The State of Commitment to Universal Health Coverage (UHC) brings a unique multi-stakeholder view to a simple question: Are countries acting on their commitments to UHC?

A combination of country profiles and a synthesis report, The State of Commitment to UHC is a political, country-focused and action-oriented tool that complements the more technical and global WHO UHC monitoring report focusing on UHC indicators on service coverage and financial protection.

It follows the UHC Political Declaration’s Key Targets, Commitments and Follow-up Actions and supports national accountability and advocacy processes to ensure political leaders are held accountable for their UHC commitments.

Key findings

The State of UHC Commitment Review is a political, country-focused and action-oriented tool that complements the more technical and global UHC monitoring report focusing on UHC indicators for service coverage and financial protection.The key findings from the latest review found that progress on UHC has stalled and in some cases reversed. The next synthesis report will be published in 2023.

Download a summary of key findings

Download State of UHC Commitment Review: key findings

Key findings summary

  1. Ensure political leadership beyond health: The majority of countries recognize UHC as a goal, however there is a lack of concrete operational steps towards achieving UHC.
  2. Leave no one behind: Vulnerable individuals and groups continue to face financial barriers to accessing the health services and commodities they need.
  3. Legislate and regulate: More than half of countries have adopted legislation to guarantee equitable access to quality and affordable healthcare and protect against financial hardship through a UHC law, and about 70% of countries have used UHC as a goal for their health plans.
  4. Uphold quality of care: Discrimination against patients and limited quality and respectful healthcare services remain a widespread challenge to maintaining  dignity, privacy and confidentiality.
  5. Invest more, invest better: Despite continued increases in overall health expenditure in 2020 due to COVID-19 response, governments’ current investment commitments and public spending for health are inadequate to achieve UHC.
  6. Move together: A limited number of countries have a formal and effective accountability mechanism for UHC, with inadequate engagement of non-state actors.
  7. Gender equality: Despite women being the majority of the health workforce, there is a lack of commitment towards increasing women's representation in health and political leadership.
  8. Emergency preparedness: The COVID-19 pandemic exacerbated inequities and disrupted the provision of essential health services.

Country profiles

Available on the UHC Data Portal, the country profiles provide a snapshot of the state of UHC commitments in individual countries, centred around the key commitment areas of the Political Declaration on UHC. Both interactive dashboard (online version) and printable dashboard (offline version) are available.

Visit the UHC Data Portal

Useful resources 

Download: State of commitment to universal health coverage: 2021 synthesis

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Download: State of commitment to universal health coverage: 2020 synthesis

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Download the State of UHC Commitment Concept Brief

Read: Blog article on 2020 Synthesis of State of Commitment

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