We analyze and help (re)design universal health coverage policy based on our conceptual framework, in-depth mixed methods research as well as expert and stakeholder consultations.
Figure 1A 360° approach to universal health coverage
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Universality is multidimensional.
1) Access: “All people have access to the full range of quality health services they need, when and where they need them, without financial hardship” (World Health Organization / WHO).
2) Quality: “Access without quality can be considered an empty universal health coverage promise” because “even if the world achieved essential health coverage and financial protection, health outcomes would still be poor if services were low-quality and unsafe”.1
3) Outcome: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being” (WHO Constitution).
1 WHO, OECD and World Bank. 2018. “Delivering quality health services: A global imperative for universal health coverage”. World Health Organization (Geneva), Organisation for Economic Co-operation and Development (Paris) and The World Bank (Washington, DC), pp. 5, 16.
Health is also multidimensional.
1) Our Health: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO Constitution). Various dimensions of health interact to determine our overall health.
2) One Health: Human health cannot be viewed in isolation – “the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent” (WHO).
People’s health service needs vary enormously, given their differential access to the drivers of health (Figure 2). Therefore, ‘universal’ coverage of health services should not be interpreted as ‘uniform’ coverage – i.e. a pre-defined set of services for everyone. This makes health needs assessment indispensable.
Drivers of healthA 360° approach to universal health coverage requires us to work with various stakeholders to ensure that the design and delivery of health policies, programs and products are informed by and address people’s health service needs and preferences – especially those who are rarely represented in evidence.
Figure 2Drivers of health
Systemic drivers
Individual drivers
Health care
Quality care (from promotive and preventive to curative, rehabilitative and palliative)
Environments
Physical, work, family, social, cultural, commercial, economic, educational, etc.
Governance
Local, national, global policies, regulations, taxes, administrative practices
Lifestyle
Diet, sleep, leisure, activity (physical, mental and social), hygiene, substance use, etc.
Capitals
Wealth, education, social network, worldview, skills (self-control, coping, etc.)
Biology
Genetics, age, sex
G7 Policy Brief
Global health requires equitable, inclusive responses, informed by research, data and evidence. Existing global health research infrastructure is afflicted by weak institutional mechanisms and perpetuation of evidence hierarchies and silos – excluding and devaluing different knowledges and lived experience.
G20 Policy Brief
This policy brief identifies the key pillars needed to ensure strong health systems and puts forward a six-point action plan for the G20 to enhance global health resilience through joint procurement, policy harmonization, monitoring, horizon-scanning and health education.
G20 Policy Brief
Ensuring ‘health for all’ remains a persistent and entrenched global challenge. G20 governments should elevate the priority accorded to health, and acknowledge the centrality of health to attaining the SDGs. We call on G20 leaders to build nations that are more inclusive and less divided, by: adopting a Health-in-All-Policies approach, prioritizing the most vulnerable, engaging citizens in policy processes, and filling health data gaps.
Indo-German Programme on Universal Health Coverage (IGUHC), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH & UHC360
The Asia Pacific is the most unequal region as far as universal health coverage is concerned. This report presents a sustainable action plan to reduce inequalities in healthy life expectancy (HALE) and prevent health risks from threatening our progress – an impact-oriented approach to universal health coverage, anchored in primary health systems that prioritize essential public health functions.
Oxford University Press
The first comprehensive reference on India’s health sector, this volume brings together the world’s leading experts to analyse the challenges facing survival and health in India – and what it would take to address them. It aims to enhance the significance of health in the context of India’s public policy, with discussions on demographic, economic, moral and legal arguments for prioritization of health in India. It also talks about the burden of disease and disability, factors responsible for the current status of health – ranging from the economic, social, spatial and the environmental to the more immediate health sector determinants and resources – and the state of health sector regulation in the country.
The Financial Express
UHC is based on the core principles of quality and equality. India’s UHC policy should focus on the reduction of inequalities in core health outcomes.
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