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Achieving Universal Health Coverage (UHC): Dominance analysis across 183 countries highlights importance of strengthening health workforce

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  • Michael Reid
  • Reena Gupta
  • Glenna Roberts
  • Eric Goosby
  • Paul Wesson

Abstract

Background: Despite increasing political will to achieve Universal Health Coverage (UHC), there is a paucity of empiric data describing what health system indicators are useful surrogates of country-level progress towards UHC. We sought to determine what public health interventions were useful tracers of country-level UHC progress. Methods: Across 183 countries we evaluated the extent to which 16 service delivery indicators explained variability in the UHC Service Coverage Index, (UHC SCI) a WHO-validated indicator of country-level health coverage. Dominance analyses, stratifying countries by World Bank income criteria, were used to determine which indicators were most important in in predicting UHC SCI scores. Findings: Health workforce density ranked first overall, provision of basic sanitation and access to clean water ranked second, and provision of basic antenatal services ranked third. In analysis stratified by World Bank income criteria, health workforce density ranked first in Lower Middle Income-Countries (LMICs) (n = 45) and third in Upper Middle Income-Countries (UMICs) (n = 51). Conclusions: While each country will have a different approach to achieving UHC, strengthening the health workforce will need to be a key priority if they are to be successful in achieving UHC.

Suggested Citation

  • Michael Reid & Reena Gupta & Glenna Roberts & Eric Goosby & Paul Wesson, 2020. "Achieving Universal Health Coverage (UHC): Dominance analysis across 183 countries highlights importance of strengthening health workforce," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-7, March.
    • Handle: RePEc:plo:pone00:0229666
    DOI: 10.1371/journal.pone.0229666
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    References listed on IDEAS

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    1. Richard M. Scheffler & Christopher H. Herbst & Christophe Lemiere & Jim Campbell, 2016. "Health Labor Market Analyses in Low- and Middle-Income Countries," World Bank Publications - Books, The World Bank Group, number 25137, December.
    2. Konrad Obermann & Tata Chanturidze & Bernd Glazinski & Karin Dobberschuetz & Heiko Steinhauer & Jean-Olivier Schmidt, 2018. "The shaded side of the UHC cube: a systematic review of human resources for health management and administration in social health protection schemes," Health Economics Review, Springer, vol. 8(1), pages 1-7, December.
    3. Michael Reid & Glenna Roberts & Eric Goosby & Paul Wesson, 2019. "Monitoring Universal Health Coverage (UHC) in high Tuberculosis burden countries: Tuberculosis mortality an important tracer of UHC service coverage," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-10, October.
    4. Stuckler, D. & Basu, S. & McKee, M., 2011. "Health care capacity and allocations among South Africa's provinces: Infrastructure-inequality traps after the end of apartheid," American Journal of Public Health, American Public Health Association, vol. 101(1), pages 165-172.
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