COVID-19 Aftermath: Direction Towards Universal Health Coverage in Low-Income Countries; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective”

Document Type : Commentary


International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand


Progressive realization of universal health coverage (UHC) requires health systems capacity to provide quality service and financial risk protection which supports access to services without financial hardship. Government health spending in low-income countries (LICs) has been low and heavily relied on external donor resources and out-ofpocket payment. This has resulted in high prevalence of catastrophic health spending or foregone care by those who cannot afford. Under fiscal constraints posed by pandemic, reforms in LICs should focus on efficiency through health resource waste reduction. Targeting the poor even with low level of health spending can make a significant health gain. Investment in primary healthcare and health workforce is the foundation for realizing UHC which cannot be postponed. Innovative tax on health hazardous products, conditional debt relief can increase fiscal space for health; while international collaboration to accelerate coronavirus disease 2019 (COVID-19) vaccine coverage can bring LICs out of acute phase of pandemic.


Main Subjects

  1. Nannini M, Biggeri M, Putoto G. Health coverage and financial protection in Uganda: a political economy perspective. Int J Health Policy Manag. 2021. doi:10.34172/ijhpm.2021.116
  2. Initiatives for Social and Economic Rights. The National Health Insurance Bill. 2019; submission to the health committee of the Parliament. Accessed November 20, 2019.
  3. Atukunda R. Advocates pushed for enactment of National Health Insurance Scheme Bill into Law.
  4. World Health Organization. Health Workforce Support and Safeguards List 2020. Geneva: WHO; 2020.
  5. World Health Organization. Health workforce thresholds for supporting attainment of universal health coverage in the African Region. Brazzaville: World Health Organization Regional Office for Africa; 2021.
  6. World Health Organization. Global strategy on human resources for health: workforce 2030. Geneva: WHO; 2016.
  7. Our World in Data. Coronavirus vaccination. 2022.
  8. African CDC. COVID-19 Vaccine Perceptions: a 15-country study. 2021.
  9. Govender K, Nyamaruze P, McKerrow N, Meyer-Weitz A, Cowden RG. COVID-19 vaccines for children and adolescents in Africa: aligning our priorities to situational realities. BMJ Glob Health. 2022;7(2):e007839. doi:10.1136/bmjgh-2021-007839
  10. United Nations Department of Economicand Social Affairs. The World Economic Situation and Prospects 2022. New York: United Nations; 2022.
  11. United Nations Office for the Coordination of Humanitarian Affairs. Global Humanitarian Overview 2022. New York: United Nations; 2022.
  12. United Nations Office for the Coordination of Humanitarian Affairs. Horn of Africa Drought: Humanitarian Update. New York: United Nations; 2022.
  13. Jowett M, Brunal MP, Flores G, Cylus J. Spending targets for health: no magic number. Geneva: WHO; 2016.
  14. World Health Organization. The world health report: health systems financing: the path to universal coverage. Geneva: WHO; 2010.
  15. Leonardo Alves T, Lexchin J, Mintzes B. Medicines Information and the Regulation of the Promotion of Pharmaceuticals. Sci Eng Ethics. 2019;25(4):1167-1192. doi:10.1007/s11948-018-0041-5
  16. Zabrodina V, Dusheiko M, Moschetti K. A moneymaking scan: Dual reimbursement systems and supplier-induced demand for diagnostic imaging. Health Economics. 2020;29(12):1566-1585. doi:10.1002/hec.4152
  17. Sparkes SP, Eozenou PH, Evans D, Kurowski C, Kutzin J, Tandon A. Will the Quest for UHC be Derailed? Health Syst Reform. 2021;7(2):e1929796. doi:10.1080/23288604.2021.1929796
  18. Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. Lancet. 2018;391(10126):1205-1223. doi:10.1016/S0140-6736(18)30198-3