Publication: Tracking Universal Health Coverage: 2023 Global Monitoring Report
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2023-09-18
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2023-09-18
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Leaving no one behind is a central promise of the 2030 Agenda for Sustainable Development, which recognizes health as a fundamental human right. Achieving Universal Health Coverage (UHC) is key to delivering on this promise. UHC ensures that everyone receives good quality health services, when and where needed, without incurring financial hardship arising from payments made for those services. The 2023 Universal Health Coverage Global Monitoring Report presents an alarming picture of stagnating access to essential health services and increased financial hardship from out-of-pocket health payments affecting especially the poorest and most vulnerable people. Globally, about 4.5 billion people, more than half of the world population, lack full access to essential health services. Since 2015, health service coverage has stagnated after a dynamic increase in previous years, indicating that urgent action is required by governments to ensure people can access health services. Past progress in service coverage was largely driven by improved access to infectious disease services, but since 2015 there has been minimal to no expansion of health service coverage related to infectious and noncommunicable diseases or for reproductive, maternal, newborn, and child health services. Financial hardship due to out-of-pocket health spending continues to worsen and undermine efforts to eradicate poverty globally. The number of people incurring catastrophic out-of-pocket health spending (more than 10% of their household budget) increased to more than 1 billion people in 2019, or almost 14% of the global population. About 1.3 billion people (almost 17% of the global population) were pushed or further pushed into poverty by out-of-pocket health spending. This includes 344 million people living in extreme poverty. Out-of-pocket health payments reduce the ability of households to afford other essential goods and services and negatively affect a family’s consumption levels. Health costs also cause individuals to forgo essential care, which can lead to more severe illnesses or even death. Reaching the goal of UHC by 2030 requires substantial public sector investment and accelerated action by governments and development partners, building on solid evidence. This includes strengthening health systems based on a primary health care approach and advancing equity in both the delivery of essential health services and financial protection. Achieving UHC also requires modern, fit-for-purpose health information systems that provide timely and reliable data to inform policy design. Such shifts are essential following the pandemic’s impact on health systems and health workers and in view of deepening macroeconomic, climate, demographic, and political trends which threaten to reverse hard-won health gains around the world.
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“World Health Organization; World Bank. 2023. Tracking Universal Health Coverage: 2023 Global Monitoring Report. © World Health Organization and the International Bank for Reconstruction and Development / The World Bank. http://hdl.handle.net/10986/40348 License: CC BY-NC-SA 3.0 IGO.”
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Publication Tracking Universal Health Coverage(World Health Organization and World Bank, 2021-12-13)Health is a fundamental human right, and universal health coverage (UHC) is critical for achieving that right. UHC represents the aspiration that good quality health services should be received by everyone, when and where needed, without incurring financial hardship. This ambition was clearly stated as a target in the United Nations Agenda 2030 for Sustainable Development and reaffirmed when world leaders endorsed the Political Declaration of the United Nations High-level Meeting on Universal Health Coverage in September 2019, the most comprehensive international health agreement in history. Beyond health and wellbeing, UHC also contributes to social inclusion, gender equality, poverty eradication, economic growth and human dignity. This report reveals that pre-pandemic, gains in service coverage were substantial and driven by a massive scaling up of interventions to tackle communicable diseases, such as HIV, tuberculosis and malaria. And while impoverishing health spending has decreased in recent years, the number of people impoverished or further impoverished by out of pocket health spending has remained unacceptably high. These trends are exacerbated by substantial and persistent inequalities between and within countries. The COVID-19 pandemic has subsequently led to significant disruptions in the delivery of essential health services. Rising poverty and shrinking incomes resulting from the global economic recession are likely to increase financial barriers to accessing care and financial hardship owing to out of pocket health spending for those seeking care, particularly among disadvantaged populations. The pre-COVID challenges, combined with additional difficulties arising from the pandemic, brings an even greater urgency to the quest for UHC. Strengthening health systems based on strong primary health care (PHC) is crucial to building back better and accelerating progress towards UHC and health security. Effective implementation of PHC-oriented health systems enables greater equity and resilience, with greater potential to deliver high-quality, safe, comprehensive, integrated, accessible, available and affordable health care to everyone, everywhere, but most especially the most vulnerable. Substantial financial investments in PHC-oriented building blocks of health systems, particularly in the areas of greatest expenditure (health and care workforces, health infrastructure, medicines and other health products) should be supported, carefully planned and informed by health system performance data to address critical gaps, particularly in low-income and lower-middle income countries. There is also an urgent need to remove remaining barriers in order to enable access to health care for all. Key barriers to UHC progress include poor infrastructure, with limited availability of basic amenities, weaknesses in the design of coverage policies to limit the harmful effects of out of pocket payments particularly for the poor and those with chronic health service needs, shortages and inefficient distribution of qualified health workers, prohibitively expensive good quality medicines and medical products, and lack of access to digital health and innovative technologies. Maintaining progress towards UHC is likely to be challenging. UHC is first and foremost a political choice. It is also a moral imperative to guarantee the right to health for all. 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Appropriations of recovery funds in areas relevant to SDG 7 reached USD 710 billion, but 90 percent of that came in the advanced economies. Emerging markets and developing countries, with their much more limited fiscal leeway, mobilized far less. Increasing clean energy and access investments in these regions requires greater support from international actors.Publication Tracking SDG 7(World Bank, Washington, DC, 2019-05-22)The Global Energy Progress Report 2019 provides a global dashboard on progress towards Sustainable Development Goal 7 (SDG7), which sets 2030 targets for reaching universal access to electricity and clean fuels and technologies for cooking, substantially increasing the share of renewable energy in the global mix, and doubling the rate of improvement of energy efficiency. All the data used in this pamphlet comes from the respective official source: for electrification, the World Bank; for clean fuels and technologies for cooking, the World Health Organization (WHO); for renewable energy, the International Energy Agency (IEA), the United Nations Statistics Division (UNSD) and the International Renewable Energy Agency (IRENA); and for energy efficiency, the IEA and UNSD. All projections are from the IEA’s World Energy Outlook. This report identifies best practices that have proven successful in recent years, as well as key approaches that policy makers may deploy in coming years. Recommendations applicable to all SDG 7 targets include recognizing the importance of political commitment and long-term energy planning, stepping up private financing, and supplying adequate incentives for the deployment of clean technology options. The following sections review progress in electricity access, access to clean cooking solutions, renewable energy, and energy efficiency. The Energy Progress Report reviews progress to 2017 for energy access and to 2016 for renewable energy and energy efficiency, against a baseline year of 2010. Its methodology is detailed at the end of each chapter.
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