What is Universal Health Coverage?

ANA RITA SEQUEIRA: Imagine a world where all people can access the health services they need to stay healthy or improve their health, without suffering financial hardships. This is universal health coverage. Recently, the broad consensus regarding the importance of universal health coverage, has been steadily building. It started in 2005, with the World Health Assembly resolution, calling countries to plan for the transition to universal health coverage. And more recently, as an essential part of the Sustainable Development Goals. Goal three, specifically includes a target to achieve universal health coverage. Universal health coverage comprises three dimensions– health services, population covered, and financing mechanisms. The three dimensions are generally illustrated like this.

The health services refer to the range of services that are available, as well as affordable, essential medicines and vaccines. For a country that already covers the entire population, that might signify the access to dental and mental health services. Other countries, to maternal and reproductive health services and essential medicines to treat infectious diseases. The population coverage implies, all people have access to basic health services without discrimination, and that accounts for the marginalised and poorest segments of the population, persons with disabilities, and indigenous peoples. And last, the financing schemes to pull resources are critical to ensure the access to and the expansion of services, and not expose the users to financial hardship.

A health policy and governance angle examines the trade-offs between these three dimensions and the strategies to maximise the delivery of care, while avoiding the catastrophic expenditure that can lead to the poverty trap. So what is the role of the government? Regulator? Service provider? Or purchaser of care? A sponsor of education and training for health care practitioners? Or do they leave the task to industry? During this third and final week, we will be discussing some of these complexities.