Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage

Voorhoeve A 1 , Edejer TTT 2 , Kapiriri L 3 , Norheim OF 4 , Snowden J 5 , Basenya O 6 Show all authors , Bayarsaikhan D 7 , Chentaf I 8 , Eyal N 9 , Folsom A 10 , Tun Hussein RH 11 , Morales C 12 , Ostmann F 13 , Ottersen T 14 , Prakongsai P 15 , Saenz C 16 , Saleh K 17 , Sommanustweechai A 18 , Wikler D 19 , Zakariah A 20

Affiliations 

  • 1 Department of Philosophy, Logic, and Scientific Method, London School of Economics, London, UK and Visiting Scholar in the Department of Bioethics at the National Institutes of Health, Bethesda, US
  • 2 Coordinator of Costs, Effectiveness, Expenditure and Priority Setting, Health Systems Governance and Financing, and Health Systems and Innovation, World Health Organization, Geneva, Switzerland
  • 3 Associate Professor in the Department of Health, Aging, and Society, McMaster University, Hamilton, Ontario, Canada
  • 4 Director of Global Health Priorities in the Department of Global Public Health and Primary Care University of Bergen, Bergen, Norway
  • 5 Research Analyst at Giving What We Can, Centre for Effective Altruism, Oxford, UK
  • 6 Performance-Based Financing Expert in the Ministry of Health, Bujumbura, Burundi
  • 7 Health Economist in the Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
  • 8 International and Intergovernmental Cooperation Program Manager in the Cooperation Division at the Ministry of Health, Rabat, Morocco
  • 9 Associate Professor, Department of Global Health and Population, TH Chan School of Public Health, Harvard University, Boston, US
  • 10 Program Director at the Results for Development Institute, Washington, DC, US
  • 11 Deputy Director, Unit for National Health Financing, Planning and Development Division, Ministry of Health, Putrajaya, Malaysia
  • 12 Representative of PAHO/WHO in Cuba, Havana, Cuba
  • 13 School of Public Policy, University College London, London, UK
  • 14 Research Fellow, Department of Global Public Health and Primary Care, University of Bergen and Associate Professor, Oslo Group on Global Health Policy, Centre for Global Health, University of Oslo, Bergen, Norway
  • 15 Director, Bureau of International Health, Ministry of Public Health, Nonthaburi, Thailand
  • 16 Bioethics Regional Advisor, Pan American Health Organization, Washington, DC, US
  • 17 Senior Economist in Health at the World Bank, Washington, DC, US
  • 18 Research Fellow at the Ministry of Public Health, Thailand
  • 19 Saltonstall Professor of Ethics and Population Health, Department of Global Health and Population, TH Chan School of Public Health, Harvard University, Boston, US
  • 20 Director, Policy, Planning, Monitoring and Evaluation, Ministry of Health, Accra, Ghana
Health Hum Rights, 2016 Dec;18(2):11-22.
PMID: 28559673

Abstract

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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