ArticleBMJ global health2025
Progress towards universal health coverage in South Asia, 2000-2030: an examination of the twin elements of primary healthcare provision and financial protection.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Health economics of Parkinson's disease prevention: why early detection matters in low- and middle-income countries.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Service Coverage and Financial Hardship Under Universal Health Coverage: Uneven Associations Across 159 Countries (2000-2023).International journal of environmental research and public health · 2026Article
- Prevalence and factors associated with uncontrolled systolic blood pressure among treated older adults in Sri Lanka: a nationwide multicenter cross-sectional study.BMC cardiovascular disorders · 2026Article
- Kerala's Aardram Mission and universal health coverage: integrated time series evidence on mortality reduction and assessment of financial protection and equity gaps.Frontiers in public health · 2026Article
- Mobilizing the banking sector for universal health coverage: a new frontier for public-private partnerships.Frontiers in health services · 2026Article
- Factors influencing healthcare access among older adults in Southeast Asia: a scoping review guided by the levesque framework.BMC health services research · 2025Article
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7 authors.
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Abstract
backgroundUniversal health coverage (UHC) is crucial for achieving Sustainable Development Goal (SDG) 3: Good Health and Well-being. This study projects UHC progress in seven South Asian countries by 2030, focusing on two crucial underpinning components, primary healthcare (PHC) service coverage and financial risk protection.
methodsWe applied Bayesian random-effects models to project UHC indicators linked to PHC and financial risk protection including the Composite Coverage Index, catastrophic health expenditures (CHE) and impoverishing health expenditures. Data were sourced from the WHO Global Health Observatory, Demographic Health Surveys, National Health Surveys and the WHO Global Health Expenditure database. Projections were made from 2000 to 2030, with PHC and government health expenditures as key predictors.
resultsThe analysis showed notable disparities in current and projected service coverage and financial protection across the region. Health service coverage is projected to increase from 53.5% in 2000 to 81.5% by 2030, with Bhutan and Sri Lanka expected to achieve higher levels. However, Afghanistan and Pakistan will likely remain below the SDG target of 80% coverage. Despite progress in coverage, financial protection is a challenge, with CHE expected to rise from 7.2% in 2000 to 18.6% by 2030. Bhutan and Sri Lanka show strong protection measures, while Afghanistan and India will face higher CHE and impoverishment rates due to high out-of-pocket spending.
conclusionThis is the first study to project trends towards UHC in South Asia using Bayesian estimates of both health coverage and financial risk protection. Progress towards UHC requires advances in both service coverage and health financing reform. Although service coverage is improving, financial protection remains insufficient, particularly in rural and conflict-affected areas. Targeted PHC investment, context-sensitive financing reforms and stronger risk-pooling mechanisms are essential-drawing lessons from stable settings (Bhutan, Sri Lanka) to guide strategies in fragile contexts (Afghanistan, Pakistan).
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