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How Can We Measure Countries’ Progress Toward Universal Health Coverage?

An increasing number of nations are aiming to establish universal health coverage. International donors and multilateral organizations are supporting these initiatives.

But what is the best way to measure their progress toward universal health coverage (UHC)?

Abt Global’s Carlos Avila and Anthony Leegwater worked with Wendy Wong of the University of Chicago to analyze where 103 countries stood on health service coverage, a key dimension of UHC. Their report, published online in June 2015 by BMC Health Services Research, used publicly-available indicators reflecting health service delivery, infrastructure, human resources, and health expenditures from 2000 to 2010.

The team defined UHC as a goal in which all people have access to health services when needed and can avoid financial hardship in paying for those services. This is the definition in the World Health Organization’s 2010 World Health Report.

“Health service coverage traditionally has been measured by the type of service and type of treatment available and commonly focus on maternal, child, and infectious diseases,” Avila said. “To get a more comprehensive picture of UHC, we also examined health expenditures, human resources for health, and health infrastructure.”

In all, the authors settled on 13 indicators for measuring health service coverage. They found wide variations across the 103 low and lower-middle income countries, with Eastern Europe and Asia having the most robust coverage and Africa the least.

This health service coverage index developed by the team showed a strong correlation with health outcome measures such as infant mortality and life expectancy.

“Countries with weaker service coverage also had, for example, high infant mortality. This leads us to conclude our indices are meaningful,” Avila said.

Read the full analysis

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