Being Fair in Universal Health Coverage: Prioritize Public Health Services for Low- and Middle-Income Countries

Using a comparative healthcare system approach, this paper discusses the existing healthcare financing methods in low-and middle-income countries in the move towards achieving universal health coverage (UHC). The article finds that traditional channels of financing the health sector in these countries include government’s budget, donors’ aid, national health insurance, and out-of-pocket model. Moreover, the paper explores other alternative mechanisms for raising resources for the health sector including tax on demerit goods, remittances, and sovereign wealth funds’ revenues. This paper is of particular interest to policymakers in low-and middle-income countries targeting to achieve UHC.

Download Full-text

Individual and Contextual Factors Associated With Maternal and Child Health Essential Health Services Indicators: A Multilevel Analysis of Universal Health Coverage in 58 Low & Middle-Income Countries

International Journal of Health Policy and Management ◽

10.34172/ijhpm.2021.121 ◽

2021 ◽

Author(s):

Seun S. Anjorin ◽

Abimbola A. Ayorinde ◽

Oyinlola Oyebode ◽

Olalekan A. Uthman

Keyword(s):

Health Services ◽

Universal Health Coverage ◽

Demographic And Health Surveys ◽

Health Coverage ◽

Multinomial Regression ◽

Middle Income ◽

Middle Income Countries ◽

Country Level ◽

Low Middle Income Countries ◽

Universal Health

Background: Universal health coverage (UHC) is part of the global health agenda to tackle the lack of access to essential health services (EHS). This study developed and tested models to examine the individual, neighbourhood and country-level determinants associated with access to coverage of EHS under the UHC agenda in low- and middle-income countries (LMICs). Methods: We used datasets from the Demographic and Health Surveys of 58 LMICs. Suboptimal and optimal access to EHS were computed using nine indicators. Descriptive and multilevel multinomial regression analyses were performed using R & STATA. Result: The prevalence of suboptimal and optimal access to EHS varies across the countries, the former ranging from 5.55% to 100%, and the latter ranging from 0% to 90.36% both in Honduras and Colombia, respectively. In the fully adjusted model, children of mothers with lower educational attainment (RRR 2.11, 95% credible interval [CrI] 1.92 to 2.32) and those from poor households (RRR 1.79, 95%CrI 1.61 to 2.00) were more likely to have suboptimal access to EHS. Also, those with health insurance (RRR 0.72, 95% CrI 0.59 to 0.85) and access to media (RRR 0.59, 95% CrI 0.51 to 0.67) were at lesser risk of having suboptimal EHS. Similar trends, although in the opposite direction, were observed in the analysis involving optimal access. The intra-neighbourhood and intra-country correlation coefficients were estimated using the intercept component variance; 57.50%% and 27.70% of variances in suboptimal access to EHS are attributable to the neighbourhood and country-level factors. Conclusion: Neighbourhood-level poverty, illiteracy, and rurality modify access to EHS coverage in LMICs. Interventions aimed at achieving the 2030 UHC goals should consider integrating socioeconomic and living conditions of people.

Download Full-text