Ensuring that everyone, particularly the most disadvantaged, has access to the high-quality medical treatment they require without facing financial hardship is the goal of universal health coverage, or UHC. It is the motivation for all of the World Bank Group’s investments in nutrition and health and is essential to fulfilling the organization’s objective to eradicate extreme poverty and promote prosperity in a habitable world. 

One of the most effective ways to promote economic expansion and job creation is to invest in health care. The impact of the World Bank Group’s ambitious objective of helping nations increase access to health services to 1.5 billion people by 2030 goes far beyond simply improving care; it also boosts economies, builds human capital, and generates millions of jobs. 

Global attempts to reduce poverty have been hampered since 2015 by a stagnation in health service coverage and a worsening of financial hardship brought on by out-of-pocket medical expenses.

Protects against financial hardship

Less than one-third of nations have lowered catastrophic out-of-pocket medical expenses and increased health service coverage in the last 20 years. Furthermore, the majority of nations for which statistics are available lag behind in terms of financial protection, service coverage, or both. The most recent UHC Global Monitoring Report can be read.

Significant public sector investment and quick action from governments and development partners are necessary to meet the UHC target. Investing in strong health information systems, promoting fairness in health care access and financial protection, and drastically reorienting health systems toward a primary health care strategy are important steps.

The death rate for children under five has decreased by 52% since 2000, demonstrating the extraordinary progress the world has made in lowering child mortality. Millions of youngsters have lived and prospered because of life-saving procedures and improved access to medical care. This is the result of decades of government, community, and partner investment and cooperation. Life-saving interventions have saved the lives of millions of youngsters. However, according to recent estimates, progress is diminishing, and millions of children continue to die from avoidable causes. An estimated 4.8 million children, including 2.3 million newborns, passed away before turning five in 2023.

Health at any cost

Accessible, reasonably priced healthcare can help nations develop their human capital and reap financial rewards. However, according to recent World Bank projections, health investments are slowing down in many nations. Although the general trend is alarming, it is particularly true in 35 nations, which together account for more than 2.5 billion people, where government health spending per capita and the proportion of government budgets allocated to health have decreased since 2019.

Importance of achieving value in healthcare

Making sure that everyone has access to the medical treatment they require without facing financial hardship is the goal of universal health coverage, or UHC. It is the impetus for all of the World Bank Group’s (WBG) investments in nutrition and health since it is essential to accomplishing the organization’s twin objectives of eradicating extreme poverty and promoting equity and shared prosperity. UHC enables nations to maximize their most valuable resource: human capital. Children cannot attend school and adults cannot work without excellent health; therefore, promoting health is a fundamental investment in human capital and economic prosperity. It is among the largest enterprises in the global economy, with 50 million employment opportunities, with more of them being for women.

Universal health coverage is dependent on improving the well-being of the national population, investment in human capital, and progressive and sustainable economic growth and development. It is the way to make people achieve their objectives and fulfill their potential. In September 2015, the General Assembly of the United Nations approved the 17 Sustainable Development Goals (SDGs), of which accomplishing universal health coverage (UHC) is a topic (SDG 3.8). Some of the other SDGs entail insurance against financial risks, accessibility to high-quality vital health services, and availability of essential medicines and vaccines to everyone safely, effectively, and of high quality at an affordable price.

Pillars of universal health care

Three pillars—basic, interconnected issues that prevent nations from moving closer to universal coverage—are recognized as being necessary to underpin a UHC approach. The goal of the junction of these three pillars is to establish a setting where UHC is a quantifiable and attainable objective. Obtaining enough money to guarantee the provision of healthcare services that address the population’s primary health requirements. To achieve this, it is recommended that nations must:

• Boost the effectiveness of revenue collection.
• Reorganize government spending priorities to allocate funds for health.
• Examine cutting-edge funding options such as tobacco taxes, foreign exchange transactions, and air ticket charges.
• Get health development assistance (aid).

Lowering the dependence on out-of-pocket payments, in which patients pay cash for medical services they receive. The paper suggests utilizing insurance or tax schemes to finance health services rather than charging for them. This spreads risk throughout the population and lowers personal financial risk. Subsidized health care is necessary for the poor, and those who can afford it should be required to pay for it through taxes or insurance; otherwise, low-risk individuals will choose not to participate in the system.

Global prevalence of universal health coverage

There isn’t a single list of nations that meet the WHO’s specific requirements for UHC. Nonetheless, the ILO has created a list of 190 nations along with an index of social health protection that incorporates quantitative metrics, including health spending, out-of-pocket expenses, and access indicators, with information on the legal status of coverage. 

The 2017 global monitoring report found that around 100 million people are forced into extreme poverty annually as a result of their medical expenses and that at least half of the world’s population still lacks access to basic health services. 

This second aspect of UHC, financial hardship resulting from out-of-pocket (OOP) medical expenses, is the main focus of the Global Monitoring Report on Financial Protection in Health 2019. The research investigates the level of people pushed into poverty by OOP payments and the extent to which such payments take greater than 10% or 25% of their income or absorbances (so-called catastrophic expenditures). More than 200 million people in the world spend more than 25 percent of their home income on well-being, and another 925 million spend more than 10 percent. The number of out-of-pocket expenses over the last few years has fallen to the poverty levels of 1.90 and 3.20 dollars per day.

End up

Universal health coverage is a critical investment in economic growth as well as human well-being. It is a real illustration of the concept that health is a public good and a human right. Even though much remains to be done, countries can come closer to UHC by focusing on increasing equal access to high-quality treatment through strengthening health systems and ensuring financial security. Besides improving the health outcome, the realization of UHC is essential to having resilient communities where nobody fears being driven into bankruptcy by illness.

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