Many countries are committed to achieving Universal Health Coverage (UHC) — increasing service coverage and financial protection — and improved population health. Moving toward UHC is an important objective for health systems. However the 2023 UHC Global Monitoring Report indicates that improvements to service coverage have stagnated and financial protection has declined, raising concerns about the ability and commitment of countries to accelerate progress on the UHC targets by 2030.
In this special issue on “Objective-Oriented Health Systems Reform: Implications for Moving Towards Universal Health Coverage,” 50 authors from 12 countries share their analyses and perspectives on health reforms in Latin America, Africa and Asia. The papers describe why and how health financing reforms were implemented to address identified objectives and causes of health system underperformance. The papers discuss positive and negative lessons for other countries as they make changes to their health systems to advance UHC.
Find individual papers within the special issue:
Introduction
Framing concepts on objective-oriented reforms
Country experiences implementing objective-oriented reforms
- Strengthening the resilience of objective-oriented health system reforms. Analysis of the left-turn in the health reform proposals in Mexico (2019) and Colombia (2023)
- Assessing root causes and solutions to address cross-programmatic inefficiencies in a subnational health system: A case study of Anambra state, Nigeria
- Examining the Implementation Experience of the Universal Health Coverage Pilot in Kenya
- Does provider autonomy work well in Tanzania? Perspective of primary care facilities on budget execution under direct facility financing and factors affecting provider autonomy in Singida Region
Perspectives on implementing objective-oriented health reforms
- Health Reforms in Pursuit of Universal Health Coverage: Lessons from Kenyan Bureaucrats
- Rwanda’s Single Project Implementation Unit: An Effective Donor Coordination Platform in the Journey to Achieving Universal Health Coverage
- Using a small lever to achieve big outcomes in a devolved health system: 20 years of Programa Sumar in Argentina
- Data integration of health financing systems as a critical enabler for objective-oriented health systems reform: A scoping review from India
- Staying the Course: Reflections on the Progress and Challenges of the UHC Law in the Philippines
Implications of objective-oriented health reform
- Policy Options for Contributory Health Insurance Schemes in Low and Lower-Middle Income Countries to Enable Progress Towards Universal Health Coverage
- Public Financial Management: A Pathway to Universal Health Coverage in Low-and-Middle Income Countries
- Cross-Programmatic Efficiency: The System is Greater Than the Sum of Its Programs
- Applied political analysis for health system reform
