Universal health coverage (UHC),
sometimes called universal coverage,
is the aspiration that all people obtain
the health services they need without
suffering financial hardship paying for
them. This requires coverage with a
range of promotive, preventive, curative,
rehabilitative and palliative services,
and in particular coverage with services
linked to the current health-related Millennium
Development Goals (MDGs)
and to noncommunicable diseases and
injuries.
UHC is increasingly seen by
countries at all income levels as an
important goal for their health system
development, as reflected in resolutions
of governing bodies of the World
Health Organization (WHO) (e.g.
WHA 58.33 of 2005 and 64.9 of 2011;
EM/RC59/R.3 of 2012) and in five
recent global ministerial-level meetings,
including a joint WHO/World
Bank meeting between ministries of
health and finance in Geneva in February
2013.
But UHC is also broader than
health. By improving people’s health,
it enables adults to work and earn an
income and children obtain an education
– allowing many to escape from
poverty. By protecting people from
financial hardship as a result of paying
for health services, it prevents others
from being pushed into poverty
[1]. Recognizing this, the Member
States of the United Nations adopted
a resolution in December 2012
(A/67/L.3) emphasizing that UHC
was important to overall human
development and suggesting that it
should be included in the post-2015
development agenda.
Moving closer to UHC contributes
to “the enjoyment of the highest
attainable standard of health” which,
as stated in the WHO constitution,
is “one of the fundamental rights of
every human being without distinction
of race, religion, political belief,
economic or social condition” [2]. It is
consistent with the concept of “health
for all” and the Alma Ata Declaration
of 1978 [3].
In addition, within the concept of
UHC it is recognized that achievement
of the highest attainable level of
health is not possible without health
financing systems that guarantee
financial risk protection and health
systems that function appropriately.
Only then can people access the
health services they need secure in
the knowledge that they will not suffer
financial hardship as a result of paying
for them.
Many factors help countries move
closer to UHC and help protect the
gains they have already made in coverage
with needed services and financial
risk protection. Social determinants
– the conditions under which people
are born, grow up, live, work and age
(e.g. levels and inequalities in income,
wealth, education and power structures
in society) – are important [4]. For example,
education helps people not only
protect their own health, but to access
health services when they need them.
Within health systems, the World
Health Report of 2010 (Health systems
financing: the path to universal coverage)
focused largely on health financing and
more than 80 countries have since requested
WHO for technical support
to help modify their health financing
systems to: raise sufficient funds for
health; reduce financial barriers and
spread risks across the population
through prepayment and pooling; and
use the available funds efficiently and
equitably [5].