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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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Published in: | PloS one 2020-03, Vol.15 (3), p.e0229666-e0229666 |
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description | 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. |
doi_str_mv | 10.1371/journal.pone.0229666 |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0229666</identifier><identifier>PMID: 32130241</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2020-03, Vol.15 (3), p.e0229666-e0229666</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Reid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Reid et al 2020 Reid et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-42b3a5b14f9e41898369564d1fc53cd5e9479d9c785ddc2452532a7eb25cb68f3</citedby><cites>FETCH-LOGICAL-c593t-42b3a5b14f9e41898369564d1fc53cd5e9479d9c785ddc2452532a7eb25cb68f3</cites><orcidid>0000-0001-6777-9619</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2371452474/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2371452474?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32130241$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mathur, Manu Raj</contributor><creatorcontrib>Reid, Michael</creatorcontrib><creatorcontrib>Gupta, Reena</creatorcontrib><creatorcontrib>Roberts, Glenna</creatorcontrib><creatorcontrib>Goosby, Eric</creatorcontrib><creatorcontrib>Wesson, Paul</creatorcontrib><title>Achieving Universal Health Coverage (UHC): Dominance analysis across 183 countries highlights importance of strengthening health workforce</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Banks (Finance)</subject><subject>Cardiovascular disease</subject><subject>Child & adolescent psychiatry</subject><subject>Density</subject><subject>Dominance</subject><subject>Family planning</subject><subject>Health promotion</subject><subject>Health sciences</subject><subject>HIV</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Income</subject><subject>Indicators</subject><subject>Labor force</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>National health insurance</subject><subject>Pregnancy</subject><subject>Public health</subject><subject>Public health 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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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32130241</pmid><doi>10.1371/journal.pone.0229666</doi><orcidid>https://orcid.org/0000-0001-6777-9619</orcidid><oa>free_for_read</oa></addata></record> |
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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 |
title | Achieving Universal Health Coverage (UHC): Dominance analysis across 183 countries highlights importance of strengthening health workforce |
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