SYLLABUS
GS-3: Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.
Context: The recently released Global Monitoring Report provides the most recent global data on progress towards universal health coverage (UHC) and tracks progress towards Sustainable Development Target 3.8.
About Universal Health Coverage (UHC)
• Universal Health Coverage (UHC) means that all people have access to the full range of quality essential health services they need, when and where they need them, without suffering financial hardship.
• It rests on two core pillars:
- Expansion of health service coverage (availability and use of essential services), and
- Financial risk protection, measured primarily through reductions in out-of-pocket (OOP) health expenditure.
• In 2015, United Nations Member States adopted the 2030 Agenda for Sustainable Development, committing to achieve Universal Health Coverage by 2030 under SDG Target 3.8 – “Achieve universal health coverage, including financial risk protection”.
About the UHC Global Monitoring Report 2025
• The report is prepared jointly by the World Bank and the World Health Organization (WHO).
• The revised global UHC monitoring framework uses the following two indicators under SDG 3.8:
- SDG indicator 3.8.1 – Service Coverage Index (SCI): Expressed as a composite index (0–100) reflecting average coverage levels.
- SDG indicator 3.8.2 – Financial Protection: Measures the proportion of the population experiencing financial hardship due to OOP health spending.
• The 2025 edition marks the first use of revised UHC indicators, providing an updated framework to assess trends and gaps since 2000.
Key Findings of the Report
• Slow global progress towards UHC:
- Since 2000, the world has advanced on both pillars of UHC, expanding health service coverage and reducing financial hardship.
- The global UHC service coverage index (SCI) rose from 54 index points in 2000 to 71 in 2023. At the current pace, the global SCI is projected to reach only 74 out of 100 by 2030.
- The share of the global population incurring financial hardship due to OOP health spending fell from 34% in 2000 to 26% in 2022.
- However, 4.6 billion people worldwide still lacked access to essential health services in 2023, and 2.1 billion faced financial hardship in health care in 2022.
• Uneven Progress in Health Service Coverage:
- Infectious disease indicators have powered the global rise in service coverage since 2000, while gains in noncommunicable diseases (NCDs) were slower.
- Within countries, women living in poverty, in rural areas and less educated ones report more difficulties in accessing care.
• Global poverty reduction drove progress on financial hardship in health:
- The rate of impoverishing OOP health spending reduced from 29% in 2000 to 20% in 2022, corresponding to 1.6 billion people facing impoverishing OOP health spending in that year.
- Global poverty rates declined since 2000 from 43% to 25%, reducing the total number of people at risk of being further impoverished by OOP health spending.
• Weak Financial Protection persists: An increasing number of people face disproportionately high out-of-pocket health costs, particularly in middle-income countries.
- Spending on medicines accounts for more than half of people’s OOP health spending in most countries.
• Stark Health Inequalities:
- In 2022, 3 out of 4 people among the poorest segment of the population faced financial hardship from health costs, compared with fewer than 1 in 25 among the richest.
- The most vulnerable groups – such as displaced populations and people living in informal settlements – are often missing in data sources used to monitor progress toward UHC.
Key Recommendations of the Report
• Ensure essential health care is free at the point of access for the poor to reduce the growing share of people living in poverty who spend on health.
• Strengthen publicly funded compulsory prepaid coverage to accelerate the reduction in financial hardship among the whole population and reduce the rate of large OOP.
• Address high OOP health spending on medicines, which absorbs on average 56% of OOP health spending in most countries.
• Accelerate expansion of essential NCD services, strengthen primary health care, encompassing prevention, early detection and treatment, to reduce barriers that hinder access to or disrupt the continuity of health services.
• Adopt multisectoral UHC approaches, recognizing that determinants of health and UHC drivers extend beyond the health sector.