Quality, affordable health care is the foundation for individuals to lead productive and fulfilling lives and for countries to have strong economies. Universal health coverage (UHC) is about ensuring that people have access to the health care they need without suffering financial hardship. It also helps drive better health and development outcomes.
In recent years, the UHC movement has gained global momentum, with the World Health Assembly and the United Nations General Assembly calling on countries to “urgently and significantly scale up efforts to accelerate the transition towards universal access to affordable and quality healthcare services.”
UHC is key to achieving the World Bank Group’s (WBG) twin goals of ending extreme poverty and increasing equity and shared prosperity. It is also an essential part of the Sustainable Development Goals (SDGs): SDG 3 includes a target to “achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.” SDG 1, with the goal to end poverty in all its forms everywhere, is also in peril without UHC, as hundreds of millions of people are impoverished by healthcare costs every year.
Today, most low- and middle-income countries are designing and implementing strategies that are accelerating progress toward UHC. The WBG is committed to helping governments achieve UHC by 2030. While the path to UHC is specific to each country, the WBG’s aim is to support countries to build healthier, more equitable societies, as well as to improve their fiscal performance and country competitiveness. The WBG does this through global, regional, and country-level research and knowledge generation, financial investments and technical assistance, and global convenings.
Ongoing WBG research is helping to evaluate UHC progress globally, including the quality of primary care, health coverage expansion initiatives, and inequalities in health outcomes. In 2015 the WBG and World Health Organization (WHO) released a first-of-its-kind report, Tracking Universal Health Coverage, to measure health service coverage and financial protection to assess countries’ progress towards UHC. This flagship report will be updated in December 2017. The report Going Universal: How 24 Countries Are Implementing Universal Health Coverage Reforms from the Bottom Up was also released in 2015, describing how different countries are pursuing UHC, based on systematic data collection, in order to provide practical insights to policymakers. In addition to this, the WBG and WHO have also jointly developed a monitoring framework to help countries track their progress and results in UHC.
To boost regional UHC efforts, in August 2016 the WBG, with the WHO, the government of Japan, Japan International Cooperation Agency, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), and the African Development Bank, launched UHC in Africa: A Framework for Action. The framework provides a big-picture view of UHC in the region and identifies key areas that will be critical to achieving better health outcomes. During the same event, the Sixth Tokyo International Conference on African Development (TICAD-VI), the WBG and the Global Fund also committed to invest $24 billion in Africa over the next three to five years to help countries implement their health reforms. Beyond Africa, to help boost health systems strengthening globally, in 2017 the WGB and the WHO published Healthy systems for universal health coverage – a joint vision for healthy lives.
Partnership is key, and the WBG works with several partners to accelerate progress towards UHC. The WBG is a co-convener with the WHO of UHC2030, the global movement to build stronger health systems for UHC. This multi-stakeholder platform also advocates for increased political commitment to UHC and facilitates accountability and knowledge sharing.
Since one of the most important challenges to achieving UHC globally is the availability and sustainability of financing, the WBG, along with partners, also convenes the UHC Annual Financing Forum at its Spring Meetings. The forum brings together countries and partners to shape a joint agenda on financing for UHC and provide a platform to advance knowledge and its application in UHC financing. By bringing the finance and health sectors together, and by bridging policy with evidence, the Forum creates one of the only global spaces that convenes key actors to help accelerate progress in countries towards sustainable financing of UHC.
In addition, the WBG is also a partner in the Joint Learning Network for UHC, a network of policymakers and practitioners from low- and middle-income countries who learn from one another, jointly problem solve, and collectively produce and use new knowledge, tools, and innovative approaches to accelerate country progress toward UHC.
The WBG also uses varied financial mechanisms, such as results-based financing (RBF), to work towards achieving UHC. RBF approaches, which link financing to pre-determined results, with payment made only upon verification that the agreed-upon results have actually been delivered, have seen promising results in the health sector. These include increasing coverage as well as quality of services while targeting resources to vulnerable populations and increased collaboration among various stakeholders. In Cameroon, for example, RBF projects saw significant increases in coverage of children’s vaccinations, maternal immunization against tetanus as well as the coverage of modern methods of family planning. The Health Results Innovation Trust Fund, funded by Norway and the United Kingdom, supports the design, implementation, and evaluation of these RBF approaches in 30 countries.
Other relevant research and tools include:
- Data and data sheets: Socioeconomic Differences in Health, Nutrition, and Population
- Publication: Attacking Inequality in the Health Sector
- Reaching the Poor with Health, Nutrition, and Population Services
- Study: Getting Better: Improving Health System Outcomes in Eastern Europe and Central Asia
- Study: Toward Universal Health Coverage in Latin America and the Caribbean
- Free software tool: Adept, which measures equity and financial protection in health.
Last Updated: Jun 30, 2017