GBD 2019: Measuring Universal Health Coverage Based on an Index of Effective Coverage of Health Services in 204 Countries and Territories, 1990-2019

This article from The Lancet assesses Universal Health Coverage (UHC) effective coverage for 204 countries and territories using data from the Global Burden of Disease (GBD) study 2019. Making progress toward providing UHC for all—where individuals can access high quality health care without experiencing financial strain—is engrained in both national and global institutions, and in the Sustainable Development Goals (SDGs). The authors sought to measure effective coverage through the adaptation of the World Health Organization’s GPW13 consultation and created 23 indicators representing health service types—such as promotion, prevention, and treatment—as well as five age groups from reproductive age through adults over 65. 

The authors found that the UHC effective coverage index improved from 45.8 in 1990 to 60.3 in 2019—however scores varied drastically between countries. Japan, for example, had an index rating of 95 whereas Somalia and the Central African Republic scored 25 on the index. UHC effective coverage in Sub-Saharan Africa has rapidly improved since 2010 with an average index increase of 2.6% per year. Other GBD super regions, however, have seen slower rates of gain between 2010 and 2019. Measuring effective coverage at the health system level ensures that health services are aligned with countries’ health profiles and are of sufficient quality to improve health in populations of all ages.

Led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, GBD is a global effort with researchers from over 150 countries and territories. IHME and other partnering organizations have developed numerous resources to disseminate and visualize the findings of the GBD studies, data visualizations and interactives, country profiles, policy reports, research articles, infographics, and the GBD Results Tool, which allows users to search GBD data.