Getting UHC on the ballot

Universal health coverage (UHC) aims to ensure that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. The outcome of elections can determine whether a government prioritizes and invests in building a robust health system that protects the right to health of the country’s people and communities.

By consistently engaging in the electoral process, UHC advocates can influence the selection of policymakers who are committed to prioritizing the fundamental right to health. Sustained engagement also fosters a culture where healthcare is a recurring and prioritized electoral issue.

This tool provides guidance for UHC advocates wishing to influence the elections taking place in their countries. 

With elections taking place in over 70 countries in 2024, this is a pivotal moment to ensure your future leaders keep health high on their political agendas and understand the importance of taking urgent and meaningful action towards health for all. 

But the work doesn’t stop once the elections are over. Staying involved after national elections and actively participating in mid-term and local elections are crucial if we wish to create lasting change. Major elections may shape the overarching political landscape, but mid-term and local elections directly impact the composition of legislatures and decision-making bodies at levels closer to the community. 

We hope you will find this guide helpful. If you have any questions or would like additional support, please email info@uhc2030.org. We also welcome your feedback on your experience using this tool and engaging in the election process in your country.

Click here to download a PDF version of the guide.

Click here to request to add your organization to the list of country contacts.

Six steps to get started

To ensure that UHC is included in political election agendas and campaigns, it is important to engage directly with political candidates and mobilize other voters to do the same. This starts with identifying your target audience from among the candidates and the people most likely to influence them.

1. Identify your target audience.

Focusing on presidential and legislative elections is crucial for UHC advocacy, as these levels of governance collectively shape the policy landscape and legislative frameworks essential for the adoption and implementation of UHC reforms. Specifically:

  • Presidential elections shape the executive leadership and policy direction of a nation, influencing the overarching vision for UHC. 
  • Legislative elections determine the composition of the legislature, impacting the formulation and passage of laws and national budgets that directly contribute to the implementation and sustainability of UHC policies, as well as the oversight of government action. 

Tool: Refer to the table of upcoming elections, which provides a list of national elections taking place in the coming months, sorted by country, dates and type of elections. 

Although our resources focus on national elections, regional and municipal elections are also key, as they influence localized healthcare strategies, resource allocation and community-level initiatives.

With this in mind, determine who you wish to engage with according to the elections taking place in your country. Consider targeting opposition candidates who are trying to replace leaders who failed to act on UHC, as they may be easier to reach than heads of government. You can then emphasize how UHC can help bring voters to their side.

Influencing political candidates involves engaging with a variety of key players – in other words, potential allies or opponents – who can shape policy discussions and priorities. This includes campaign managers, political consultants and advisors, party leaders and officials, fundraisers and donors, and even family members. 

In particular, advocacy within parties can influence the development of party agendas and priorities, which in turn shape the legislative agenda, the allocation of resources and the development and implementation of policies once the elections are done.

Additionally, former elected officials, community leaders, activists and advocacy organizations can have significant influence, as they have the potential to boost a candidate’s credibility and visibility within specific demographic or interest groups. CSOs, NGOs, media outlets and academic and research institutions can also influence political candidates.

Ask yourself: How can I best reach this candidate? Do I have any direct or indirect connections to the candidate or to people close to them? 

By engaging a diverse range of stakeholders and reaching out to the people close to your target audience, you increase your chances of influencing decisions at the highest levels.

Tool: The Health for All Advocacy Toolkit includes a Power Mapping Template (page 54) to help you determine how best to influence key decision-makers.

 

2. Prepare your messages.

Once you’ve identified your target audience, you can tailor your messages to resonate with their specific concerns and aspirations. What is the specific action you want your target audience to take? Here are some examples: 

  • Legislation and policy support: Advocate for candidates to support and champion legislation and policies that advance UHC. This includes measures to expand health coverage, improve healthcare quality and reduce financial barriers to accessing services.
  • Increased healthcare funding: Request that candidates prioritize increased funding for the healthcare sector in national budgets. Adequate financial resources are essential for expanding infrastructure, enhancing healthcare services and ensuring the sustainability of UHC initiatives.
  • Primary healthcare strengthening: Advocate for the strengthening of primary healthcare services, focusing on preventive and essential healthcare at the community level. 

You must then tailor your asks to the context of the political campaign, local healthcare challenges and the candidates’ platform. 

Ask yourself: What are the messages that would best resonate with your target audience? 

For instance, if their campaign focuses on job creation, consider formulating your key messages to highlight how UHC can contribute to employment by, for example, keeping workers healthy and productive. It is essential to target the political objectives of the candidate, and to help them understand that UHC can be a path to winning the election. 

When preparing your messages, use evidence-based arguments to make the case for the economic, social and public health benefits of UHC. 

Be concise; use plain language; and formulate clear, specific and measurable requests to ensure that candidates understand the concrete steps needed to advance UHC. If possible, provide general indications of how much the steps will cost, emphasizing that UHC is an investment and that a healthy population is a prerequisite for a healthy economy

And don’t hesitate to share your story. Telling your personal story when advocating for UHC can be a powerful and compelling way to connect with political candidates, evoke empathy, and make the issue more relatable and emotionally resonant. It can help candidates understand the tangible consequences of their choices and underscore how adding UHC to their agenda can increase votes.

Once you have developed your messages, prepare a short takeaway publication or briefing paper that you can leave with your target audience. Your publication should include a short description of UHC and its status in your country/region/state; notes on what can be done quickly (within a term of office) to get the situation back on track; and an overview of the health, economic and political benefits of this approach. Refer to our resource section below for a link to examples of briefing papers.

Review your messages thoroughly until you feel comfortable explaining and summarizing the content. 

Finally, prepare your elevator pitch. Condense your messages down to a few sentences – a brief introduction that you can say in under 30 seconds to share your key points and grab the attention of your target audience. 

Tools:

3. Engage your target audience.

Once you have prepared your messaging, it’s time to contact and engage with your target audience. The contact details of political candidates should be available through online search engines or on official campaign websites, social media platforms, election commission websites, local party offices, public records and directories. You can also attend campaign events, town halls and public forums where the candidate is speaking to request contact information. 

Be sure to use official and reliable sources to ensure the accuracy of the contact information, and avoid using personal contact information obtained without consent or from unofficial sources to respect privacy and adhere to ethical standards.

If this step feels intimidating, remember that engaging with your current and future decision-makers is a fundamental aspect of a democratic society. 

Ask yourself: What communication method am I most comfortable with to engage a conversation?

You can send formal letters or emails, share your stance on social media, make phone calls, or participate in town hall meetings or public forums. You can also take gradual steps. For instance, you might start by attending a public meeting, observing discussions and then gradually participating as you feel more comfortable. 

Before reaching out, practice what you want to say (see section 2 above). This will boost your confidence and help you articulate your thoughts. 

If the idea of individual communication is still intimidating, consider joining or forming a group with other UHC advocates. There’s strength in numbers, and group efforts can have a more significant impact.

What if engagement is discouraged in my country or current political climate?

Engaging in a political climate that does not readily enable participation can be challenging, but it is not impossible. Here are some strategies to influence change:

  • Educate and inform: In a challenging political climate, misinformation may be prevalent. Prioritize education and information dissemination, such as through public awareness campaigns. Provide clear, concise and evidence-based information about the benefits and importance of UHC to counter misconceptions.
  • Build grassroots support: Focus on grassroots advocacy by mobilizing community members. Develop outreach programs, host community events and use social media platforms to connect with individuals at the local level. Grassroots support can create pressure on policymakers from the ground up.
  • Collaborate with non-traditional allies: Look for non-traditional allies who might not be directly associated with healthcare but have a shared interest in societal well-being. Collaborating with diverse groups, such as business associations, religious organizations or community leaders, can broaden the base of support.

Adapting strategies to the specific challenges of your political climate and remaining resilient in the face of obstacles are key elements of advocacy in less enabling environments. Persistence, strategic thinking and a commitment to inclusivity can contribute to making UHC a priority, even in challenging political climates.

Tool: The UHC Advocacy Letter template allows you to contact decision-makers to call for urgent action for UHC. You can also refer to the @UHC2030 and @CSOs4UHC accounts on X (formerly Twitter) for examples of concise messages on UHC.

4. Amplify your message.

In addition to reaching out to candidates and influential people directly, consider other engagement mechanisms to amplify your message, such as organizing or attending seminars and conferences, creating petitions and sharing your views on social media.

Media engagement, such as through op-eds, articles and interviews, can also influence the political agenda by keeping UHC at the forefront of discussions.

If you are part of an organization, consider conducting public awareness campaigns to educate voters and candidates about the importance of UHC. This can involve organizing community events and using social media to disseminate information. 

You don’t have to start from scratch. Existing resources like the UHC Day toolkit can be reused or adapted to your needs. 

Work with civil society organizations (CSOs) to amplify your message and leverage collective strength. You can visit the Civil Society Engagement Mechanism for UHC2030 (CSEM) website to find CSOs near you. Partnerships with health and care workers, patient advocacy groups, and grassroots organizations can also help create a broader coalition for UHC. 

And, of course, encourage other UHC supporters to actively participate in the electoral process. This can mean simply talking to people around you about the importance of UHC and the ongoing elections, but can also include registering voters, promoting voter education on UHC, and organizing get-out-the-vote initiatives.

Tool: Advocacy letter

5. Document commitments and campaign promises.

To hold candidates accountable for their UHC promises, it is important to keep track of their commitments and statements. Campaign promises not only provide valuable insight into candidates’ policy priorities, they also serve as a benchmark to measure the performance of elected officials. By documenting these promises, communities and the media have a tool to hold politicians accountable for the pledges they made during their campaigns. 

To find campaign promises, refer to official campaign websites where candidates often outline their policy platforms and commitments. Candidates may also use social media platforms to share their promises and engage with voters directly. Public speeches, town hall meetings, debates, forums and interviews provide additional opportunities for candidates to articulate their plans and address voter concerns. Finally, local media outlets, including newspapers and TV and radio stations, often cover candidates’ promises. 

Tools:

6. Follow up after the election.

Establish or participate in mechanisms to monitor political commitments and advocate for the implementation of UHC policies once candidates are in office. To do so: 

  • Monitor leaders’ actions and policy decisions to compare them to the commitments made during election campaigns. 
  • Engage in ongoing dialogue with elected officials through meetings, letters or public forums to express concerns and emphasize the importance of fulfilling UHC commitments. 
  • Use media channels and social media platforms to raise public awareness about leaders’ adherence to UHC promises. 
  • Collaborate with CSOs to enhance your impact. 
  • Actively participate in legislative processes, providing input and mobilizing support for UHC-related policies. 

Last but not least: engage with your parliamentarians. Parliamentarians play a pivotal role in upholding accountability within a democratic framework and bringing citizen voices into the legislative arena. They draft and pass laws, approve the national budgets, and oversee the executive branch to ensure policy adherence. 

Tool: Register to become a member of CSEM. This will give you instant access to UHC-related civil society updates, resources and events, and allow you to actively engage in raising civil society voices and ensuring UHC policies are inclusive and equitable.

Resources to come! Keep coming back to the online version of this tool and sign up for the UHC2030 newsletter to receive updates on how to establish accountability and monitoring mechanisms for UHC. 


Maintaining political neutrality is paramount when advocating for UHC. 

The issue of healthcare affects individuals across the political spectrum, and by remaining politically neutral, advocates can engage a diverse range of stakeholders without alienating any particular group.

A neutral stance will allow UHC advocates to collaborate with policymakers from different political parties, fostering a more inclusive and constructive dialogue.