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

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 countr...

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Bibliographic Details
Published in:PloS one 2020-03, Vol.15 (3), p.e0229666-e0229666
Main Authors: Reid, Michael, Gupta, Reena, Roberts, Glenna, Goosby, Eric, Wesson, Paul
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Analysis
Banks (Finance)
Cardiovascular disease
Child & adolescent psychiatry
Density
Dominance
Family planning
Health promotion
Health sciences
HIV
Hospitals
Human immunodeficiency virus
Income
Indicators
Labor force
Medical screening
Medicine
Medicine and Health Sciences
National health insurance
Pregnancy
Public health
Public health movements
Rankings
Sanitation
Sanitation services
Social Sciences
Sustainable development
Tracers
Variables
Workers
Workforce
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Summary: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. 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. 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). 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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0229666