Universal health coverage programs transforming care for poorest and most vulnerable

Article originally published on World Bank website.

The expansion of universal health coveragenurses-in-tonga 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 World Bank 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 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,”

– Daniel Cotlear, 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.”