Access issues
Access to healthcare depends on an individual's environment, the availability of services, and the removal of barriers to accessing those services.
What we call the "enabling environment" consists of a range of social, political, cultural and institutional factors. These factors determine whether people have the right information about health services and how the society around them affects access.
Women and girls often face particular barriers. Some find their wellbeing is not prioritised by family members meaning they are not allowed or supported to access healthcare when they need it. Limited household funds are prioritised elsewhere.
For others, the wider community has more of a say over their bodies than they do. For instance, they have little choice over when to have children and how many to have.
Other factors such as economic empowerment and education are critical to access to healthcare, particularly for groups such as women and girls or the very poorest and marginalised.
Removing barriers
We focus on removing certain critical barriers to improve access to healthcare in developing countries.
The first set of barriers are largely financial and can have devastating effects on the poor. We work to make sure services are free at the point of use.
A second set of barriers are physical. Our work is about ensuring that people can physically access healthcare. So that means improving transport systems and making sure services are run in an appropriate, non-discriminating manner.
If a clinic is judgmental towards a girl who has come seeking family planning - or if it disrespects her privacy - she is unlikely to return and word of mouth will discourage others.
User fees
Nobody should die or suffer ill health because they are too poor to afford treatment when they need it, at the point of use. We support international efforts to achieve universal coverage of basic health services.
We are already helping many developing countries replace user fees at the point of use with more equitable domestic health financing systems that enable the poorest to access health services when they need them.
We provide support for a range of reforms that improve approaches to raising, pooling and allocating resources across the whole of society in order to optimise health outcomes.
We also support innovative funding schemes that aim to target specific groups to encourage more utilisation of health services such as through voucher programmes, cash incentive programmes and social insurance programmes, especially for women and children.
For example, in Sierra Leone the UK has been a strong supporter of the government's launch of free healthcare for children under five, and pregnant and breastfeeding women which has resulted in huge increases in health service utilisation.
Access to medicines
Access to good quality, essential medicines is a fundamental part of delivering effective health services and saving lives, yet each year millions of people die due to preventable and treatable diseases such as HIV, malaria and tuberculosis.
Others suffer needlessly due to chronic or neglected diseases, illnesses that could be eliminated but remain untreated. Improving access to medicines could save millions of lives each year.
According to the World Health Organisation, up to 90% of the population in developing countries purchase medicines through out-of-pocket payments, making medicines the largest family expenditure item after food.
In Uganda, a survey estimated that the annual cost of purchasing effective medicines to treat just malaria was equivalent to 62 days of household basic food costs.
We work across a wide range of areas to improve access to medicines as part of health systems:
- we seek to strengthen health systems, including improving access to medicines, through bilateral programmes
- we promote global health innovation, such as providing £25m per annum for the development of new drugs and vaccines
- we work to create a supportive international environment
- we take a multisector approach to increasing access to medicines.