1167Disease Burden and Universal Health Coverage Monitoring

Abstract

Abstract Background Achieving universal health coverage (UHC) is a target of the Sustainable Development Goals, and the monitoring of its progress is of use to clarify what to be enhanced for better health. While the WHO and the World Bank Group jointly developed a scale with the above purpose (WHO/WB index: Hogan et al., 2018), it fails to reflect the fact that different needs to health coverages may exist depending on a stage of epidemiological transition. Methods To consider potential differences in health coverage needs depending on the stage of the epidemiological transition, we reformulated the index by incorporating weight as the proportion of age-adjusted mortality rate among monitored domains (i.e. reproductive, maternal, new-born and child health, infectious disease, non-communicable diseases [NCD]), of which data collected from the WHO Global Health Observatory. Additionally, we utilised indicators of policy achievements on NCD by the WHO’s Noncommunicable Diseases Progress Monitor 2015. Results The UHC progress monitored by the WHO/WB index had a mean of 61.83 (%) while it declined by about 4% point on average when NCD indicators were replaced. Furthermore, the UHC progresses evaluated with weights calculated from disease burden decreased by about 10% point for both measures, suggesting that some countries may not provide demanded health coverages. Conclusion The UHC progress decreased when disease burden for each country was taken into consideration. This indicates the necessity to assess the UHC progressby reflecting disease structure of each country, not by an identical scale for all nations. Key messages The monitoring of universal health coverage is required to reflect disease structure of each country.