Universal Health Coverage A Call for Action

By Dr. Dr. Andemichael Ghirmay, World Health Organisation (WHO)


The Message of Dr. Matshidiso Moeti, WHO Regional Director for Africa, delivered by Dr. Andemichael Ghirmay, WHO Liaison Officer for Zanzibar 7th April 2018. 


Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality while ensuring that the use of these services does not expose the user to financial hardship.

This calls for governments to increase domestic allocation of resources for health to protect citizens from hardships and catastrophic health expenditure and ensure sustainable development goals. The current reality is still the opposite in Africa on average about 38% of the health expenditure is covered from out-of-pocket (OPP) expenditure exposing individuals, families and communities to financial hardships, poverty and destitution. The emergence of Non-Communicable Diseases as a double burden to the already debilitating effects of malaria, HIV/AIDS, diarrhea and other communicable diseases and that affect the productive segment of the population in developing countries, further complicates the burden.   

The first-ever, Mid-Term Review of the Health Sector Strategic Plan-III (HSSP-III) which was conducted by the Ministry of Health of Zanzibar technically supported by WHO revealed the achievements and challenges ensuring Universal Health Coverage in Zanzibar.

The Revolutionary Government of Zanzibar’s policy is free medical services to all. This noble policy ensures that poor people are protected from exclusion to access social services including health. Access to physical health infrastructure is universal with a total of 136 different levels of health facilities in a radius of 5-7 kilometers available in the islands.

However, donor contribution for health funding in 2015/16 was almost 50%. Total Health Expenditure as proportion of Gross Domestic Product (GDP) was at 3.4% and governments’ health expenditure as a proportion of the total health expenditure in 2015/16 was 48%.

Evidences show that, low income countries that allocate 5-6% of their GDP to health have a better Universal Health Coverage and government health expenditure of 70% or more as proportion of the total health expenditure cushion populations from a catastrophic out of pocket expenditures. Zanzibar needs to improve these two indicators to ensure availability of quality Universal Health Coverage to its population.


Honorable Hamad Rashid Mohamed, Minister of Health for Zanzibar, making a statement during the World Health Day commemoration in Kijini Village, 7th April 2018.

The theme of the Global World Health Day commemoration of 7th April 2018 was “Universal Health Coverage: Everyone, Everywhere” and resonated the need for reaching everyone everywhere without prejudice. Zanzibar commemorated the event in Kijini Village, 60 kilometers out of stone town in North A District. During the occasion, Honorable Hamad Rashid Mohamed, Minister of Health, reiterated the need for reaching everyone, everywhere and encouraged the citizens to call them to action. He said we are accountable to people and anyone who wants to reach me, I am availing my personal telephone number for contact.  

The message of Dr. Matshidiso Moeti, WHO Regional Director for Africa, called on African leaders to live up to the SDG pledges they made in 2015, and requested all to take concrete actions to ensure Universal Health Coverage. She reaffirmed that WHO will continue to support countries to build stronger, resilient and responsive health systems to advance Health for All.

As a practical step to translate the commitment of reaching everyone, everywhere, the Revolutionary Government of Zanzibar has built a new Primary Health Care Unit for the community in Kijini and WHO provided solar panels to ensure continuity of basic services in the health facility. During the occasion, various health services including screening for hypertension, diabetes, donation of blood and other basic health services were provided to the public.

The Revolutionary Government of Zanzibar investment in health infrastructure and a free health policy for its citizens is commendable. WHO encourages more investment in health to reaffirm and ensure Universal Health Coverage to all Zanzibaris.


“We will not settle for a world in which people have to choose between sickness and poverty because of the costs of paying for care out of their own pockets”.Dr. Tedros Adhanom Ghebreyesus, WHO Director General, at 71st World Health Assembly 21st May 2018.