Open AccessAchieving Universal Health Coverage (UHC): Dominance analysis across 183 countries highlights importance of strengthening health workforce
Author(s) -
Michael Reid,
Reena Gupta,
G. B. S. Roberts,
Eric Goosby,
Paul S. Wesson
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0229666
Subject(s) - workforce , service delivery framework , dominance (genetics) , sanitation , psychological intervention , business , environmental health , medicine , economic growth , service (business) , economics , nursing , biochemistry , chemistry , pathology , marketing , gene
Background 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. Methods 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. Findings 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). Conclusions 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.