Monitoring progress towards universal health coverage at country and global levels

• Published in: PLoS medicine Vol. 11; no. 9; p. e1001731
• Main Authors: Boerma, Ties, Eozenou, Patrick, Evans, David, Evans, Tim, Kieny, Marie-Paule, Wagstaff, Adam
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-09-2014; Public Library of Science (PLoS)
• Subjects: Case studies; Collection Review; Data collection; Delivery of Health Care - economics; Delivery of Health Care - trends; Disease prevention; Global Health - economics; Global Health - trends; Health aspects; Health Care Reform - economics; Health Care Reform - trends; Health facilities; Health Promotion - economics; Health Promotion - trends; Healthcare Financing; Humans; Information systems; Medicine and Health Sciences; Monitoring systems; National health insurance; Population; Rehabilitation; Socioeconomic factors; Universal Health Insurance - economics; Universal Health Insurance - trends; Singapore; Estonia
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1001731

Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries.