No health net for 3.1 bln by 2023 deadline

The World Health Organization (WHO) 13th General Programme of Work targeted universal health coverage (UHC) between 2019 and 2023

By Madhumita Paul
Published: Monday 31 August 2020

An estimated 3.1 billion people worldwide will lack effective health service coverage by 2023, according to a recent study. Nearly a third (968.1 million) of them will be in south Asia.

The World Health Organization (WHO) 13th General Programme of Work targeted universal health coverage (UHC) between 2019 and 2023. That would mean all people receive quality healthcare without financial stress.

The study — published August 27, 2020 in journal The Lancet — focused on measuring country-level effective coverage and developing a new framework to capture how well countries’ health systems delivered health gains relative to their populations’ health needs.The findings showed a gap of more than 70 points between locations with the highest and lowest levels of UHC in 2019. This was despite global advances on the effective UHC index since 1990.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 Universal Health Coverage Collaborators who carried out the study — assessed effective UHC for 204 countries and territories from 1990 to 2019, using 23 indicators across health service types and population-age groups. To reach an effective UHC index of at least 80 — under maximum efficiency — countries needed to reach $1,398 in pooled health spending per capita per year.

Globally, performance on the effective UHC index improved to 60.3 in 2019 from 45.8 in 1990. Large variations from over 95 to below 25, however, remained across countries and regions.

Japan had the highest effective coverage score in 2019, while Central African Republic and Somalia had the lowest performance on effective UHC. Sub-Saharan Africa accelerated gains since 2010 compared to other regions, at an average 2.6 per cent per year up to 2019. Zimbabwe, the Democratic Republic of the Congo, Guinea-Bissau and South Africa had the fastest growth in effective coverage performance.

Poor performance on various non-communicable diseases hindered progress on UHC in many countries, compared to communicable diseases and maternal and child health. The study did not measure the financial risk protection component of UHC, but researchers did look at per capita health spending by countries. They found increased spending could be important for many countries to improve effective UHC performance.

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