Universal health coverage programs that cover one-third of the world are transforming care for the poorest and most vulnerable: new World Bank Group report

September 25, 2015

Over past decade, expanding pro-poor coverage in countries paving way toward better health outcomes and less inequality


New York City, September 25, 2015 – A World Bank Group report released today during the United Nations General Assembly shows that more countries around the world are rolling out universal health coverage programs designed to expand access to health care and reduce the number of people impoverished by paying for the health care they need. The report, Going Universal: How 24 countries are implementing universal health coverage reforms from the bottom up, looks at how 24 countries have embarked on the path to universal health coverage and are expanding coverage to the poor—who too often get much less from their health systems than the better-off.

The expansion of universal health coverage is critical: According to the World Health Organization (WHO) and the World Bank Group, 400 million people do not have access to essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of out-of-pocket health spending.

The authors looked at how policy makers in countries are tackling five key challenges: covering people, expanding benefits, managing money, improving the supply of health care services and strengthening accountability. Countries studied in Going Universal  included Argentina, Brazil, Chile, China, Columbia, Costa Rica, Ethiopia, Georgia, Ghana, Guatemala, India, Indonesia, Jamaica, Kenya, Kyrgyz Republic, Mexico, Nigeria, Peru, Philippines, South Africa, Thailand, Tunisia, Turkey and Vietnam.

They found that the countries’ programs are new, massive and transformational: Most were launched in the past decade, together they cover more than 2 billion people and all are fundamentally changing the way health systems operate. Each of the programs aims to overcome a legacy of inequality by overcoming gaps in the financing and coverage of services that disadvantage the poor. The report showed that universal health coverage requires both greater investment, and a shift in spending to dedicate additional resources in a pro-poor and fiscally sustainable way.

The report comes as world leaders meet in New York City to adopt the Sustainable Development Goals for 2030, including for the first time, a goal to achieve universal health coverage.

This report offers practical insights to policy makers worldwide who are seeking to accelerate progress toward universal health coverage—and it offers the potential of achieving greater equity and better results for the money spent,” said Daniel Cotlear, one of the authors of the report and a Lead Economist in Health, Nutrition and Population at the World Bank Group.

The authors documented and analyzed countries’ experiences based on a systematic data collection effort that captured in great detail how countries have been implementing universal health coverage reforms.

WHO and the World Bank Group recommend that countries pursuing universal health coverage should aim to achieve a minimum of 80% population coverage of essential health services, and that everyone everywhere should be protected from catastrophic and impoverishing health payments.

Universal health coverage is a triple win: It improves people’s health, reduces poverty and fuels economic growth,” said Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank Group. The report highlights how far many countries are on the path to universal health coverage, but it also shows how far many still have to go to ensure that the poorest have access to essential health services and are protected from health expenses that cause them severe financial hardship. As the world focuses on how to achieve the new Sustainable Development Goals, acting on these findings will help to ensure that the world’s poor are not left behind.”

The Bill & Melinda Gates Foundation supported this report, which will be launched at The Rockefeller Foundation on September 25, 2015.

The report is available here:

The World Bank Group and Universal Health Coverage

In line with its global strategy for health, nutrition and population, the World Bank Group supports developing countries’ efforts to achieve universal health coverage and provide quality, affordable health care to everyone—regardless of their ability to pay—reducing financial risks associated with ill health, and increasing equity. The path to universal health coverage is specific to each country. Whatever the path, the World Bank Group’s aim is to help countries build healthier, more equitable societies, as well as to improve their fiscal performance and country competitiveness—toward the goals of ending poverty and boosting shared prosperity.

Twitter: @WBG_Health

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