ArticleBulletin of the World Health Organization2020
Pooling financial resources for universal health coverage: options for reform.
Article in Bulletin of the World Health Organization, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis.Global health action · 2023Pooled it
- Pooled it
- Challenges to Achieving Universal Health Coverage Throughout the World: A Systematic Review.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2022Pooled it
- Implications of Kenya's Enhanced Public Officers Medical Scheme on Equity in Strategic Purchasing and Progress Towards Universal Health Coverage.Public health challenges · 2026Article
- Article
- Health financing inequality in fragmented health systems: evidence from Mexico, 2000-2023.International journal for equity in health · 2026Article
- Socioeconomic inequalities in the continuum of care for maternal health in an upper-middle-income country: the case of Mexico.Cadernos de saude publica · 2026Article
- Health financing strategies for achieving Universal Health Coverage in low- and middle-income countries: a narrative review.Frontiers in public health · 2026Review
- Evaluating Honduras' health financing system: a comprehensive application of the WHO Health Financing Progress Matrix.Revista panamericana de salud publica = Pan American journal of public health · 2026Article
- Fragmentation in health system financing: a major challenge for improving effectiveness, efficiency, equity and choice within health systems.BMJ public health · 2026Review
- A qualitative study of the government's implementation of the Universal Health Coverage in Egypt: stakeholders' perspective.Health research policy and systems · 2025Article
- Barriers to early diagnosis and treatment of oral cancer in countries in Africa: a scoping review.BMC oral health · 2025Article
- Financing surgery in LMICs: building sustainable and equitable systems for universal surgical access - a narrative review.BMC surgery · 2025Review
- Article
- Countdown to 2030: overview of current and planned health financing reforms for universal health coverage in the WHO African Region.Journal of global health · 2025Article
- Trust in the integrity of a micro health insurance scheme and its determinants in two rural districts of Ethiopia.BMC health services research · 2025Article
- Navigating Nepal's health financing system: A road to universal health coverage amid epidemiological and demographic transitions.PloS one · 2025Article
- Article
- Systematic Review of Financing Functions for Universal Health Coverage in Low- and Middle-Income Countries: Reforms, Challenges, and Lessons Learned.Public health reviews · 2025Review
- Moving toward universal health coverage with a national health insurance program: A scoping review and narrative synthesis of experiences in eleven low- and lower-middle income countries.PLOS global public health · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Universal health coverage (UHC) means that all people can access health services of good quality without experiencing financial hardship. Three health financing functions - revenue raising, pooling of funds and purchasing health services - are vital for UHC. This article focuses on pooling: the accumulation and management of prepaid financial resources. Pooling creates opportunities for redistribution of resources to support equitable access to needed services and greater financial protection even if additional revenues for UHC cannot be raised. However, in many countries pooling arrangements are very fragmented, which create barriers to redistribution. The purpose of this article is to provide an overview of pooling reform options to support countries who are exploring ways to enhance redistribution of funds. We outline four broad types of pooling reforms and discuss their potential and challenges in addressing fragmentation of health financing: (i) shifting to compulsory or automatic coverage for everybody; (ii) merging different pools to increase the number of pool members and the diversity of pool members' health needs and risks; (iii) cross-subsidization of pools that have members with lower revenues and higher health risks; and (iv) harmonization across pools, such as benefits, payment methods and rates. Countries can combine several reform elements. Whether the potential for redistribution is actually realized through a pooling reform also depends on the alignment of the pooling structure with revenue raising and purchasing arrangements. Finally, the scope for reform is constrained by institutional and political feasibility, and the political economy around pooling reforms needs to be anticipated and managed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.