: Good Health and Well-Being - SDG Tracker [Internet]. Our World in Data. [cited 2021 Dec 5]. Available from: https://sdg-tracker.org/good-health
11. 11. WHO. Population with household expenditures on health greater than 10% of total household expenditure or income (SDG 3.8.2) (%) [Internet] [cited 2021 Dec 5]. Available from: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/population-with-household-expenditures-on-health-greater-than-10-of-total-household-expenditure-or-income-(sdg-3-8-2)-(-)
12. 12. Share of Out-of-Pocket Expenditure on Healthcare, 2014 [Internet]. Our World in Data. [cited 2021 Dec 5]. Available from: https://ourworldindata.org/grapher/shareof-out-of-pocket-expenditure-on-healthcare
13. 13. T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı. Sürdürülebilir kalkinma amaçlari değerlendirme raporu 2019[Internet]. Ankara; 2019. Available from: https://www.sbb.gov.tr/2019-yayinlari/
14. 14. TÜİK. Hane Halkı Tüketim Harcaması, 2019 [Internet]. [cited 2021 Dec 5]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Household-Consumption-Expenditures-2019-33593
15. 15. TÜİK. Sağlık Harcamaları İstatistikleri, 2019 [Internet]. [cited 2021 Dec 5]. Available from: https://data.tuik.gov.tr/Bulten/Index?p=Health-Expenditure-Statistics-2019-33659
16. 16. WHO. Universal health coverage (UHC) [Internet]. [cited 2021 Dec 7]. Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
17. 17. WHO. Declaration of Alma-Ata [Internet]. [cited 2021 Nov 21]. Available from: https://www.who.int/teams/social-determinants-of-health/declaration-of-alma-ata
18. 18. Temel Sağlık Hizmetleri Dünya Konferansı: Astana Bildirisi - HASUDER [Internet]. [cited 2021 Dec 9]. Available from: https://hasuder.org.tr/temelsaglik-hizmetleri-dunya-konferansi-astana-bildirisi/
19. 19. Kittelsen SK, Fukuda-Parr S, Storeng KT. Editorial: The political determinants of health inequities and universal health coverage. Global Health [Internet]. 2019;15:1-5. Available from: http://dx. doi.org/10.1186/s12992-019-0514-6
20. 20. Nomura S, Siesjö V, Tomson G, Mohr W, Fukuchi E, Shibuya K, et al. Contributions of information and communications technology to future health systems and universal health coverage: Application of Japan’s experiences. BMC. 2020;18(73):1-9.
21. 21. Van Roode T, Pauly BM, Marcellus L, Strosher HW, Shahram S, Dang P, et al. Values are not enough: Qualitative study identifying critical elements for prioritization of health equity in health systems. Int J Equity Health. 2020;19(1):1-13.
22. 22. Tangcharoensathien V, Mills A, Patcharanarumol W, Witthayapipopsakul W. Universal health coverage: Time to deliver on political promises. Bull World Health Organ. 2020;98(2):78-78A.
23. 23. Perehudoff K, Demchenko I, Alexandrov NV, Brutsaert D, Ackon A, Durán CE, et al. Essential medicines in universal health coverage: A scoping review of public health law interventions and how they are measured in five middle-income countries. Int J Environ Res Public Health. 2020;17(24):1-26.
24. 24. Cerf ME. Sustainable Development Goal Integration, Interdependence, and Implementation: the Environment–Economic–Health Nexus and Universal Health Coverage. Glob Challenges. 2019;3(9):1-6.
25. 25. Mukherjee JS, Mugunga JC, Shah A, Leta A, Birru E, Oswald C, et al. A practical approach to universal health coverage. Lancet Glob Heal [Internet]. 2019;7(4):e410–1. Available from: http://dx.doi.org/10.1016/S2214-109X(19)30035-X
26. 26. Jowett M, Cylus J, Brunal MP, Flores G. Spending targets for health: no magic number. Health Systems Governance and Financing, WHO. Geneva; 2016.
27. 27. Barber SL, O’dougherty S, Torres LV, Tsilaajav T, Ong P. Other considerations than: How much will universal health coverage cost? Bull World Health Organ. 2020;98(2):95-9.
28. 28. UNAIDS. UNAIDS data 2021. Available from: https://www.unaids.org/en/resources/documents/2021/2021_unaids_data
29. 29. WHO. Vaccine equity [Internet]. [cited 2021 Dec 14]. Available from: https://www.who.int/campaigns/vaccine-equity
30. 30. WHO. COVAX Working for global equitable access to COVID-19 vaccines [Internet]. [cited 2021 Dec 13]. Available from: https://www.who.int/initiatives/act-accelerator/covax
31. 31. UNICEF. COVID-19 Vaccine Market Dashboard | UNICEF Supply Division [Internet]. [cited 2021 Dec 14]. Available from: https://www.unicef.org/supply/covid-19-vaccine-market-dashboard
32. 32. Our World in Data. Coronavirus (COVID-19) Vaccinations - Statistics and Research - Our World in Data [Internet] [cited 2021 Dec 14]. Available from: https://ourworldindata.org/covid-vaccinations
33. 33. GAVI. We’ve had COVID-19 vaccines for one year. How can we make better use of them? | Gavi, the Vaccine Alliance [Internet]. [cited 2021 Dec 14]. Available from: https://www.gavi.org/ vaccineswork/weve-had-covid-19-vaccines-one-year-how-can-we-make-better-use-them
34. 34. UNDP. Global Dashboard for Vaccine Equity - UNDP Data Futures Platform [Internet]. [cited 2021 Dec 14]. Available from: https://data.undp.org/ vaccineequity/
35. 35. WHO. Everybody’s business: strengthening health systems improve health outcomes:WHO’s framework for action. [Internet]. 2007 [cited 2021 Nov 14]. Available from: https://www.who.int/healthsystems/strategy/everybodys_business.pdf
36. 36. WHO. The World Health Report 2000-Health Systems: Improving Performance [Internet]. WHO, Geneva. 2000 [cited 2021 Nov 14]. Available from: https://www.who.int/whr/2000/en/whr00_en.pdf
37. 37. WHO. The World Health Report. Research for universal health coverage. WHO,Geneva. 2013.
38. 38. WHO. WHO’s 7 policy recommendations on building resilient health systems [Internet]. [cited 2021 Dec 6]. Available from: https://www.who.int/news/item/19-10-2021-who-s-7-policy-recommendations-on-building-resilient-healthsystems
39. 39. Barron GC, Laryea-Adjei G, Vike-Freiberga V, Abubakar I, Dakkak H, Devakumar D, et al. Safeguarding people living in vulnerable conditions in the COVID-19 era through universal health coverage and social protection. Lancet Public Heal. 2021;2667(21):1-7.
40. 40. Ünal B, Kılıç B. Toplum Yönelimli Birinci Basamak Sağlık Hizmeti. Türkiye Klin. 2021;20-6.
41. 41. T.C. Cumhurbaşkanlığı Mevzuat Bilgi Sistemi. Kurulu B, Tarihi K. Genel sağlık sigortası kapsamında gelir tespiti, tescil ve izleme sürecine ilişkin usul ve esaslar hakkında yönetmelik [Internet]. [cited 2022 Feb 15]. Available from: https://www.mevzuat.gov.tr/MevzuatMetin/3.5.20112512.pdf
42. 42. SGK. Aylık İstatistik Bilgileri [Internet] [cited 2022 Feb 15]. Available from: http://www.sgk.gov.tr/wps/portal/sgk/tr/kurumsal/istatistik/aylik_istatistik_bilgileri
43. 43. DİSK. DİSK-AR Salgının bilançosu çıkardı: 3,6 MİLYON İSTİHDAM KAYBI [Internet]. 2021. Available from: www.arastirma.disk.org.tr
44. 44. HASUDER. Halk Sağlığı ve Sosyal Bilimler Çalışma Grubu. In: Okyay P, Üner S, editors. Halk Sağlığı Bakış Açısıyla COVID-19 Pandeminin İlk Yılı. Ankara; 2021. p. 237-253.
45. 45. Aydın K, Sönmüş A. Türkiye’de ve G-20 ülkelerinde covit-19 sürecinde devletlerin politikaları. Al-Farabi Int J Soc Sci. 2021;6(1):90-5. Available from: http://dergipark.gov.tr/farabi
46. 46. Özbay F. Türkiye’ de yoksulluk ile mücadelede sosyal bütçe anlayışı. Econharran Harran Üniversitesi İktisadi ve İdari Bilim Fakültesi Derg. 2022;6(9):1-11.
47. 47. Lal A, Erondu NA, Heymann DL, Gitahi G, Yates R. Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. Lancet. 2021;397:61-7. doi:10.1016/%0AS0140-6736(20)32228-5.