Reevaluating factors in global Universal Health Coverage implementation pre-COVID-19

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2024-11-01 DOI:10.1016/j.cegh.2024.101840

Rahayu Lubis , Fauzi Budi Satria , Santi Martini , Harnavi Harun , Rafdzah Ahmad Zaki , Surya Utama , Juanita

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引用次数: 0

Abstract

Background

Universal Health Coverage (UHC) strives to ensure equitable access to high-quality healthcare services for all. Despite this goal, the COVID-19 pandemic exposed significant healthcare shortages worldwide. This study reevaluates key determinants of UHC implementation on a global scale before the pandemic, offering insights to shape strategies for achieving UHC by 2030 in light of current circumstances.

Methods

This ecological study analyzed data from 178 countries. UHC implementation was assessed using two indicators: Health Service Coverage (HSC) and Financial Protection (FP). Independent variables, including the Human Development Index (HDI), Health Worker Density (HWD), and Governance Effectiveness (GE), were proposed based on the Systemic Rapid Assessment Toolkit (SYSRA) framework. Data from 2000 to 2019 were sourced from open databases. Statistical analysis was performed using R version 4.3.1, with a significance level of p < 0.05.

Results

Countries with higher HDI exhibited significantly better HSC (p < 0.05) and FP (p < 0.05). Furthermore, HDI emerged as the primary contributor to HSC (accuracy = 0.77, Kappa = 0.64), while HSC played a central role in determining FP (accuracy = 0.61, Kappa = 0.21). Governance Effectiveness (GE) also significantly influenced FP in addition to HSC.

Conclusion

Rather than solely focusing on building healthcare infrastructure and expanding the healthcare workforce, balancing progress in both development and governance is a promising approach for countries striving to attain UHC by 2030.

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重新评估《COVID-19》前全球全民健康保险实施的各种因素

背景全民健康保险（UHC）致力于确保所有人都能公平地获得高质量的医疗保健服务。尽管有这一目标，但 COVID-19 大流行暴露了全球范围内严重的医疗短缺问题。本研究重新评估了大流行前全球范围内实施全民医保的关键决定因素，为根据当前情况制定到 2030 年实现全民医保的战略提供了见解。这项生态研究分析了 178 个国家的数据：这项生态研究分析了 178 个国家的数据。自变量包括人类发展指数 (HDI)、卫生工作者密度 (HWD) 和治理有效性 (GE)，根据系统快速评估工具包 (SYSRA) 框架提出。2000 年至 2019 年的数据来源于开放数据库。结果人类发展指数（HDI）越高的国家，其HSC（p <0.05）和FP（p <0.05）均显著提高。此外，HDI 成为 HSC 的主要贡献因素（准确率 = 0.77，Kappa = 0.64），而 HSC 在决定 FP 方面发挥了核心作用（准确率 = 0.61，Kappa = 0.21）。结论对于努力在 2030 年实现全民健康目标的国家而言，平衡发展和治理方面的进展是一种很有前景的方法，而不是仅仅关注医疗基础设施建设和扩大医疗队伍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.