online questionnaires. Annex 1 provides details about the methodology used for
each of the five research areas.
It is important to note that the evidence required to assess a major health-system
reform like universal coverage is very different from that needed to evaluate
intervention effectiveness. Unlike discrete clinical interventions, the UCS reform
created new institutions and institutional arrangements comprising a multitude
of interventions moulded by a range of contextual factors. This assessment tried
to take stock of this complex change over a decade. Assessing the impact of a
major reform, therefore, is an imperfect science. Despite the reasonably strong
evidence found to support the assertions in this report, especially from national
representative household surveys, it is necessary nonetheless to exercise some
caution in attributing impacts exclusively to the reform.