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Submitted by Jim Campbell on
Adam - a great piece, and a lot of synergy with other work that is looking at quality of care. One of those pieces, in development with the Global Health Workforce Alliance, looks at "UHC: the Grand Challenge of HRH". A technical paper was shared with Ministers and participants at this week's World Bank / WHO Ministerial-level meeting on Universal Health Coverage (18-19 Feb). I hope you got chance to read it? Out of this work a new cube is born. One that sets out a conceptual framework for looking at effective coverage (i.e. quality) The HRH/UHC cube is an adaptation of the Universal Health Coverage cube (WHO, 2010) and the Availability, Accessibility, Acceptability, utilisation and Quality (AAAQ) dimensions that are included in both a) the right to health (General Comment No.14, 2000) and b) the Tanahashi framework (1978). The figure is to prompt discussion on the ‘Effective Coverage’ i.e. the differences between the theoretical coverage implied by the Availability of the workforce versus the actual coverage resulting from the Quality of the workforce. New data from Afghanistan, using this approach, will be available soon, but the results identify that effective coverage of MNH services is a fraction of the proxy indicator of 'Skilled Birth Attendants'. The debate must turn to quality, not quantity, and this is an HRH discussion that is applicable to ALL countries, not only those with a lower density of health workers per 1,000 population. Thanks, Jim Campbell