UNIVERSAL HEALTH COVERAGE

 Universal health coverage (UHC) is expressly based on the 1948 WHO constitution which states
health as a fundamental human right and is committed to ensuring the highest attainable level of
health for all. Achieving UHC is a global commitment embodied in the SDG agenda and a key
component of reducing inequality and fighting poverty worldwide. While great progress has been
made in recent decades, nearly half of the world's population still does not benefit from complete
coverage of essential health services and millions of people are still pushed into extreme poverty,
because they have to pay for health care.

WORLD HEALTH STATISTICS 2021

Service coverage

Improvements in essential healthcare coverage have been noted across all regions and all income
groups, with the UHC service coverage index (UHC SCI) increasing from a global average of 45
(from 100) in 2000 to 66 in 2017. The greatest progress has been made in LICs. , driven
primarily by interventions for communicable diseases and, to some extent, for better
reproductive, maternal, newborn and child health (RMNCH) services. 

Achieving UHC requires several approaches. The primary health care approach and the life
course approach are essential. As the first point of entry between patients and the health system,
primary health care enables everyone to benefit from basic health services while reducing
financial and geographic barriers. Its strengthening at the community level is a key aspect of
realizing UHC, and needs to be further supported. Applying a life course approach optimizes
people's health by meeting their needs and maximizing opportunities at all phases of life so that
they can and do what they reasonably value at all ages, always guided by principles that promote
human rights and gender equality.    

Financial protection is achieved when direct payments for health services do not cause financial
hardship. Unfortunately, the gains in service coverage come at a great cost to some individuals
and their families. The incidence of catastrophic health expenditures – defined as large self-
expenditures in relation to household consumption or income – increased steadily between 2000
and 2015. The proportion of the population with health expenditures alone exceeding 10% of
their household budget increased from 9.4% to 12.7% during this period, and the proportion of
direct expenditures exceeding 25% increased from 1.7% to 2.9%. Overall, financial protection
before COVID-19 worsened rather than improved. The world cannot afford a health system
without financial protection.     

Inequality in the field of infectious diseases

Socioeconomic inequalities exist in all countries and have an important impact on health. There
are systemic differences in infectious diseases between social groups with different dimensions
such as economic status, education, place of residence, occupation and so on. Poorer and
disadvantaged populations tend to suffer from a higher burden of infectious diseases, for example
due to low knowledge of protective behaviours, increased exposure due to living and working
conditions, poor health seeking behavior and barriers to accessing health services, all of which
hinder detection and treatment. fast. HIV/AIDS Overall, HIV knowledge, attitudes and practices
(KAP) tend to be better among the rich and educated. For example, in more than half of countries
for which data are available between 2010–2019, there is a gap of at least 20 percentage points
between the richest and poorest KAP indicators. Knowledge of HIV was also at least 20
percentage points higher among the most educated than the least educated.     

Tuberculosis Overall, half of people affected by TB face catastrophic costs (over 20% of
household income) as a result of the disease, ranging in 16 countries between 19% and 83%. For
people with drug-resistant TB, this proportion increases to 80%. The likelihood of facing disaster
costs is more than 20 percentage points higher among the poorest households in most countries  

Malaria fever is the main symptom for suspecting malaria and triggers diagnostic testing of
patients in most malaria-endemic settings. The history of fever and subsequent steps taken to seek
treatment have become the basis for measuring access to malaria case management. Overall,
there are large inequalities in care-seeking behavior for children with fever, which tend to be
lower among the poor, uneducated and rural subpopulations. Seeking immediate care for children
under 5 years of age with fever was at least 20 percentage points higher in the richest quintile
than in the poorest quintile in more than half of the study countries. This inequality in access
persists, with little or no change seen overall in the last 10 years.    

HEALTH MONITORING FOR SDG s

Inequality in the distribution of health workers

The unfair distribution of HWF – in terms of age, gender, place of work – hinders national
capacity to achieve UHC.

Access and delivery of health technology

Access to and delivery of medicines, vaccines and diagnostic tools is critical to addressing the
most established and emerging health problems, and to restoring overall momentum towards
health-related SDGs. Around the world, the need to reduce face-to-face consultations without
compromising the quality and access of essential healthcare services has revitalized telemedicine
and brought it to the forefront of the COVID-19 era. Discussions about the need and feasibility of
telemedicine have spread across various medical specialties and care settings.