Health Financing Trends and Universal Health Coverage

Abstract

Introduction: About half of world’s population still does not have full coverage of essential health services. All UN Member States have agreed to achieve universal health coverage (UHC) by 2030. UHC means that all individuals receive needed quality essential health services without financial hardship. Aim and objectives: To assess global health financing trends from year 2000 to 2014 and its projections to 2040. Material and Methods: Data collected on health spending and its projections from 1995 to 2040 were analyzed to find its trends and UHC. Results: In 2000 to 2014 PEH grew more than income. Deterioration occurred in domestic public funds and prioritization of budget for health from MDGs to SDGs, especially in LICs. Less domestic public funds were spent for PHC. In 2016, UHC index ranged from 85·7 in Switzerland to 26·9% in Somalia. Per capita health spending in 2040 was expected to be 45·9 times larger in high- income than in low-income countries. Global health-related SDG index in 2017 was 59·4. No countries projected to meet NCD and suicide SDG targets for 2030. Political economy of UHC reforms hastened the achievement of UHC. Discussion: Study 2000-2014 highlighted the role of domestic PEH. It drew attention to separate domestic public and external source expenditures. It proposed enhanced collaboration between Health policy makers, Ministries of Health and Finance; and to use domestic public funds in LMICs to help policy makers for budget allocation. Studies on health sector reforms showed the need to understand the political economy reforms. Health Ministers of all countries should incorporate health reforms in their governments. Conclusion: In LMICs, per capita PEH from domestic sources should be enhanced. The domestic public funds should be mainly spent on PHC. Advocacy for health needs to be done to influence decisions within political, economic, and social systems.