Working and discussion papersDecember 2019Anthony McDonnell, Ana F. Urrutia and Emma SammanWomen and children await health services in Bangui, Central African Republic. Photo: UNICEF/Pierre HoltzThis paper aims to understand why and how countries provide health coverage, particularly to left-behind groups. To address these questions, we identified 49 geographically, economically and culturally diverse countries that have either achieved universal health coverage (UHC) or have made good progress towards it. This paper synthesises the existing literature and identifies global and regional trends underlying progress, as well as the enablers, strategies and constraints each country faced in trying to expand healthcare. While there is no single path to UHC, this paper identifies common trends. For instance, countries normally move to provide health coverage during the reconstruction that follows fragility, such as following a war, coup or economic crisis. Wealth appears to be far less important than government capacity in providing coverage (although poorer countries are more likely to struggle with capacity). Government-run health systems seem to perform better than privately financed alternatives (e.g. insurance models). Before UHC is achieved, health reforms are often subject to contestation but once countries move towards universal coverage, this becomes stable and is unlikely to be reversed.Read the research Working paper | Reaching universal health coverageDocumentpdf Data | Reaching universal health coverageDocumentxlsxRelated Informal payments in the public health sector in Guinea-BissauInformal payments are widespread in the health sector in Guinea-Bissau. Why is this so, and how can the practice be curtailed and the causes dealt with?Working and discussion papers7 October 2019Failing to reach the poorest: subnational financing inequalities and health and education outcomesThis report assesses how well subnational financing targets the worst health and education outcomes in all 82 low- and middle-income countries.Research reports and studies24 September 2019 Leave no one behind: adolescents with disabilities in JordanThis policy brief analyses a survey on young people with disabilities in Jordan.Briefing papers22 July 2019 Civil society engagement in tax reform This project seeks to develop understanding of the role that civil society organisations can play in domestic efforts to strengthen tax systems.Projects1 December 2018See more:healthsustainable development goalstaxfragile statespoliticsgovernanceGlobal
