Monitoring Progress towards Universal Health Coverage at Country and Global Levels
Monitoring Progress towards Universal Health Coverage at Country and Global Levels
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DOI：
10.1371/journal.pmed.1001731
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发表时间：
2014-09-01
期刊：
影响因子：
15.8
通讯作者：
Wagstaff, Adam
中科院分区：
文献类型：
--
作者：
Boerma, Ties;Eozenou, Patrick;Wagstaff, Adam
全民健康覆盖（UHC）被定义为卫生系统绩效的预期结果，即所有需要卫生服务（促进、预防、治疗、康复和姑息治疗）的人都能获得这些服务，而不会造成过度的经济困难。全民健康覆盖有两个相互关联的组成部分：根据需要提供全方位的优质基本卫生服务，以及防止因卫生服务自付费用而陷入经济困难，包括可能出现的贫困。这两个部分都应该使全体人民受益。本文总结了 13 个国家案例研究和五次技术审查的结果，这些研究是作为制定监测全民健康覆盖进展的全球框架的一部分而进行的。案例研究表明，将全民健康覆盖监测重点放在卫生系统绩效的两个独立组成部分上的相关性和可行性：卫生服务的覆盖水平和财务保护，重点是公平。这些组成部分与全民健康覆盖的定义直接相关，并衡量全民健康覆盖战略和政策的直接结果。研究还表明，全民健康覆盖监测如何能够完全融入现有的、定期的卫生部门进展和绩效总体监测中。强调了与监测基本卫生服务覆盖范围、财务保护和公平相关的几个方法和实际问题。对于大多数国家来说，解决监测全民健康覆盖进展所需数据的可用性和质量方面的差距至关重要。
Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries.