Universal Health Coverage

When financial-risk protection mechanisms are in place to ensure that the cost of using care does not put people at risk of financial hardship.

The 2023 State of UHC Commitment Review shows that countries are primarily focused on service and population coverage for UHC, but there is a lack of emphasis on financial coverage.

Only 45% of countries have set specific national spending goals for health in their plans and policies, and there has been no increase in primary healthcare spending in recent years. This lack of investment on top of the ongoing financial barriers to healthcare continue to exacerbate the burden of NCDs worldwide, despite international policy goals and targets for NCDs and UHC.

Access to high-quality essential services across the continuum of care which leave no one behind

Many countries struggle with providing adequate coverage and access to NCD services across the continuum of care, including screening, diagnosis, treatment, rehabilitation and palliative care. For example, half of adults living with diabetes are undiagnosed and unable to access insulin; hypertension is only under medical control for 1 in 5 people; chronic kidney disease often goes untreated, and over 90% of cancer patients in low-income countries lack access to radiotherapy.

Too often, health systems are fragmented and focused on single-disease care rather than an integrated, life course approach.

The 2023 State of UHC Commitment Review states that while many countries have set UHC as a goal in their national policies and plans, only a small number have developed a clear action plan to achieve it, and efforts have often been focused on vertical health programmes rather than comprehensive care for the population.

Equity in access to health services across all populations, which leave no one behind

Despite efforts to improve access to healthcare services for all populations, health inequalities persist, particularly for marginalised groups and those with low socioeconomic status. These individuals have a higher risk of dying from NCDs due to lack of access to health services and exposure to risk factors. Out-of-pocket payments for healthcare also push these groups into poverty.

Learn about an integrated primary health care programme that leaves no population behind in Jordan!

The 2023 State of UHC Commitment Review tells us that many UHC implementation efforts have often only focused on specific population groups and discriminatory practices have been reported. The pandemic has likely worsened these inequalities and there is limited participation from non-state actors in efforts to improve UHC monitoring, evaluation, and accountability. What’s more, only a small number of countries have implemented formal accountability mechanisms for UHC.