The World Health Organization (WHO) has reported that progress towards achieving universal health coverage (UHC) is faltering globally, with significant challenges hindering advancements in health services coverage. Since 2015, improvements in health services coverage have plateaued, and the proportion of the population facing catastrophic out-of-pocket health expenditures has been steadily increasing since 2000.
The UHC service coverage index showed an increase from 45 to 68 between 2000 and 2021. However, the pace of progress has slowed in recent years, with only a marginal increase of 3 index points between 2015 and 2021, remaining stagnant since 2019. This indicates that approximately 4.5 billion people did not have full access to essential health services in 2021.
Moreover, around 2 billion individuals are experiencing financial hardships, with 1 billion facing catastrophic out-of-pocket health expenses. The COVID-19 pandemic exacerbated the situation by disrupting essential health services in 92% of countries at the peak of the crisis in 2021, with 84% of countries still reporting disruptions in 2022.
To address these challenges and pave the way for a more robust health system, WHO advocates for the reorientation of health systems using a primary health care (PHC) approach. Scaling up PHC interventions in low and middle-income countries could potentially save 60 million lives and increase the average life expectancy by 3.7 years by 2030.
UHC entails ensuring that all individuals have access to quality health services without encountering financial barriers. It encompasses a comprehensive range of essential health services, from prevention to treatment, rehabilitation, and palliative care. Achieving UHC is a key target of the Sustainable Development Goals (SDGs) adopted in 2015, aiming to improve health outcomes and promote well-being globally.
Despite efforts to expand service coverage, the global trend of stagnation in progress and the escalating burden of catastrophic health expenditures persist across regions and income groups. Inequalities within countries remain a significant challenge, with disparities in health service coverage and financial hardships disproportionately affecting vulnerable populations.
Monitoring health inequalities is crucial to identify marginalized groups and inform policy decisions towards achieving equitable access to health services. The disruption of essential services during the COVID-19 pandemic underscored the importance of strengthening health systems and enhancing resilience to future health crises.
In conclusion, the pursuit of universal health coverage requires concerted efforts to address existing gaps in service provision, mitigate financial risks for individuals, and promote equitable access to essential health services. By prioritizing primary health care and implementing targeted interventions, countries can make significant strides towards achieving UHC and improving health outcomes for all.
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