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As a growing number of countries tackle the fiscal challenge of providing universal health coverage (UHC) for their citizens, the World Bank released a set of 22 case studies of countries that have significantly expanded access to health care in the last decade, with the aim of helping countries make more informed health policy and program choices.
Researchers looked systematically at countries’ experiences with a set of parameters related to achieving UHC, including designing and managing benefits packages, expanding coverage to the poorest and excluded populations, providing quality care, and health financing. The 22 countries studied included Argentina, Brazil, Chile, China, Colombia, Costa Rica, Ethiopia, Georgia, Guatemala, India, Indonesia, Jamaica, Kenya, Kyrgyz Republic, Mexico, Nigeria, Peru, Philippines, Thailand, Tunisia, Turkey and Vietnam. The Bank also released an analysis of the impact of UHC efforts in the developing world.
The studies show that although approaches to UHC vary, four-fifths or more of the countries share common implementation instruments. These include: an explicitly defined benefits package, expansion of coverage financed by general taxation, enrollment requirements, and reform of public provision of health services, all backed by strong political support. Also notable was that less than half of the countries studied had systems in place to monitor improvements in people’s health.
Several of the countries have implemented various results-based financing approaches to help improve both supply- and demand-side performance. Cases like Argentina, Turkey and the Philippines show that RBF contributed to increases in coverage and quality of essential services as one of the strategies for health systems striving for universal health care.
Strengthening accountability is a key objective and very much resonates with some of the strategies employed under RBF programs. This includes incentivizing higher productivity, ensuring that public subsidies prioritize the poor and vulnerable and a strong focus on analyzing and reporting results on a regular basis.
Access the country case studies