Universal Health Coverage

Results for Development works with changes agents in low- and middle-income countries to advance universal health coverage by facilitating collaborative learning, providing tailored support for the design and implementation of national or sub-national health systems reforms, and conducting research and analysis to capture practical country lessons and catalyze innovations.

The Challenge

More than three billion people globally — many of them living in poverty — must pay out of pocket to receive health services. An estimated 400 million people lack access to one or more essential services, 100 million are pushed into poverty every year as a result of health care expenditures, and many others are forced to go without needed services.

By prioritizing universal health coverage (UHC), countries can ensure that all citizens have access to the quality, essential health services they need without suffering financial hardship — a pre-condition to enabling thriving and productive communities.

Fortunately, momentum for universal health coverage is mounting. In 2015, the UN recognized universal health coverage as critical to reducing poverty, and all UN member countries have agreed to achieve universal health coverage by 2030. Countries are stepping up their efforts and experimenting with models suited to their contexts for moving toward universal health coverage. However, they must overcome design and technical challenges to achieve universal health coverage, including tackling large informal sector populations, transforming how health services are delivered to ensure they are more people-centered, addressing the complexity of health financing systems, maximizing limited available revenue sources and considering the shifting political landscapes that affect the continuity of reform efforts.

Our Approach

R4D is working with change agents in over 30 countries to support policymakers and practitioners as they design efficient, equitable and sustainable healthcare systems. Our approach focuses on building in-country capacity to use evidence and effectively implement health reforms on critical topics such as sustainable financing, strengthening primary care systems, improving quality of health services and expanding population coverage.

  • Since 2008, R4D has helped galvanize energy and political will around a global push for universal health coverage. We coordinated an early global task force for universal health coverage that was convened by the Rockefeller Foundation and co-authored a frequently-cited 2012 Lancet article that looked at efforts to advance universal health coverage in nine countries in Africa and Asia.
  • In 2010, we helped launch the Joint Learning Network — a thriving, member-driven community of global health policymakers and practitioners who are working together to collectively address barriers to achieving universal health coverage. Today, R4D serves as the network coordinator and provides technical facilitation to two technical initiatives, the Primary Health Care Initiative and the Provider Payment Initiative.
  • In 2017, R4D launched the African Collaborative for Health Financing Solutions — a peer-learning community that is working with country and regional stakeholders to help them address universal health coverage financing challenges.

Photo: Swasth Health Clinic ©Center for Health Market Innovations/R4D

R4D President and CEO Gina Lagomarsino on Universal Health Coverage

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R4D Digital Communities

We create and support global communities of innovators, funders and policymakers for continuous and iterative learning, knowledge generation, exchange and collaboration. Explore some of our communities: