Health and Healthcare Systems

How we’ll achieve sustainable health equity in rural and refugee communities

Reaching the most vulnerable will lead us to sustainable health equity.

Reaching the most vulnerable will lead us to sustainable health equity. Image: Surgical Systems Research Group

Neema Kaseje
Founder, Surgical Systems Research Group
Robert Metzke
Global Head of Sustainability, Philips
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This article is part of: World Economic Forum Annual Meeting

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  • While the number of displaced people in the world is increasing to staggering levels, this group’s access to life-saving health services remains significantly low in rural areas.
  • It is important to reach refugee and rural communities to achieve sustainable health equity.
  • At Davos 2023, 39 CEOs made the Zero Health Gaps Pledge, making executive-level commitments to reduce disparities in access to healthcare.
  • Better access to life-saving health services can be achieved by getting the funding mechanisms right, improving infrastructure and addressing shortages in equipment and a health workforce.

In 2022, the world saw more than 100 million displaced people on record for the first time, a “staggering milestone,” as the United Nations described it.

While there are concerning healthcare gaps among this entire group, many are located in rural areas with limited or no access to life-saving health services due to inadequate infrastructure, a lack of equipment and a shortage in a trained health workforce, including specialist healthcare workers. For the individual patient, this means delay or no access to health care, increased disability and, in extreme cases, death.

The few healthcare workers who are present are overworked with limited training opportunities. Moreover, from a financing perspective, donor funding is plummeting and sustainable financing mechanisms such as health insurance schemes are absent or underutilized.

At Davos 2023, there was recognition that health was a human right and that we needed to work together to eliminate health disparities globally.

On 19 January, 39 CEOs committed to a “Zero Health Gaps Pledge,” including by platforming those typically disenfranchised, leveraging technology to deliver personalized care and forming strategic collaborations. More importantly, there were key discussions around how we can reach the people who have been made most vulnerable, particularly in rural and refugee communities, to accelerate our progress towards sustainable health equity.

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Reaching refugee and rural communities

Over the past four days, commitments and partnerships were made and forged to achieve sustainable health equity in rural and refugee communities; concrete joint action will be taken to deliver health services in these communities in the immediate and near future.

Specifically, to address the lack of sustainable financing, a coalition of World Economic Forum 2023 participants made of private sector and civil society members are exploring ways to catalyze national health insurance coverage among refugee and host communities, particularly children in need of surgical services.

In partnership with community health workers (CHWs), surgeon specialists will identify children needing surgical services and ensure their families have insurance coverage. This approach will address the sustainable financing of health services in communities left behind, leveraging assets already present in current systems. It will also shift the system to serve the most vulnerable.

In addition to identifying and promoting patient insurance coverage, healthcare workers will anticipate the resources they need to carry out procedures successfully. Based on needs identified by surgeons, doctors, CHWs and nurses providing services on the ground, our coalition will work to deliver medical devices and equipment that are adapted to their contexts, such as by taking into account extreme temperatures and ongoing needs for biomedical support.

For instance, the Philips Lumify handheld ultrasound by Philips will be distributed to strengthen the clinical team’s ability to recognize and treat surgical diseases. This investment will be accompanied by digital tools to optimize health care and health outcomes including telehealth options to instantly collaborate with specialists. This intervention will lead to more patients receiving access to quality health care faster with improved survival rates.

In addition, our coalition is committing to working together to increase the lifespan and usability of medical devices to reduce our carbon footprint and contribute to sustainable health equity.


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Access to sustainable healthcare

Today, inefficiencies in health services provision contribute significantly to the lack of access to life-saving health services in rural and refugee contexts. For instance, a surgical procedure may be delayed or cancelled because a specific piece of equipment is missing. Inefficiencies may also occur when there is variability in processes and procedures.

Our coalition will work with surgeons, anaesthetists and nurses to eliminate inefficiencies using digital tools, including educational tools to improve the efficiency and the quality of surgical services supported by Caresyntax.

In particular, artificial intelligence machine learning technology will be used to eliminate variability in operating room procedures and processes to optimize the number of surgeries that can be done by the clinical team and the quality of services. Insights from the digital data will be used to optimize team performance through iterative coaching.

Furthermore, our coalition will include climate action technical expertise to guide our progress towards health equity to ensure the environmental sustainability of our interventions.

Within a year, working in partnership with subnational health ministries in sub Saharan Africa, our coalition hopes to increase the number of patients accessing life-saving health services.

We hope to see a reduction in out-of-pocket expenses when accessing health services. We hope to see a health workforce that is better equipped and able to provide quality health services.

More importantly, we hope to see a reduction in the morbidity and mortality related to surgical conditions and better access to care.

Bjoern Von Siemens, Founder and Chief Financial Officer, Caresyntax GmbH; Guillaume Lefevre, Head of Brokers Channel & Customers Commercial Insurance at Zurich Italy ; Paul Baldassari, Executive Vice-President, Worldwide Operations, Flex Ltd; and H.R.H. Jaime de Bourbon Parme, Climate Envoy, Netherlands Government also contributed to this article.

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