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Monitoring Progress Towards UHC

The WHO and World Bank, in 2014, published their report Monitoring Progress Towards Universal Health Coverage at Country and Global Levels, in which they gave the world’s first prototype document for indicators of Universal Health Coverage (UHC). In effect, they made indicators such as service coverage rates and financial coverage measurable and comparable.

In the report, they also propose a common framework for monitoring progress in UHC and that monitoring progress in UHC be part of monitoring national health system performance. In accordance with the definition, monitoring of UHC relates to two aspects of health system performance: levels of coverage with health services and financial protection. Monitoring UHC requires regular assessment of inputs (finances, health workforce and medicines), outputs (service provision), coverage of interventions, health impacts and the social determinants of health.

Detailed information may be found at the following link:

https://www.who.int/publications/i/item/monitoring-progress-towards-universal-health-coverage-at-country-and-global-levels-framework-measures-and-targets

In 2015, the WHO began systematically measuring the status of UHC worldwide and producing a biennial report on its latest findings.

That report, the Tracking Universal Health Coverage: Global monitoring report, has thus far been published in 2015, 2017, 2019, and 2021; detailed information may be found at the following link: https://www.who.int/data/monitoring-universal-health-coverage

WHA 58.33 Sustainable health financing, universal coverage and social health insurance

The 2005 (58th) World Health Assembly endorsed a resolution WHA58.33 for “Sustainable health financing, universal coverage and social health insurance.”

The resolution was the first resolution to be made by the WHA with respect to UHC. It recognized that “health-financing systems in many countries need to be further developed in order to guarantee access to necessary services while providing protection against financial risk” Thus, it urged Member States:

  • “to ensure that health-financing systems include a method for prepayment of financial contributions for health care, with a view to sharing risk among the population and avoiding catastrophic health-care expenditure and impoverishment of individuals as a result of seeking care;
  • “to ensure adequate and equitable distribution of good-quality health care infrastructures and human resources for health so that the insured will receive equitable and good-quality health services according to the benefits package;
  • “to recognize that, when managing the transition to universal coverage, each option will need to be developed within the particular macroeconomic, sociocultural and political context of each country;
  • “to take advantage, where appropriate, of opportunities that exist for collaboration between public and private providers and health-financing organizations, under strong overall government stewardship;
  • “to share experiences on different methods of health financing, including the development of social health-insurance schemes, and private, public, and mixed schemes, with particular reference to the institutional mechanisms that are established to address the principal functions of the health-financing system;”

Detailed information may be found at the following link:

https://cdn.who.int/media/docs/default-source/health-financing/sustainable-health-financing-universal-coverage-and-social-health-insurance.pdf?sfvrsn=f8358323_3

WHA 64.9 Sustainable health financing structures and universal coverage

At the 2011 (64th) World Health Assembly, Member States shared their experiences thus far in implementing UHC, and endorsed resolution WHA64.9, which summarized the states’ experience and provided guidelines, and urges Member States to promote the transparency and efficiency of health-financing, and provided the following suggestions:

  • “to aim for affordable universal coverage and access for all citizens on the basis of equity and solidarity, so as to provide an adequate scope of health care and services and level of costs covered;
  • “to continue, as appropriate, to invest in and strengthen the health-delivery systems, in particular primary health care and services, and adequate human resources for health and health information systems, in order to ensure that all citizens have equitable access to health care and services;
  • “to ensure that external funds for specific health interventions do not distort the attention given to health priorities in the country, that they increasingly implement the principles of aid effectiveness, and that they contribute in a predictable way to the sustainability of financing;
  • “to promote the efficiency, transparency and accountability of health-financing governing systems;
  • “to share experiences and important lessons learnt at the international level for encouraging country efforts, supporting decision-makers, and boosting reform processes;
  • “to establish and strengthen institutional capacity in order to generate country-level evidence and effective, evidence-based policy decision-making on the design of universal health coverage systems, including tracking the flows of health expenditures through the application of standard accounting frameworks.”

Detailed information may be found at the following link:

https://cdn.who.int/media/docs/default-source/health-financing/sustainable-health-financing-structures-and-universal-coverage.pdf?sfvrsn=d5d909b3_3