Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries

The last few years have seen a growing commitment worldwide to universal health coverage (UHC). Yet there is a lack of clarity on how to measure progress towards UHC. This paper proposes a ‘mashup’ index that captures both aspects of UHC: that ever...

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Main Authors: Wagstaff, Adam, Cotlear, Daniel, Eozenou, Patrick Hoang-Vu, Buisman, Leander Robert
Format: Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2015
Subjects:
Online Access:http://documents.worldbank.org/curated/en/2015/11/25239709/measuring-progress-towards-universal-health-coverage-application-24-developing-countries
http://hdl.handle.net/10986/23432
id okr-10986-23432
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic LIVING STANDARDS
CHILD HEALTH
EMPLOYMENT
PAYMENTS FOR HEALTH CARE
PEOPLE
VACCINATION
HEALTH EXTENSION
FINANCING
ANTENATAL CARE
HEALTH REFORMS
INCOME
HEALTH CARE UTILIZATION
PREVENTION
LAWS
HEALTH EXPENDITURES
DOCTORS
HEALTH ECONOMICS
COMMUNITY HEALTH
PRIMARY CARE
COST-EFFECTIVENESS
MONITORING
HEALTH INSURANCE
HEALTH CARE
FINANCIAL PROTECTION
CERVICAL CANCER
INCENTIVES
NATIONAL HEALTH INSURANCE
HEALTH
ECONOMIC POLICY
POLICY DISCUSSIONS
BREAST CANCER
POCKET PAYMENTS
HYPERTENSION
HEALTH FACILITIES
PUBLIC HEALTH
HOSPITALIZATION
HEALTH SECTOR
CAPITATION
CHOICE
DIABETES
EXERCISES
HEALTH STATUS
COSTS
IMMUNIZATION
PATIENTS
PATIENT
INTERVENTION
PROBABILITY
HEALTH SYSTEMS
PUBLIC HOSPITALS
HEALTH CENTERS
IMPACT EVALUATIONS
HEALTH CARE SERVICES
HEALTH INSURANCE SCHEME
HOSPITAL ADMISSIONS
ACCESS TO HEALTH SERVICES
USE OF HEALTH SERVICES
MEDICAL CARE
HOSPITAL CARE
TUBERCULOSIS
HEALTH ORGANIZATION
SCREENING
HEALTH CARE COVERAGE
HIV/AIDS
INSURANCE COVERAGE
MORTALITY
MEDICAL TREATMENT
COST OF CARE
COSTS OF HEALTH CARE
HEALTH SPENDING
COSTS OF CARE
EQUITY
CHILDBIRTH
HEALTH PLAN
WORKERS
SOCIAL HEALTH INSURANCE
AGED
HEALTH CARE PROVISION
CARE
HEALTH POLICY
BUDGETS
DEMAND
HEALTH OUTCOMES
HEALTH SERVICES USE
INCOME DISTRIBUTION
FAMILY PLANNING
EXPENDITURES
MEASUREMENT
NUTRITION
HEALTH POSTS
ADOLESCENTS
HEALTH COVERAGE
PRIMARY HEALTH CARE
NATIONAL HEALTH
HEALTH SYSTEM
INSURANCE
OUTPATIENT CARE
WEIGHT
PREGNANT WOMEN
HEALTH CARE DELIVERY
CARDIOVASCULAR DISEASES
CHILDREN
HOSPITAL SUPPLY
CLINICS
EVALUATION
RISK
INPATIENT CARE
HUMAN RESOURCES
HEALTH PROVIDERS
POVERTY
INTEGRATION
HEALTH EXPENDITURE
ILLNESS
INCIDENCE
POPULATION
POLICY RESEARCH
HEALTH CARE FINANCE
FINANCIAL RISK
STRATEGY
FEES
EPIDEMIOLOGY
FAMILIES
MEDICINES
HEALTH FINANCING
HOSPITALS
HEALTH INTERVENTIONS
HEALTH CARE SYSTEMS
BIRTH ATTENDANT
HEALTH SERVICE
HEALTH SERVICES
HOUSEHOLD EXPENDITURE
IMPLEMENTATION
PREGNANCY
HEALTH STRATEGY
BREASTFEEDING
HUMAN DEVELOPMENT
spellingShingle LIVING STANDARDS
CHILD HEALTH
EMPLOYMENT
PAYMENTS FOR HEALTH CARE
PEOPLE
VACCINATION
HEALTH EXTENSION
FINANCING
ANTENATAL CARE
HEALTH REFORMS
INCOME
HEALTH CARE UTILIZATION
PREVENTION
LAWS
HEALTH EXPENDITURES
DOCTORS
HEALTH ECONOMICS
COMMUNITY HEALTH
PRIMARY CARE
COST-EFFECTIVENESS
MONITORING
HEALTH INSURANCE
HEALTH CARE
FINANCIAL PROTECTION
CERVICAL CANCER
INCENTIVES
NATIONAL HEALTH INSURANCE
HEALTH
ECONOMIC POLICY
POLICY DISCUSSIONS
BREAST CANCER
POCKET PAYMENTS
HYPERTENSION
HEALTH FACILITIES
PUBLIC HEALTH
HOSPITALIZATION
HEALTH SECTOR
CAPITATION
CHOICE
DIABETES
EXERCISES
HEALTH STATUS
COSTS
IMMUNIZATION
PATIENTS
PATIENT
INTERVENTION
PROBABILITY
HEALTH SYSTEMS
PUBLIC HOSPITALS
HEALTH CENTERS
IMPACT EVALUATIONS
HEALTH CARE SERVICES
HEALTH INSURANCE SCHEME
HOSPITAL ADMISSIONS
ACCESS TO HEALTH SERVICES
USE OF HEALTH SERVICES
MEDICAL CARE
HOSPITAL CARE
TUBERCULOSIS
HEALTH ORGANIZATION
SCREENING
HEALTH CARE COVERAGE
HIV/AIDS
INSURANCE COVERAGE
MORTALITY
MEDICAL TREATMENT
COST OF CARE
COSTS OF HEALTH CARE
HEALTH SPENDING
COSTS OF CARE
EQUITY
CHILDBIRTH
HEALTH PLAN
WORKERS
SOCIAL HEALTH INSURANCE
AGED
HEALTH CARE PROVISION
CARE
HEALTH POLICY
BUDGETS
DEMAND
HEALTH OUTCOMES
HEALTH SERVICES USE
INCOME DISTRIBUTION
FAMILY PLANNING
EXPENDITURES
MEASUREMENT
NUTRITION
HEALTH POSTS
ADOLESCENTS
HEALTH COVERAGE
PRIMARY HEALTH CARE
NATIONAL HEALTH
HEALTH SYSTEM
INSURANCE
OUTPATIENT CARE
WEIGHT
PREGNANT WOMEN
HEALTH CARE DELIVERY
CARDIOVASCULAR DISEASES
CHILDREN
HOSPITAL SUPPLY
CLINICS
EVALUATION
RISK
INPATIENT CARE
HUMAN RESOURCES
HEALTH PROVIDERS
POVERTY
INTEGRATION
HEALTH EXPENDITURE
ILLNESS
INCIDENCE
POPULATION
POLICY RESEARCH
HEALTH CARE FINANCE
FINANCIAL RISK
STRATEGY
FEES
EPIDEMIOLOGY
FAMILIES
MEDICINES
HEALTH FINANCING
HOSPITALS
HEALTH INTERVENTIONS
HEALTH CARE SYSTEMS
BIRTH ATTENDANT
HEALTH SERVICE
HEALTH SERVICES
HOUSEHOLD EXPENDITURE
IMPLEMENTATION
PREGNANCY
HEALTH STRATEGY
BREASTFEEDING
HUMAN DEVELOPMENT
Wagstaff, Adam
Cotlear, Daniel
Eozenou, Patrick Hoang-Vu
Buisman, Leander Robert
Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries
geographic_facet Africa
East Asia and Pacific
South Asia
relation Policy Research Working Paper;No. 7470
description The last few years have seen a growing commitment worldwide to universal health coverage (UHC). Yet there is a lack of clarity on how to measure progress towards UHC. This paper proposes a ‘mashup’ index that captures both aspects of UHC: that everyone—irrespective of their ability-to-pay—gets the health services they need; and that nobody suffers undue financial hardship as a result of receiving care. Service coverage is broken down into prevention and treatment, and financial protection into impoverishment and catastrophic spending; nationally representative household survey data are used to adjust population averages to capture inequalities between the poor and better off; nonlinear tradeoffs are allowed between and within the two dimensions of the UHC index; and all indicators are expressed such that scores run from 0 to 100, and higher scores are better. In a sample of 24 countries for which there are detailed information on UHC-inspired reforms, a cluster of high-performing countries emerges with UHC scores of between 79 and 84 (Brazil, Colombia, Costa Rica, Mexico and South Africa) and a cluster of low-performing countries emerges with UHC scores in the range 35–57 (Ethiopia, Guatemala, India, Indonesia and Vietnam). Countries have mostly improved their UHC scores between the earliest and latest years for which there are data—by about 5 points on average; however, the improvement has come from increases in receipt of key health interventions, not from reductions in the incidence of out-of-pocket payments on welfare.
format Working Paper
author Wagstaff, Adam
Cotlear, Daniel
Eozenou, Patrick Hoang-Vu
Buisman, Leander Robert
author_facet Wagstaff, Adam
Cotlear, Daniel
Eozenou, Patrick Hoang-Vu
Buisman, Leander Robert
author_sort Wagstaff, Adam
title Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries
title_short Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries
title_full Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries
title_fullStr Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries
title_full_unstemmed Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries
title_sort measuring progress towards universal health coverage : with an application to 24 developing countries
publisher World Bank, Washington, DC
publishDate 2015
url http://documents.worldbank.org/curated/en/2015/11/25239709/measuring-progress-towards-universal-health-coverage-application-24-developing-countries
http://hdl.handle.net/10986/23432
_version_ 1764453821899079680
spelling okr-10986-234322021-04-23T14:04:15Z Measuring Progress towards Universal Health Coverage : With an Application to 24 Developing Countries Wagstaff, Adam Cotlear, Daniel Eozenou, Patrick Hoang-Vu Buisman, Leander Robert LIVING STANDARDS CHILD HEALTH EMPLOYMENT PAYMENTS FOR HEALTH CARE PEOPLE VACCINATION HEALTH EXTENSION FINANCING ANTENATAL CARE HEALTH REFORMS INCOME HEALTH CARE UTILIZATION PREVENTION LAWS HEALTH EXPENDITURES DOCTORS HEALTH ECONOMICS COMMUNITY HEALTH PRIMARY CARE COST-EFFECTIVENESS MONITORING HEALTH INSURANCE HEALTH CARE FINANCIAL PROTECTION CERVICAL CANCER INCENTIVES NATIONAL HEALTH INSURANCE HEALTH ECONOMIC POLICY POLICY DISCUSSIONS BREAST CANCER POCKET PAYMENTS HYPERTENSION HEALTH FACILITIES PUBLIC HEALTH HOSPITALIZATION HEALTH SECTOR CAPITATION CHOICE DIABETES EXERCISES HEALTH STATUS COSTS IMMUNIZATION PATIENTS PATIENT INTERVENTION PROBABILITY HEALTH SYSTEMS PUBLIC HOSPITALS HEALTH CENTERS IMPACT EVALUATIONS HEALTH CARE SERVICES HEALTH INSURANCE SCHEME HOSPITAL ADMISSIONS ACCESS TO HEALTH SERVICES USE OF HEALTH SERVICES MEDICAL CARE HOSPITAL CARE TUBERCULOSIS HEALTH ORGANIZATION SCREENING HEALTH CARE COVERAGE HIV/AIDS INSURANCE COVERAGE MORTALITY MEDICAL TREATMENT COST OF CARE COSTS OF HEALTH CARE HEALTH SPENDING COSTS OF CARE EQUITY CHILDBIRTH HEALTH PLAN WORKERS SOCIAL HEALTH INSURANCE AGED HEALTH CARE PROVISION CARE HEALTH POLICY BUDGETS DEMAND HEALTH OUTCOMES HEALTH SERVICES USE INCOME DISTRIBUTION FAMILY PLANNING EXPENDITURES MEASUREMENT NUTRITION HEALTH POSTS ADOLESCENTS HEALTH COVERAGE PRIMARY HEALTH CARE NATIONAL HEALTH HEALTH SYSTEM INSURANCE OUTPATIENT CARE WEIGHT PREGNANT WOMEN HEALTH CARE DELIVERY CARDIOVASCULAR DISEASES CHILDREN HOSPITAL SUPPLY CLINICS EVALUATION RISK INPATIENT CARE HUMAN RESOURCES HEALTH PROVIDERS POVERTY INTEGRATION HEALTH EXPENDITURE ILLNESS INCIDENCE POPULATION POLICY RESEARCH HEALTH CARE FINANCE FINANCIAL RISK STRATEGY FEES EPIDEMIOLOGY FAMILIES MEDICINES HEALTH FINANCING HOSPITALS HEALTH INTERVENTIONS HEALTH CARE SYSTEMS BIRTH ATTENDANT HEALTH SERVICE HEALTH SERVICES HOUSEHOLD EXPENDITURE IMPLEMENTATION PREGNANCY HEALTH STRATEGY BREASTFEEDING HUMAN DEVELOPMENT The last few years have seen a growing commitment worldwide to universal health coverage (UHC). Yet there is a lack of clarity on how to measure progress towards UHC. This paper proposes a ‘mashup’ index that captures both aspects of UHC: that everyone—irrespective of their ability-to-pay—gets the health services they need; and that nobody suffers undue financial hardship as a result of receiving care. Service coverage is broken down into prevention and treatment, and financial protection into impoverishment and catastrophic spending; nationally representative household survey data are used to adjust population averages to capture inequalities between the poor and better off; nonlinear tradeoffs are allowed between and within the two dimensions of the UHC index; and all indicators are expressed such that scores run from 0 to 100, and higher scores are better. In a sample of 24 countries for which there are detailed information on UHC-inspired reforms, a cluster of high-performing countries emerges with UHC scores of between 79 and 84 (Brazil, Colombia, Costa Rica, Mexico and South Africa) and a cluster of low-performing countries emerges with UHC scores in the range 35–57 (Ethiopia, Guatemala, India, Indonesia and Vietnam). Countries have mostly improved their UHC scores between the earliest and latest years for which there are data—by about 5 points on average; however, the improvement has come from increases in receipt of key health interventions, not from reductions in the incidence of out-of-pocket payments on welfare. 2015-12-17T23:00:20Z 2015-12-17T23:00:20Z 2015-11 Working Paper http://documents.worldbank.org/curated/en/2015/11/25239709/measuring-progress-towards-universal-health-coverage-application-24-developing-countries http://hdl.handle.net/10986/23432 English en_US Policy Research Working Paper;No. 7470 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research Africa East Asia and Pacific South Asia