Evidence map›Paper›PMID 42539399›Full record

ReviewFrontiers in public health2026

Health financing strategies for achieving Universal Health Coverage in low- and middle-income countries: a narrative review.

Sharmake Gaiye Bashir, Yusuf Hared Abdi, Zakaria Ibrahim Issack, Ilyas Abdullahi Khalif, Sumaya Ahmed Ali, Shadia Mohamed Ali, Bashir Mohamed Abdi, Yusuf Abdullahi Hubow, Aniso Mohamed Abdi, Mohamed Sharif Abdi and 3 more

Abstract readReview
In one paragraph

Review in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Sharmake Gaiye BashirFaculty of Health Science, Salaam University, Mogadishu, Somalia.
Yusuf Hared AbdiCenter for Health Research and Innovation, Somali National University, Mogadishu, Somalia.
Zakaria Ibrahim IssackHealth Emergency Department, Ministry of Health & Human Service, Mogadishu, Somalia.
Ilyas Abdullahi KhalifFaculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia.
Sumaya Ahmed AliFaculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia.
Shadia Mohamed AliFaculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia.
Bashir Mohamed AbdiFaculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia.
Yusuf Abdullahi HubowFaculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia.
Aniso Mohamed AbdiFaculty of Health Sciences and Tropical Medicine, Somali National University, Mogadishu, Somalia.
Mohamed Sharif AbdiCenter for Health Research and Innovation, Somali National University, Mogadishu, Somalia.
Naima Ibrahim AhmedCenter for Health Research and Innovation, Somali National University, Mogadishu, Somalia.
Yakub Burhan AbdullahiCenter for Health Research and Innovation, Somali National University, Mogadishu, Somalia.
Gallad Dahir HassanCenter for Health Research and Innovation, Somali National University, Mogadishu, Somalia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Low- and middle-income countries (LMICs) face persistent health financing challenges, including heavy out-of-pocket payments, fragmented risk pools, and constrained fiscal space that undermine financial protection and equitable access to care. Objective: This narrative review synthesizes evidence on health financing strategies in LMICs, examining how revenue generation, risk pooling, and strategic purchasing can advance Universal Health Coverage (UHC). Methods: PubMed/MEDLINE, Scopus, and Web of Science were searched for English-language publications from January 2016 to February 2026, supplemented by policy documents from international health organizations. Of 120 records identified, 58 full texts were assessed and 24 sources were included, comprising systematic reviews, country case studies, and policy analyses across sub-Saharan Africa, South Asia, and Southeast Asia. A formal risk-of-bias appraisal was not applied; instead, sources underwent a structured credibility assessment. Results: Tax-based financing and subsidized insurance models appear more consistently associated with coverage expansion and financial protection when supported by adequate public funding, mandatory inclusion, and large risk pools. Social health insurance contributes to equity only where enrollment is mandatory and premiums for the poor and informal workers are subsidized. Community-based insurance plays a complementary rather than cornerstone role, while donor funding and innovative mechanisms offer supplementary support but raise concerns about sustainability and scale. Across settings, fragmented, voluntary, and out-of-pocket-dominated arrangements are repeatedly linked to weaker financial protection. Conclusion: No single financing model is sufficient for UHC. The evidence suggests that integrated, tax-anchored systems with consolidated risk pools, strategic purchasing, and strengthened governance represent the most plausible pathway for LMICs, though financing reform alone cannot guarantee progress, since service readiness, workforce capacity, and governance determine whether financial coverage becomes effective coverage.

Indexed as

Developing CountriesHealthcare FinancingUniversal Health InsuranceHealth ExpendituresHumansfinancial risk protectionhealth financinglow- and middle-income countriesout-of-pocket expenditureUniversal Health Coverage

Identifiers

PMID42539399
PMCPMC13423627

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Registered trials

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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.