Complex emergencies: overcoming barriers to health care

Area of Science:

• Global Health
• Humanitarian Assistance
• Sustainable Development Goals

Background:

• The term 'health in the last mile' addresses challenges in healthcare access for underserved populations.
• A global report was commissioned to conceptualize and assess barriers, needs, and vulnerabilities in last-mile healthcare.
• This commentary highlights key findings for an academic audience from the Norwegian Red Cross perspective.

Purpose of the Study:

• To propose a definition and methodology for identifying populations in the 'last mile' of healthcare access.
• To extend the understanding of last-mile populations beyond conflict zones and disaster areas.
• To analyze the health needs and access barriers faced by the most vulnerable groups.

Main Methods:

• Conceptualization and assessment of 'health in the last mile'.
• Identification of structural and geographical barriers and vulnerabilities.
• Analysis of overlapping vulnerabilities in diverse humanitarian settings.

Main Results:

• Last-mile populations are inadequately reached by current universal health coverage strategies.
• Local humanitarian actors play a crucial role in reducing healthcare access barriers.
• The report defines 'the last mile' by converging factors and identifies 18 potential last-mile population groups.
• Global epidemics like COVID-19 highlight evolving vulnerabilities and can create new last-mile populations.

Conclusions:

• Millions remain excluded from global health progress due to systemic barriers.
• Solutions are needed to overcome these barriers and ensure access to basic healthcare.
• Achieving Sustainable Development Goals 3 and 16 requires addressing last-mile healthcare challenges.