Nigeria: The Joint Learning Network's Concerted Effort to Strengthen UHC

Access to healthcare is a fundamental human right. The World Health Organization (WHO) Constitution states that everyone has the right to the highest standard of health.

The 1978 Alma Ata declaration highlighted the goal of "Health for All." This established universal health coverage (UHC) as a public health priority. In 2005, UHC gained momentum, supported by a WHO resolution and the 2010 World Health Report. This report introduced three key dimensions: population coverage, service coverage, and financial protection.

The push for UHC continued into the 20th and 21st centuries. The United Nations and other organizations promoted it as a global priority. Access to healthcare has been recognized since ancient times, showing its importance for individuals and communities.

Despite this recognition, achieving UHC remains challenging in low- and middle-income countries. Fragmented knowledge sharing worsens these challenges. Countries often lack mechanisms to document and share successful practices.

Even when best practices are known globally, adapting them locally is difficult. Local political, economic, and cultural contexts complicate implementation. A tailored approach is needed to encourage local ownership and support.

The Joint Learning Network (JLN) for UHC was created to address these challenges. Established in 2010, it emerged from discussions among several countries at a global health meeting in May 2009. Countries like India, Thailand, Ghana, Vietnam, and Kenya recognized their shared obstacles in achieving UHC.

As Kadarpeta noted, "the idea of having a platform to discuss UHC implementation came naturally." JLN member countries share information and develop tools for health system reforms aimed at achieving UHC.

Currently, JLN includes 40 member countries across Africa, Asia, Europe, and Latin America. Twelve non-member countries also participate in collaborative efforts through workshops and exchanges.

Rahul Kadarpeta emphasized the need for collaboration: "We had to come together to share ideas." This process simplifies complex policies into practical advice based on real-world experiences.

JLN focuses on being country-driven rather than relying on top-down assistance. It draws knowledge directly from senior policymakers and practitioners on the ground.

Each member country forms a Country Core Group with key stakeholders from various sectors. These groups set learning priorities and elect leaders for the network's agenda.

Despite advancements in health financing strategies like provider payment mechanisms or public finance management, translating these into practice remains tough. Dr. Rahul Kadarpeta highlighted this struggle as central to implementing effective actions based on abstract policies.

Over the past decade, JLN's model has made measurable impacts across low- and middle-income countries:

1. Practical Learning: JLN facilitated over 40 collaboratives resulting in 45 practical tools.
2. Widespread Use: Tools have been downloaded over 8,000 times across at least 94 countries.
3. National Transformations: Countries like Ghana and Nigeria have seen policy impacts due to JLN initiatives.
4. Scaling Engagement: Over 75 nations participate in JLN activities with more than 400 technical experts involved.

JLN recognizes that thematic areas within UHC reforms are dynamic; what worked years ago may not be effective now due to evolving systems.

One challenge is turnover among policymakers who shape the network's direction over time. As leaders retire or move up within their organizations, continuity can suffer.

Kadarpeta mentioned that consistent orientation helps new leaders understand JLN principles while maintaining open discussions' safe space through mentorship from experienced members.

Progress varies among member countries; some have tackled foundational reforms while others face basic challenges today that older members addressed years ago.

Newer entrants like Burkina Faso or South Sudan are just starting their journeys toward UHC reform compared to those who joined earlier nearly fifteen years ago.

This progression requires tailored knowledge-sharing approaches within JLN’s network structure so newer members can learn effectively from seasoned ones without applying outdated strategies blindly.