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Examining the association between service coverage of UHC and global disease burden: A cross-country panel analysis

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  • Chakma, Tisha
  • Karim, Suzana
  • Rabbani, Atonu

Abstract

Over the past two decades, numerous countries have enhanced their Universal Health Coverage (UHC), as indicated by the UHC Service Coverage Index (SCI), alongside a global reduction in the disease burden measured by Disability-Adjusted Life Years (DALYs). This paper uses a cross-country panel of 190 countries from 2000 to 2019 to identify the association between UHC SCI and DALYs gain. We find that a one-unit increase in the UHC SCI was associated with a significant decrease in total DALYs. Furthermore, UHC SCI was mostly associated with lowering DALYs from communicable, maternal, neonatal, and nutritional diseases but showed little to no significant association with non-communicable diseases or injuries. These results are robust to various robustness tests. Notable reasons include governments spending more on communicable, maternal, neonatal, and nutritional diseases than on non-communicable diseases and injuries, which is also the case for external aid. Our results also suggest that moving towards UHC helps lower-income countries more than higher-income countries, as developed nation-states have already established a well-functioning health system. Addressing non-communicable diseases and injuries will be essential to improve health outcomes and achieve SDGs in future.

Suggested Citation

  • Chakma, Tisha & Karim, Suzana & Rabbani, Atonu, 2025. "Examining the association between service coverage of UHC and global disease burden: A cross-country panel analysis," Social Science & Medicine, Elsevier, vol. 369(C).
    • Handle: RePEc:eee:socmed:v:369:y:2025:i:c:s0277953625001613
    DOI: 10.1016/j.socscimed.2025.117832
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    References listed on IDEAS

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    1. Tomoki Fujii, 2018. "Sources of health financing and health outcomes: A panel data analysis," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1996-2015, December.
    2. Jacopo Gabani & Sumit Mazumdar & Marc Suhrcke, 2023. "The effect of health financing systems on health system outcomes: A cross‐country panel analysis," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 574-619, March.
    3. Ties Boerma & Patrick Eozenou & David Evans & Tim Evans & Marie-Paule Kieny & Adam Wagstaff, 2014. "Monitoring Progress towards Universal Health Coverage at Country and Global Levels," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-8, September.
    4. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    5. Lucia Hanmer & Robert Lensink & Howard White, 2003. "Infant and child mortality in developing countries: Analysing the data for Robust determinants," Journal of Development Studies, Taylor & Francis Journals, vol. 40(1), pages 101-118.
    6. Tomoyuki Takura & Hiroko Miura, 2022. "Socioeconomic Determinants of Universal Health Coverage in the Asian Region," IJERPH, MDPI, vol. 19(4), pages 1-15, February.
    7. Roth, Jonathan & Sant’Anna, Pedro H.C. & Bilinski, Alyssa & Poe, John, 2023. "What’s trending in difference-in-differences? A synthesis of the recent econometrics literature," Journal of Econometrics, Elsevier, vol. 235(2), pages 2218-2244.
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