By: Ilona Kickbusch, Director, Global Health Program, Graduate Institute of International and Development Studies and Jeffrey L. Sturchio, Senior Partner, Rabin Martin
Universal Health Coverage: An Annotated Bibliography is the first product of a new, multi-year collaboration between the Global Health Program at the Graduate Institute of International and Development Studies and Rabin Martin. Given the large and growing literature on universal health coverage, this offering cannot be comprehensive. Instead it is intended as an introductory guide to the subject, one that will expand as the debate evolves in the coming months.
The bibliography is organized into eight sections: concepts and considerations; governance; equity and social protection; health systems financing; health systems delivery; health workforce; metrics; and country case studies. These seemed to be natural categories to organize the many studies, reports and commentaries we found to be helpful in working our way along the learning curve. They also reflect the foci of the existing literature. The WHO defines UHC as “ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.” This clearly demonstrates that issues surrounding how health care is paid for are of fundamental importance, together with an improved understanding of the need to shape health financing systems to promote UHC, while keeping equity and social protection firmly in mind. No country in the world will achieve UHC without strong political will and recognition of the crucial role that strong governance at local, national and international levels will play in the countries’ journey towards UHC. To achieve UHC, countries need to address the percentage of the population covered, the percentage of the costs prepaid at the point of service and the percentage of interventions that are covered by prepaid schemes. To be able to do this effectively, countries will find that intersectoral cooperation is critical. As a result, issues around the delivery of services (including preventive services) will be critical.
Finally, we included a number of country case studies to illustrate the on-the-ground realities that countries around the world face in their efforts to reach UHC. Theses case studies clearly demonstrate the many different avenues that countries can take to reach UHC, highlighting the fact that there is no “one-size-fits all” path to UHC. Each country will need to work at its own pace, factoring in the many parameters (e.g. burden of diseases, demographics, political will, state of their health systems, private-public sector mix, financing system, etc.) that relate to their own country when devising their strategy to reach UHC.
We hope that our readers find this first working paper useful to inform their own discussions on UHC. While we don’t have all the answers yet, we are certain that the lively interest in the concept of UHC and the health economy is likely to continue for some time to come. Please don’t hesitate to contact us with citations for future editions of this bibliography – and, more importantly, your thoughts on how we can collectively improve our understanding of UHC and its practical implications for addressing the changing needs of our complex global health systems.