Universal Health Coverage: a new index to monitor SDG 3.8
Achieving universal health coverage (UHC), including decent-quality essential service coverage and financial protection for all, is target 3.8 of the Sustainable Development Goals (SDG). To monitor this SDG, The Lancet Global Health publication designed an index that aims to assess the actual coverage of essential health services. It is supposed to summarize the ability for all people to receive the services that they need, without being exposed to financial hardship. It is computed by gathering 16 indicators from 4 areas of interest: i) reproductive, maternal, new-born, and child health ii) infectious disease iii) non-communicable diseases and iv) service capacity and access.
Unsurprisingly, ranking is consistent with national income and the index varies from 80 for developed countries to less than 35 for low-income or conflict-afflicted countries. Moreover, according to the study, the relationship between UHC index and life expectancy is significant even after statistically controlling them with economic development and level of education. It is a way to “prove” the link between means (coverage) and impacts (life expectancy).
Some limitations exist, especially due to raw indicators availability and coverage. For example, in most countries there is currently little data for robust indicators of coverage of interventions regarding non-communicable diseases, mental health, injuries, and emergencies. Some indicators might also not be totally comparable across countries as they come from surveys and national sources.
As with all index, UHC is far from being perfect but it is a first, good step to monitor Health Coverage and next steps could be to compare Health Coverage and sick leaves, workers productivity and health expenses by age ranges.
*Coverage index for essential health services (based on tracer interventions that include reproductive, maternal, newborn and child health, infectious diseases, noncommunicable diseases and service capacity and access). It is presented on a scale of 0 to 100. Values greater than or equal to 80 are presented as 80 as the index does not provide fine resolution at high values.
Source: Hogan et al. An index of the coverage of essential health services for monitoring UHC within the SDGs, Lancet Global Health 2017