This article provides a commentary to Ole Norheim’ s editorial entitled “Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage.” It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both natio...

The World Health Organization's (WHO's) World Health Report 2010, "Health systems financing, the path to universal coverage," promoted universal health coverage (UHC) as an aspirational objective for country health systems. Yet, in addition to the dimensions of services and coverage, distribution of coverage in the population, and financial risk protection highlighted by the report, the conside...

this article discusses what ethicists have called “unacceptable trade-offs” in health policy choices related to universal health coverage (uhc). since the fiscal space is constrained, trade-offs need to be made. but some trade-offs are unacceptable on the path to universal coverage. unacceptable choices include, among other examples from low-income countries, to expand coverage for services wit...

the world has made a great deal of progress through the millennium development goals (mdgs) to improve the health and well-being of people around the globe, but there remains a long way to go. here we provide reflections on rwanda’s experience in working to meet the health-related targets of the mdgs. this experience has informed our proposal of five guiding principles that may be useful for co...

BACKGROUND There is an emerging global consensus on the importance of universal health coverage (UHC), but no unanimity on the conceptual definition and scope of UHC, whether UHC is achievable or not, how to move towards it, common indicators for measuring its progress, and its long-term sustainability. This has resulted in various interpretations of the concept, emanating from different discip...

binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of rwanda in achieving the millennium development goals (mdgs) and a proposal of 5 principles to carry forward in post-2015 health development. this commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. specifically, we argue th...

BACKGROUND Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health syste...

BACKGROUND There is limited work done on developing methods for measurement of universal health coverage. We undertook a study to develop a methodology and demonstrate the practical application of empirically measuring the extent of universal health coverage at district level. Additionally, we also develop a composite indicator to measure UHC. METHODS A cross-sectional survey was undertaken a...

Implementing universal health coverage (UHC) is widely perceived to be central to achieving the Sustainable Development Goals (SDGs), and is a work program priority of the World Health Organization (WHO). Much has already been written about how low- and middle-income countries (LMICs) can monitor progress towards UHC, with various UHC monitoring frameworks available in the literature. However, ...

Underpinning the global commitment to universal health coverage (UHC) is the fundamental role of health for well-being and sustainable development. UHC is proposed as an umbrella health goal in the post-2015 sustainable development agenda because it implies universal and equitable effective delivery of comprehensive health services by a strong health system, aligned with multiple sectors around...