UHC Forward Blog

Joint Learning Network for Universal Health Coverage will welcome new member countries in 2014

As the Universal Health Coverage (UHC) movement picks up pace around the globe and many countries face the tough challenges of implementing reforms to achieve UHC, the Joint Learning Network (JLN) has decided to expand its membership. This announcement comes after a meeting of the JLN Steering Group in Accra, Ghana, on November 6, 2013.

The planned expansion of the JLN is in response to a growing demand for practical knowledge from countries on the path to UHC, and an expressed desire by current JLN members to enrich the learning process by engaging with a wider and more diverse group of reformer countries.

The JLN seeks to produce new knowledge about how to implement UHC reforms that can be used by countries around the globe.

A novel indicator to predict countries’ likelihood of achieving universal health coverage

By Andrea B. Feigl and Eric L. Ding

While there is an increased focus on achieving universal health coverage among low and middle-income countries, empirical determinants of universal healthcare coverage are poorly understood. With the goal to study the economic, social, and political predictors of universal coverage, we systematically researched the common definition and dimensions of universal coverage and created a novel indicator that captures the most important UHC dimensions of legal coverage, universal access to services, and universal enrollment.

Utilizing and indicator that we termed Evidenced Formal Coverage (EFC), we determined that a country has achieved universal coverage if:

  1. Universal healthcare coverage is written into the country’s law
  2. At least 85% of the population is covered under the law

No UHC without health workers

This week two thousand people gathered in Recife, Brazil for the 3rd Global Forum on Human Resources for Health. As well as looking back on progress made over the past decade, the Forum also looked ahead to the role of health workers in achieving Universal Health Coverage (UHC).

The overarching message from the Forum is that UHC depends on health workers. However, new data published at the Forum warns that we face a current shortage of more than 7.2 million doctors, nurses and midwives, not to mention those uncounted community health workers who are often the only healthcare providers available to the poorest people.

Healthcare: A democratic dividend?

This article is cross-posted from This is Africa a service from the Financial Times

Empirical studies have linked democracy to improved social indicators, but debate rages on the causal mechanisms at play. Africa shows there is no straightforward link between multiparty electoral democracy and better healthcare outcomes.

In the 1990s, the Nobel prize-winning economist Amartya Sen made a compelling case for democratisation. ''No famine has ever taken place in the history of the world in a functioning democracy,'' he wrote. This is because governments ''have to win elections and face public criticism, and have strong incentives to undertake measures to avert famines and other catastrophes.''

His argument has shaped thinking in countless areas of public service delivery - from education to infrastructure; but none more so than healthcare.

The Week in Headlines

UHC Forward's Weekly Roundup of Headlines from Around the Globe

Week of October 21, 2013 - Governments around the world are engaging in serious political and technical discussions on how to expand health coverage. Still others are considering such reforms, but are struggling to navigate the legal, financial, and political frameworks of their countries to determine the best path towards universal health coverage (UHC).

Below is a list of UHC-related headlines from around the world.

The Role of PBF to Achieve UHC and to Build Bridges to Insurance Systems

An interesting debate on universal health coverage is taking place in the Health Harmonization Community of Practice. The below comment is by Robert Soeters and Godelieve van Heteren with comments from Frank van de Looij of Sina Health in reaction to the exciting debate.

A performance-based financing approach is a health reform framework, which aims at achieving universal health coverage (UHC) and that could also be combined with different revenue collection and pooling mechanisms. Different from other health financing mechanisms, PBF focuses in the first place on improving the quality of service delivery, efficiency and sustainability. Health systems based only on tax revenues, government provision and producing free health care or national obligatory insurance schemes often underestimate the impact of provider behavior on the quality of care and efficiency.

You can't have one without the other: Why the private sector matters in reaching UHC

By Thierry van Bastelaer

I want to live in a world where all governments, however resource-challenged, take care of their populations’ most basic needs — starting with health. In this world, fiscal resources would be unlimited (or donors will be around forever), and social solidarity is so strong that everybody is happy to pitch in to provide free care to the poorest.

A recent report from Oxfam “Universal Health Coverage: Why Health Insurance Schemes are Leaving the Poor Behind,” seems to suggest that this is the world that we live in. Unfortunately, it’s not. Arguing, as Oxfam does, that the public sector can finally bring about universal health coverage on its own ignores the complex political and economic realities in most developing countries.

Local politics have dynamics of their own — and they are not always focused on the needs of the poorest. Charismatic, socially driven leaders retire or are replaced.

Extending Coverage to the Informal Sector: JLN Countries Exchange Lessons and Challenges with Indonesia

By Annette Ozaltin

Cross-posted from the Joint Learning Network

Six of Indonesia’s government ministries participated in a high level forum on September 30 - October 2, 2013 that seems to have broken a logjam on how to attain health coverage for households dependent on informal sector workers. The High Level Forum on Expanding Coverage to the Informal Sector, supported by the JLN, AusAID, GIZ, WHO and the World Bank, resulted in an agreement to implement pilots that will evaluate options in extending coverage to this population group.

Universal health coverage, real or selective? Time for global health advocates to unite

By Gorik Ooms

About a year ago, at the AIDS 2012 conference in Washington DC, I wondered why the theme universal health coverage was virtually absent from the conference. It looked as if UNAIDS' universal test-and-treat strategy and WHO's universal health coverage plan were designed for two different worlds, as I argued in a blog post then. Such a division of global health advocates was bad news for global health, in my opinion, especially in light of the coming MDG negotiations. We should not count on three or more health-focused MDGs this time.

But I also understood why the AIDS activists at the conference were wary about supporting universal health coverage.

Latin America's Lessons for UHC

By Joe Kutzin

More meetings on UHC and health financing (a fact, not a complaint)

I go to a lot of meetings on UHC and health financing (again, that’s a fact, not a complaint). In the past two weeks, I participated in a panel discussion on UHC at the WHO Regional Committee for Africa, and I’m just back from a meeting on the role of the Regional Office for the Americas (PAHO) in supporting its member-states to make equitable progress towards UHC. While neither meeting was focused solely or even primarily on health financing, I almost always am, and as I sat in PAHO’s DC office I began to think about what lessons does Latin America’s rich experience hold for low- and middle- income countries elsewhere in the world.