Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-22T04:49:50.810Z Has data issue: false hasContentIssue false

Chapter 3 - Universal Health Coverage and Health System Strengthening

from Section 1 - Analyzing Health Systems: Concepts, Components, Performance

Published online by Cambridge University Press:  08 December 2022

By
Awad Mataria ,
Sameh El-Saharty ,
Sumit Mazumdar ,
Abdinasir Abubakar ,
Rana Hajjeh  and
Sameen Siddiqi
Edited by
Sameen Siddiqi ,
Awad Mataria ,
Katherine D. Rouleau  and
Meesha Iqbal
Sameen Siddiqi
Affiliation:
Aga Khan University
Awad Mataria
Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau
Affiliation:
University of Toronto
Meesha Iqbal
Affiliation:
UTHealth School of Public Health, Houston
Get access

Summary

This Chapter examines the evolution in global thinking on Universal Health Coverage (UHC) and the role of Health Systems Strengthening. It describes the path from primary health care to health systems and UHC. The concept of UHC is elucidated by introducing its dimensions, intermediary objectives and ultimate goals; and by explaining what it does and does not mean in practice. The Chapter also explains how progress towards UHC can be measured and hence monitored as per the Sustainable Development Agenda. It also summarizes the challenges that low and middle-income countries (L&MICs) face to advance UHC. The Chapter concludes by illustrating the interlinkage between UHC and health security based on lessons learnt from the COVID-19 pandemic.

Keywords

Universal Health CoverageHealth System StrengtheningUHC definitionService coverageFinancial protectionPopulation coverageUHC measurementService coverage indexCatastrophic health expendituresImpoverishmentUHC challengesGlobal health securityL&MIC
Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
 , pp. 34 - 50
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization. From primary health care to universal coverage: the “affordable dream.” 2017. www.who.int/publications/10-year-review/chapter-uhc.pdf?ua=1 (accessed December 14, 2021).Google Scholar
World Health Organization. World Health Report 2008: Primary Health Care (Now More Than Ever). Geneva, World Health Organization, 2008. https://reliefweb.int/sites/reliefweb.int/files/resources/98C1FCE13A0C5968C12574E1003F944B-who_oct2008.pdf (accessed December 10, 2021).Google Scholar
World Health Organization. Declaration of Astana. 2018. www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf (accessed December 10, 2021).Google Scholar
World Health Organization. The World Health Report 2010: Health Systems Financing: The Path to Universal Coverage. Geneva, World Health Organization, 2010. https://apps.who.int/iris/handle/10665/44371 (accessed December 25, 2021).Google Scholar
United Nations. Transforming our world: The 2030 Agenda for Sustainable Development. https://sdgs.un.org/2030agenda (accessed December 15, 2021).Google Scholar
Bärnighausen, T., Sauerborn, R.. One hundred and eighteen years of the German health insurance system: are there any lessons for middle- and low-income countries? Soc Sci Med 2002; 54(10): 1559–1587.CrossRefGoogle ScholarPubMed
Beveridge, W.. Social insurance and allied services. 1942. https://apps.who.int/iris/bitstream/handle/10665/57560/scan.pdf?sequence=1&isAllowed=y (accessed July 18, 2021).Google Scholar
World Health Organization. Constitution of the World Health Organization. 1948. www.who.int/governance/eb/constitution/en/ (accessed December 10, 2021).Google Scholar
World Health Organization. Universal health coverage. 2021. www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc) (accessed December 10, 2021).Google Scholar
Sobel, H. L., Huntington, D., Temmerman, M.. Quality at the centre of universal health coverage. Health Policy Plan 2016; 31(4): 547–549.Google Scholar
National Academies of Sciences, Engineering, and Medicine. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: National Academies Press, 2018. www.ncbi.nlm.nih.gov/books/NBK535653/pdf/Bookshelf_NBK535653.pdf (accessed February 3, 2022).Google Scholar
Barker, P.. Making universal health coverage whole: adding quality as the fourth dimension. 2016. www.ihi.org/communities/blogs/_layouts/15/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=340 (accessed February 3, 2022).Google Scholar
Mataria, A., El-Saharty, S., Hamza, M. M., et al. Transforming health financing systems in the Arab world toward universal health coverage. 2021. https://link.springer.com/referenceworkentry/10.1007/978-3-030-36811-1_155 (accessed February 3, 2022).Google Scholar
WHO Regional Office for the Eastern Mediterranean. Towards universal health coverage: challenges, opportunities and roadmap. 2013. https://applications.emro.who.int/docs/RC_Techn_paper_2013_tech_disc_2_15016_EN.pdf?ua=1 (accessed February 2, 2022).Google Scholar
World Health Organization. Developing a national health financing strategy: a reference guide. 2017. https://apps.who.int/iris/handle/10665/254757 (accessed December 14, 2021).Google Scholar
World Bank. Measuring progress towards universal health coverage: with an application to 24 developing countries. Policy Research Working Paper 7470. 2015. https://openknowledge.worldbank.org/handle/10986/23432 (accessed July 23, 2021).Google Scholar
GBD 2019 Universal Health Coverage Collaborators. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396(10258): 1250–1284.Google Scholar
WHO, World Bank. Monitoring progress towards universal health coverage at country and global levels: framework, measures and targets. 2014. http://apps.who.int/iris/bitstream/handle/10665/112824/WHO_HIS_HIA_14.1_eng.pdf?sequence=1 (accessed December 14, 2021).Google Scholar
Jannati, A., Sadeghi, V., Imani, A., et al. Effective coverage as a new approach to health system performance assessment: a scoping review. BMC Health Serv Res 2018; 18(1): 886.Google Scholar
Jha, A., Godlee, F., Abbasi, K.. Delivering on the promise of universal health coverage. BMJ 2016; 353: i2216.Google Scholar
Wagstaff, A., Neelsen, S.. A comprehensive assessment of universal health coverage in 111 countries: a retrospective observational study. Lancet Glob Health 2020; 8(1): e39–e49.CrossRefGoogle ScholarPubMed
World Health Organization. Primary Health Care on the Road to Universal Health Coverage 2019 Monitoring Report Conference Edition. Geneva, World Health Organization, 2019. www.who.int/docs/default-source/documents/2019-uhc-report.pdf (accessed December 13, 2021).Google Scholar
World Health Organization, World Bank. Tracking Universal Health Coverage: 2021 Global Monitoring Report: Conference Edition. Geneva, World Health Organization, 2021. https://cdn.who.int/media/docs/default-source/world-health-data-platform/events/tracking-universal-health-coverage-2021-global-monitoring-report_uhc-day.pdf?sfvrsn=fd5c65c6_5&download=true (accessed January 29, 2022).Google Scholar
Aftab, W., Siddiqui, F. J., Tasic, H., et al. Implementation of health and health-related sustainable development goals: progress, challenges and opportunities – a systematic literature review. BMJ Glob Health 2020; 5(8): e002273.Google Scholar
World Bank. Classifying countries by income. 2019. https://datatopics.worldbank.org/world-development-indicators/stories/the-classification-of-countries-by-income.html (accessed December 25, 2021).Google Scholar
World Health Organization. Global expenditure on health: public spending on the rise? 2021. www.who.int/publications/i/item/9789240041219 (accessed December 25, 2021).Google Scholar
World Health Organization. Spending targets for health: no magic number. 2016. www.who.int/publications/i/item/WHO-HIS-HGF-HFWorkingPaper-16.1 (accessed December 13, 2021).Google Scholar
World Health Organization. Strengthening health financing systems in the Eastern Mediterranean Region towards universal health coverage: health financing atlas 2018. 2019. https://apps.who.int/iris/handle/10665/311328 (accessed December 25, 2021).Google Scholar
Jamison, D. T., Summers, L. H., Alleyne, G., et al. Global health 2035: a world converging within a generation. Salud Publica Mex 2015; 57(5): 444–467.Google Scholar
Braveman, P. A., Kumanyika, S., Fielding, J., et al. Health disparities and health equity: the issue is justice. Am J Public Health 2011; 101(Suppl. 1): S149–S155.Google Scholar
Horton, R., Clark, S.. The perils and possibilities of the private health sector. Lancet 2016; 388(10044): 540–541.Google Scholar
McPake, B., Hanson, K.. Managing the public–private mix to achieve universal health coverage. Lancet 2016; 388(10044): 622–630.Google Scholar
Gwatkin, D. R., Ergo, A.. Universal health coverage: friend or foe of health equity? Lancet 2011; 377(9784): 2160–2161.Google Scholar
Allotey, P., Tan, D. T., Kirby, T., et al. Community engagement in support of moving toward universal health coverage. Health Syst Reform 2019; 5(1): 66–77.Google Scholar
Odugleh-Kolev, A., Parrish-Sprowl, J.. Universal health coverage and community engagement. Bull World Health Organ 2018; 96(9): 660–661.Google Scholar
World Health Organization. All roads lead to universal health coverage. 2017. www.who.int/news-room/commentaries/detail/all-roads-lead-to-universal-health-coverage (accessed December 14, 2021).Google Scholar
Alwan, A., Shideed, O., Siddiqi, S.. Essential public health functions: the experience of the Eastern Mediterranean Region. East Mediterr Health J 2016; 22(9): 694–700.Google Scholar
Soucat, A., Kickbusch, I.. Global common goods for health: towards a new framework for global financing. Global Policy 2020; 11(5): 628–635.CrossRefGoogle Scholar
Soucat, A.. Financing common goods for health: fundamental for health, the foundation for UHC. Health Syst Reform 2019; 5(4): 263–267.Google Scholar
Mataria, A., Brennan, R., Rashidian, A., et al. “Health for All by All” during a pandemic: “Protect Everyone” and “Keep the Promise” of universal health coverage in the Eastern Mediterranean Region. East Mediterr Health J 2020; 26(12): 1436–1439.Google Scholar
Debie, A., Khatri, R. B., Assefa, Y.. Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature. Health Res Policy Sys 2022; 20. doi: 10.1186/s12961-022-00858-7.Google Scholar
Wenham, C., Katz, R., Birungi, C., et al. Global health security and universal health coverage: from a marriage of convenience to a strategic, effective partnership. BMJ Glob Health 2019; 4(1): e001145.Google Scholar
Kieny, M. P., Bekedam, H., Dovlo, D., et al. Strengthening health systems for universal health coverage and sustainable development. Bull World Health Organ 2017; 95(7): 537–539.Google Scholar
United Nations. Universal Declaration of Human Rights. www.un.org/en/about-us/universal-declaration-of-human-rights (accessed December 13, 2021).Google Scholar
World Health Organization. Universal health coverage: a political choice. 2017. www.who.int/director-general/speeches/detail/universal-health-coverage-a-political-choice (accessed February 8, 2022).Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×