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PRESS RELEASE January 18, 2018

Countries Increasingly Adopt Pro-poor Universal Health Coverage Reforms to Build Human Capital and Drive Inclusive Economic Growth

Washington DC, January 18, 2018 – Countries are increasingly adopting pro-poor health systems reforms with the goal of ensuring Universal Health Coverage (UHC), as an essential element of ensuring sustainable and inclusive economic growth, according to new research released today by the World Bank. 

The sixteen country case studies released today add to the 24 countries which have already been reviewed as part of the World Bank’s Universal Health Coverage Study Series (UNICO). Thirty three of the 40 countries covered have initiated UHC reforms just since the year 2000. They are seeking to expand health services to more people, cover a broader range of health conditions and ensure that health care is made affordable. The reforms studied are transformational, covering more than 2.6 billion people, over a third of the world’s population. 

“Countries are driving the global momentum on UHC. Our research offers policymakers around the world rich insight into the different approaches that can be taken to achieve better health coverage and greater affordability for populations while also ensuring the financial sustainability of health systems,” said Daniel Cotlear, Lead Economist in Health, Nutrition and Population at the World Bank Group and lead author of the UHC study series. 

The research finds that while countries take different paths, what they have in common is their pro-poor orientation and focus on affordability. Countries take two main approaches to ensuring greater equity and increasing access to health services for the poor.  Some directly expand community and primary care services which serve low-income populations. Others choose to open up hospital and complex tertiary care services, which are usually too expensive to be accessible to the poor, by creating public insurance schemes which pay for those services for low-income populations. 

Most countries’ programs eliminate user fees for poor populations, and many subsidize care for near-poor populations.  There is much discussion about subsidizing or requiring contributions to informal sector workers and their families; Thailand, Colombia and Mexico fully subsidize their health care, while Turkey, Costa Rica and Childe require them to pay social security contributions for their care. 

The increased drive towards UHC is timely. The 2017 UHC Global Monitoring Report, released in December 2017, found that half the world’s population does not have access to quality essential health services. Close to 100 million people are pushed into extreme poverty every year (at the $1.90 a day level), while 800 million spend more than ten percent of their household budget on health care.  

“Universal Health Coverage is essential not just to ensure that we meet the SDG3 Goal on Health, but also our common SDG1 Goal of Ending Poverty,” said Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank Group. “Countries are at the vanguard of the drive towards UHC because they and their populations recognize it is a foundational investment needed to build a nation’s human capital and be ready to thrive in the economy of the future.”

The countries covered in the latest UNICO series include Armenia, Azerbaijan, Croatia, Dominican Republic, England, Gabon, Israel, Korea, Malawi, Malaysia, Morocco, Russia, Sri Lanka, Tanzania and a review of health financing policies in 46 African countries.

The full series is available at

The World Bank Group and Universal Health Coverage

In line with its global strategy for health, nutrition and population, the World Bank Group supports 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—in order to build human capital, end poverty and boost shared prosperity.