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Universal health coverage

    Overview

    Universal health coverage (UHC) means that all people and communities receive quality health services when and where they need them without suffering financial hardship. It covers the full spectrum of health services throughout the life-course, from promotion to prevention, treatment, rehabilitation, and palliative care.  

    UHC requires strong and resilient health systems based on primary health care approach, as well as working with communities and other sectors to address the determinants of health. Although there are broad principles, good practices, and strategic directions for UHC, there is no ‘one size fits all’ approach—each country chooses its own path and pace, based on the context, even beyond health—fiscal, public administration, political, and cultural factors. Progress is incremental and can be accelerated with sustained political commitment, smarter investments, continuous monitoring, learning and evaluation, and course corrections. 

    UHC is the overarching target of the Sustainable Development Goal on Health (SDG 3), central to achieving the Triple Billion targets globally and the foundation for realizing the For the Future vision in the Western Pacific Region. Over the past decade, countries in the WHO Western Pacific Region have made significant health gains in service coverage and increased commitments to advance UHC through various policy and programme interventions. However, financial protection has decreased especially with the interrelated challenges of the COVID-19 pandemic. 

    In 2015, the Regional Committee of the Western Pacific endorsed the action framework that can guide countries in developing their UHC roadmaps based on taking concrete actions for improving the five interrelated attributes of high-performing health systems—quality, efficiency, equity, accountability, as well as sustainability and resilience. This has been reinforced in regional agendas and subsequently highlighted in taking systems approach and bringing together various health agendas towards the shared goal of improving health for all. 

    WHO response

    As a foundation for UHC, WHO recommends reorienting health systems using a primary health care (PHC) approach. Achieving UHC is a WHO strategic priority, with the goal of 1 billion more people benefitting from universal health coverage by 2025.

    In countries with fragile health systems, we focus on technical assistance to build national institutions and service delivery to fill critical gaps in emergencies. In more robust health system settings, we drive public health impact towards health coverage for all through policy dialogue for the systems of the future and strategic support to improve performance.

    This work is supported by normative guidance and agreements; data, research and innovation; and leadership in the realms of diplomacy, advocacy, gender equality, health equity and human rights, multisectoral action, and finance.

    2030 Agenda for SDGs

    UHC is one of the targets that all UN Member States committed to achieving by 2030 as part of the Sustainable Development Goals (SDG). UHC is not only an overarching target but also provides a unifying agenda for overall progress on SDG 3, “Good Health and Well-Being for all at all ages”. This includes financial risk protection, access to quality essential health services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. 

    Globally, the UHC service coverage index (SCI) increased from 45 in 2000 to 68 in 2021, however the world has seen a stagnating pace of progress in recent years and no change since 2019, depriving millions of people of lifesaving and health-enhancing interventions. In the Western Pacific Region, UHC SCI increased from 49 to 79 during the same period. While there is improvement in coverage of essential services, financial protection declined as the percentage of households with catastrophic health expenditure increased from 9.8% to 19.8% in 2019. 

    It is imperative to note that UHC progress across and within the countries in the Region considerably varies given the diversity of countries and shifting health demands. Regional averages can, however, mask actual variations across countries and areas, which were further exacerbated during the COVID-19 pandemic. 

    WHO has a range of evidence-informed approaches, strategies, and tools to support countries get back on track towards the progressive realization of UHC and broader sustainable development goals.

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