Attainment Of Universal Health Coverage Research Articles

Effect of social capital on enrolment of informal sector occupational groups in the national health insurance scheme in Ghana: a cross-sectional survey

BackgroundEnrolment of informal sector workers in Ghana’s National Health Insurance Scheme (NHIS) is critical to achieving increased risk-pooling and attainment of Universal Health Coverage. However, the NHIS has struggled over the years to improve enrolment of this subpopulation. This study analysed effect of social capital on enrolment of informal sector workers in the NHIS.MethodsA cross-sectional survey was conducted among 528 members of hairdressers and beauticians, farmers, and commercial road transport drivers’ groups. Descriptive statistics, principal component analysis, and multinomial logit regression model were used to analyse the data.ResultsSocial capital including membership in occupational group, trust, and collective action were significantly associated with enrolment in the NHIS, overall. Other factors such as household size, education, ethnicity, and usual source of health care were, however, correlated with both enrolment and dropout. Notwithstanding these factors, the chance of enrolling in the NHIS and staying active was 44.6% higher for the hairdressers and beauticians; the probability of dropping out of the scheme was 62.9% higher for the farmers; and the chance of never enrolling in the scheme was 22.3% higher for the commercial road transport drivers.ConclusionsSocial capital particularly collective action and predominantly female occupational groups are key determinants of informal sector workers’ participation in the NHIS. Policy interventions to improve enrolment of this subpopulation should consider group enrolment, targeting female dominated informal sector occupational groups. Further studies should consider inclusion of mediating and moderating variables to provide a clearer picture of the relationship between occupational group social capital and enrolment in health insurance schemes.

Digital health and health equity: How digital health can address healthcare disparities and improve access to quality care in Africa.

The healthcare industry is constantly evolving to bridge the inequality gap and provide precision care to its diverse population. One of these approaches is the integration of digital health tools into healthcare delivery. Significant milestones such as reduced maternal mortality, rising and rapidly proliferating health tech start-ups, and the use of drones and smart devices for remote health service delivery, among others, have been reported. However, limited access to family planning, migration of health professionals, climate change, gender inequity, increased urbanization, and poor integration of private health firms into healthcare delivery rubrics continue to impair the attainment of universal health coverage and health equity. Health policy development for an integrated health system without stigma, addressing inequalities of all forms, should be implemented. Telehealth promotion, increased access to infrastructure, international collaborations, and investment in health interventions should be continuously advocated to upscale the current health landscape and achieve health equity.

Violence against physicians working in public tertiary care hospital of Bangladesh: a facility-based cross-sectional study

BackgroundViolence against physicians in the workplace is a prevalent global issue, and Bangladesh is no exception. Such violence significantly disrupts healthcare delivery and the attainment of universal health coverage. This...

Perceptions and Factors affecting Utilization of Primary Health Care Services in a predominantly Urban Community in South-South Nigeria

Background: Primary Health Care is the cornerstone of a sustainable national health system for the attainment of universal health coverage. There is poor demand for health services at the primary level of care. This study assessed the perceptions and factors affecting the utilization of primary health care services in a predominantly urban community in South-South Nigeria.
 Methods: This descriptive cross-sectional study was done in Egor, Benin City, Southern Nigeria. A structured, and interviewer administered questionnaire was distributed to 371 heads of household who were selected using multistage sampling method. The data were analyzed using IBM SPSS version 25.
 Results: Majority of the respondents were males 191 (51.6%). More than half, 195 (52.5%) were in the age group of 35-49 years. Less than half, 171 (46.1%)of the respondents had utilized primary health care services. Only, 42 (24.6%) perceived the services utilized were satisfactory. Immunization, 45 (26.3%), child, 39 (22.8%) and maternal, 32 (18.7%) health care services were the most utilized. Sex (OR = 0.599; CI = 0.38-0.94, p = 0.027), religion (OR = 2.246; CI = 1.066-4.735, p = 0.033), and occupation (OR = 2.437; CI = 1.106-5.367, p = 0.027) were factors associated with the utilization of health services in the study locale.
 Conclusions: The utilization of the primary health care services was low, and the perception of services utilized was not satisfactory. The Local Government Health Authority needs to strengthen the primary health care system. Also, improved community engagement and participation could enhance health services access and uptake.

How healthy is the health budget of Amrit Kaal: 2023-24?

Political will is the key to public health policy-making and a major driving force for the attainment of Universal Health Coverage (UHC) in any nation. To achieve UHC, the Indian government laid down National Health Policy in 1983 and updated it in 2002 and recently in 2017. This recent policy emphasized increasing healthcare spending and economic growth. In the current budget, there is an increment in the share of GDP of 0.34% from the previous year's allocation, but still staggering for the envisaged 2.5% to achieve UHC. Enthusiastic announcements of opening 157 new nursing colleges, a separate programme for eliminating sickle cell anemia by 2047, and Centers of excellence establishment for pharma companies for promoting research and development and focusing on Particularly Vulnerable Tribal Groups (PVTGs) are the few overarching and new highlights in the current budget. But, in a country so huge and varied in terms of its needs in every sector, the announcements in the financial budget speech taking India forward in becoming a "shining star" is a matter of debate. This is an attempt to review the budget for this financial year in the healthcare sector and what it means: is the country willing to build a self-driven healthcare sector in the Amrit Kaal with strong public finances and a robust financial sector through "efforts by all"?

Implementing e-procurement at the Zimbabwe’s National Pharmaceutical Company (NatPharm): Challenges and Prospects

This study explores the challenges and benefits of adopting electronic procurement (e-procurement) technologies to facilitate anti-corruption mechanisms, accountability and transparency in the procurement of pharmaceuticals at the National Pharmaceutical (NatPharm) Company in Zimbabwe. Pharmaceutical corruption is a serious threat to the attainment of Universal Health Coverage. It is imperative for the Government of Zimbabwe to adopt Information Communication Technologies (ICTs) to detect and prevent corruption and fraud, thereby, addressing leakages, mismanagement and theft of medicines, thereby, improving population health outcomes. The study used a qualitative exploratory case study approach and data was gathered through documentary review. The study findings reveal that, pharmaceutical procurement is highly vulnerable to corruption at NatPharm. Bid rigging, procurement-related corruption, bribery and nepotism characterise pharmaceutical procurement at NatPharm. The study recommends the adoption of a transparent e-procurement system with open contracting and integrity pacts to reduce corruption, increase transparency and accountability at NatPharm.

Sub-national variations in general service readiness of primary health care facilities in Ghana: Health policy and equity implications towards the attainment of Universal Health Coverage

Sub-national variations in general service readiness of primary health care facilities in Ghana: Health policy and equity implications towards the attainment of Universal Health Coverage

A health-systems journey towards more people-centred care: lessons from neglected tropical disease programme integration in Liberia

BackgroundNeglected tropical diseases (NTDs) are associated with high levels of morbidity and disability as a result of stigma and social exclusion. To date, the management of NTDs has been largely biomedical. Consequently, ongoing policy and programme reform within the NTD community is demanding the development of more holistic disease management, disability and inclusion (DMDI) approaches. Simultaneously, integrated, people-centred health systems are increasingly viewed as essential to ensure the efficient, effective and sustainable attainment of Universal Health Coverage. Currently, there has been minimal consideration of the extent to which the development of holistic DMDI strategies are aligned to and can support the development of people-centred health systems. The Liberian NTD programme is at the forefront of trying to establish a more integrated, person-centred approach to the management of NTDs and provides a unique learning site for health systems decision makers to consider how shifts in vertical programme delivery can support overarching systems strengthening efforts that are designed to promote the attainment of health equity.MethodsWe use a qualitative case study approach to explore how policy and programme reform of the NTD programme in Liberia supports systems change to enable the development of integrated people-centred services.ResultsA cumulation of factors, catalysed by the shock to the health system presented by the Ebola epidemic, created a window of opportunity for policy change. However, programmatic change aimed at achieving person-centred practice was more challenging. Deep reliance on donor funding for health service delivery in Liberia limits the availability of flexible funding, and the ongoing funding prioritization towards specific disease conditions limits flexibility in health systems design that can shape more person-centred care.ConclusionSheikh et al.’s four key aspects of people centred health systems, that is, (1) putting peoples voices and needs first; (2) people centredness in service delivery; (3) relationships matter: health systems as social institutions; and (4) values drive people centred health systems, enable the illumination of varying push and pull factors that can facilitate or hinder the alignment of DMDI interventions with the development of people-centred health systems to support disease programme integration and the attainment of health equity.

Effect of mobile phone-based health insurance contribution payment system on retention of coverage in the National Health Insurance Scheme in Ghana: an evaluation study

BackgroundGhana introduced a mobile phone-based contribution payment system in its national health insurance scheme (NHIS) in December 2018 to improve the process of enrolment. We evaluated the effect of this digital health intervention on retention of coverage in the Scheme, one year after its implementation.MethodsWe used NHIS enrolment data for the period, 1 December 2018–31 December 2019. Descriptive statistics and propensity-score matching method were performed to examine a sample of 57,993 members’ data.ResultsProportion of members who renewed their membership in the NHIS via the mobile phone-based contribution payment system increased from 0% to 8.5% whilst those who did so through the office-based system only grew from 4.7% to 6.4% over the study period. The chance of renewing membership was higher by 17.4 percentage points for users of the mobile phone-based contribution payment system, compared to those who used the office-based contribution payment system. The effect was greater for the informal sector workers, males and the unmarried.ConclusionsThe mobile phone-based health insurance renewal system is improving coverage in the NHIS particularly for members who hitherto were less likely to renew their membership. Policy makers need to devise an innovative way for new members and all member categories to enrol using this payment system to accelerate progress towards attainment of universal health coverage. Further study needs to be conducted using mixed-method design with inclusion of more variables.

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem.
 Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0.
 Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents. Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare. Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 - $6.56 and $3.28 – $6.56, respectively.
 Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria.

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem.
 Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0.
 Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents. Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare. Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 - $6.56 and $3.28 – $6.56, respectively.
 Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria.

The potency of a free maternal healthcare policy in achieving universal health coverage a cross-sectional qualitative study

Background: The main focus of Ghana’s free maternal healthcare policy under the national health insurance scheme was to reduce the maternal mortality ratio. Aim: This study aims at ascertaining the potency of this policy in the achievement of universal health coverage in Ghana. Method: A cross-sectional qualitative study was conducted in the Bibiani-Anwiaso-Bekwai Municipality from June to December 2021 among women in their reproductive age (15-49 years) to ascertain how the policy has enhanced women’s access to maternal healthcare thereby facilitating the attainment of universal health coverage. Written informed consent and permission to participate in the study was obtained from each participant. In the case of those under 18 years, consent was sought from their parents/guardians A multistage sampling technique was used to select districts, health facilities and study participants. Focus group discussion and four key informants interviews were conducted among two nurses and two midwives who were selected using purposive sampling. The data obtained from respondent was analysed using content analysis. Results: Generally the women included in this study were knowledgeable about the policy as they recounted that, through the policy, health services they could not afford before are now accessible without any financial constraints. This means that the policy has provided many women and neonates access to maternal healthcare and healthcare in general and therefore has contributed to the attainment of universal health coverage in the municipality. Conclusions: The policy has provided financial access to women in maternal healthcare in particular and healthcare in general. This shows that the policy has a strong potential to contribute to the attainment of universal health coverage in the municipality and the country at large. Therefore, women should be encouraged to subscribe to the health insurance policy

Social innovation in health: strengthening Community Systems for Universal Health Coverage in rural areas

BackgroundIn seeking the attainment of Universal Health Coverage (UHC), there has been a renewed emphasis on the role of communities. This article focuses on social innovation and whether this concept holds promise to enhance equity in health services to achieve UHC and serve as a process to enhance community engagement, participation, and agency.MethodsA cross-country case study methodology was adopted to analyze three social innovations in health in three low- and middle-income countries (LMICs): Philippines, Malawi, and Colombia. Qualitative methods were used in data collection, and a cross-case analysis was conducted with the aid of a simplified version of the conceptual framework on social innovation as proposed by Cajaiba-Santana. This framework proposes four dimensions of social innovation as a process at different levels of action: the actors responsible for the idea, the new idea, the role of the institutional environment, and the resultant changes in the health and social system.ResultsThe study found that each of the three social innovation case studies was based on developing community capacities to achieve health through community co-learning, leadership, and accountability.The process was dependent on catalytic agents, creating a space for innovation within the institutional context. In so doing, these agents challenged the prevailing power dynamics by providing the communities with respect and the opportunity to participate equally in creating and implementing programs. In this way, communities were empowered; they were not simply participants but became active agents in conceptualizing, implementing, monitoring, and sustaining the social innovation initiatives.ConclusionThe study has illustrated how three creative social innovation approaches improved access and quality of health services for vulnerable rural populations and increased agency among the intervention communities. The processes facilitated empowerment, which in turn supported the sustained strengthening of the community system and the achievement of community goals in the domain of health and beyond.

Evaluating Enrollee Perceived Benefit of the Contributory Scheme Post Implementation in Katsina State Contributory Scheme North-West of Nigeria

Background: The Katsina State Contributory Health Care Management Agency (KTSCHMA) is visualized as one of the single most powerful social security interventions in the State’s effort geared toward the attainment of Universal Health Coverage (UHC). The Agency is designed to provide a cost-effective comprehensive healthcare delivery system for employees of formal sectors, self-employed, poor, and vulnerable groups. This study was conducted to assess the perceived benefit, problems and suggested ways of improving the scheme among civil servants in Katsina state, Nigeria. Methods: The study was a cross-sectional study conducted among 393 state civil servants. Participants were selected using a multistage sampling technique and data was obtained using a structured questionnaire. Data were analyzed with SPSS version 2.5 to obtain frequencies, means, and standard deviation. Results: The majority 53.8% of the respondents had reported reduced out-of-pocket expenditure as the major perceived benefit of the scheme, 20.9% easy access to healthcare service delivery, 13.2% availability of quality drugs, 9.3% affordable healthcare delivery, 2.6% short waiting time and 0.2% reported the benefit of the scheme is to achieve universal health coverage. Regarding the scheme perceived problems, almost half 50.5% of the respondents indicated the unavailability of most prescribed drugs as the main problem, and the majority 54.4% reported regular monitoring of the scheme operations by the Agency as the main way of improving the scheme. Conclusions: Reducing out-of-pocket expenditure and easy access to qualitative healthcare service delivery is the main enrollee perceived benefit of the scheme and the finding in this study show the high level of out-of-stock of prescribed drugs. Major suggestions proffered by enrolees for improving the scheme covered were regular monitoring of Healthcare Providers, provision of drugs and consumables, sensitization workshops on the modus operandi of the scheme, prompt response to enrollee complaints, and continuous review of the policy.

Eye Health Integration in Southern and Eastern Africa: A Scoping Review.

Integrated health systems are deemed necessary for the attainment of universal health coverage, and the East, Central, and Southern Africa Health Community (ECSA-HC) recently passed a resolution to endorse the integration of eye health into the wider health system. This review presents the current state of integration of eye health systems in the region. Eight hundred and twelve articles between 1946 and 2020 were identified from four electronic databases that were searched. Article selection and data charting were done by two reviewers independently. Thirty articles met the eligibility criteria and were included in the narrative synthesis. Majority were observational studies (60%) and from Tanzania (43%). No explicit definition of integration was found. Eye health was prioritized at national level in some countries but failed to cascade to the lower levels. Eye health system integration was commonly viewed in terms of service delivery and was targeted at the primary level. Eye care data documentation was inadequate. Workforce integration efforts were focused on training general health-care cadres and communities to create a multidisciplinary team but with some concerns on quality of services. Government funding for eye care was limited. The findings show eye health system integration in the ECSA-HC region has been in progress for about four decades and is focused on the inclusion of eye health services into other health-care programs. Integration of comprehensive eye care into all the health system building blocks, particularly financial integration, needs to be given greater emphasis in the ECSA-HC.

Rapid assessment of NCD services rollout in Health and Wellness Centres in North-Eastern Indian state: A cross- sectional study.

The creation of health and wellness centres (HWCs) to deliver comprehensive primary healthcare (CPHC) is a programmatic response to the changing demographic and epidemiological profile in India. Since the north-eastern (NE) states face distinct challenges to routine healthcare services, and it has been two years since the rollout of non-communicable disease (NCD) services through the HWCs, a rapid assessment of the rollout with respect to all components of CPHC was undertaken in the NE state of Manipur. The assessment was undertaken using a mixed methodology to assess the rollout of NCD services under CPHC based on the functionality criteria of HWCs. The districts and the facilities were sampled purposively using pre-defined criteria. Primary data were collected using adapted pre-tested semi-structured tools and an interview schedule, which were triangulated with facility-based records and field observations. The data were anonymized, analysed thematically and presented under the domains of CPHC. The assessment aided in identifying progress and challenges in the rollout of NCD services through the HWCs. Overall, the initiative was successful in generating demand and community awareness of the expanded range of services at the primary level. Yet, constraints posed by infrastructural gaps, logistical delays, training gaps, fund flow and weak community-level convergence compounded by the COVID-19 pandemic challenged seamless NCD service delivery. In as much as the attainment of universal health coverage is dependent on NCD prevention and control, the rollout of NCD services is dependent on strong institutional structures, especially at the primary level. The assessment highlights the need to strengthen the HWCs through adequate financing, human resources, logistics for medicines and technology, community participation, citizen engagement and change management.

High-level policy and governance stakeholder perspectives on health sector reform within a developing country context

Background: Health sector reform is a government-guided sustained process of structural change in programs and institutions of the health sector. Many developing countries like Nigeria have instituted various reforms in the health sector. However, issues in provision of quality healthcare persist. Hence this study explored high level stakeholders’ perspectives on health reform in Nigeria. Methods: The study was a descriptive case study using qualitative key informant interviews with purposively selected high-level government stakeholders in the Nigerian healthcare system comprising the Federal Ministry of Health and its agencies and institutes. Key aspects of health reform as identified by the World Health Organization were captured and used to develop a semi-structured interview guide. Seven Key Informant Interviews were carried out and recordings were transcribed verbatim and manually analyzed using standard techniques of thematic content analysis. Results: The emerging themes showing why reform has not led to improvement in the quality of healthcare include maladministration of the healthcare system, lack of an evidence-based engagement process and situation analysis involving all stakeholders, human resource shortages, weak health insurance, neglected primary healthcare system, poor financing, and weak political will. Conclusions: The study assessed policy and governance stakeholders’ views and perspectives on health sector reform in Nigeria. Findings showed various reasons why reform has not worked in Nigeria including poor stakeholder engagement and not following an evidence-based approach. Addressing these challenges by implementing some stakeholder perspectives including decentralizing the reform process and capturing the opinion of the people the reform is meant for can improve current and ongoing health reform policies. This could lead to an improved health system which can drive the attainment of Universal Health Coverage in Nigeria.

Dignity and respectful maternity care as an essential step towards universal health coverage

Most women experience disrespect and abuse in delivery rooms instead of support, and respect. Disrespect and abuse of women seeking maternity care are becoming an urgent problem and creating a growing community of concern that spans the domains of healthcare research, quality, and education; human rights; and civil rights advocacy. Deprivation of respectful mother care is an important cause of traumatic childbirth experiences as much as inadequate care make mothers feel that they are forced to be in the delivery bed, exposed, and left with no help. Good communication between parturient and care provider is associated with higher patient satisfaction with care and safety. All maternity care personnel should take cognizance of the issue of respectful maternity care and take appropriate corrective measures. By providing respectful maternity care we will take a concrete step ahead toward the attainment of universal health coverage.

Role of digital health insurance management systems in scaling health insurance coverage in low- and Middle-Income Countries: A case study from Nigeria

BackgroundIncreasing global commitment to Universal Health Coverage (UHC) in the past decade has triggered UHC-inspired reforms and investments to expand health service coverage in many Low- and Middle-Income Countries (LMICs). UHC aims to ensure that all people can access quality health services, safeguard them from public health risks and impoverishment from out-of-pocket payments for healthcare when household members are sickAimThis paper reviews the role of health insurance as a policy tool to address health financing as a contributory mechanism for accelerating the achievement of UHC in LMICs. We focus on Nigeria's legal framework for health insurance coverage for its whole population and the role of technology in facilitating enrollment to health insurance schemes.MethodsFrom May to July 2022, we adopted a cross-sectional case study design combining: (i) a literature review of the effects of UHC with (ii) document analysis of health insurance systems in Nigeria, and (iii) secondary analysis of health insurance datasets to understand experiences of deploying MedStrat, a locally-developed digital health insurance management system, and its features that support the administration of health insurance schemes in multiple states of Nigeria. We drew on contemporary technology adoption models to triangulate diverse data analyzed from literature and documents reviews and from health insurance datasets to identify: (i) enablers of adoption of digital insurance schemes, (ii) the contribution of digital technology to expanding access to health insurance, and (iii) further scalability of digital insurance intervention.ResultsPreliminary findings suggests that digital insurance management systems can help to increase the number of enrollees for insurance especially among poor households. Three contextual enablers of adoption of digital insurance schemes were a favourable policy environment, public-private-partnerships, and sustained stakeholder engagement and training.Discussion and conclusionKey elements for successful scaling of digital health insurance schemes across Nigeria and similar contexts include: (i) ease of use, (ii) existing digital infrastructure to support electronic insurance systems, and (iii) trust manifested via data encryption, maintaining audit trails for all data, and in-built fraud prevention processes. Our findings affirm that digital health technology can play a role in the attainment of UHC in LMICs.

Public-Private Partnership Supported Health Facilities and Progress towards Attainment of Universal Health Coverage in Kilimanjaro, Tanzania

BackgroundPublic-Private-Partnership-supported health facilities have been operational in Tanzania, and specifically, in Kilimanjaro since 1990s. This study provides a snapshot of the contribution of PPP-supported health facilities’ operations towards attainment of Universal Health Coverage (UHC) in Kilimanjaro region.MethodsAdopting a cross-sectional research design, samples of 384 households and 30 health facilities were selected through a multi-stage and purposive sampling approaches, respectively. Questionnaires and key informant interviews (KIIs) were administered (June 2020 - February 2021). Using IBM-SPSS v.23, chi-square was used to compare PPP-supported and government health facilities’ service delivery quality and affordability. Content analysis was done on KIIs.ResultsWith PPP-support unweighted mean index score for service availability (SA) was 46.59% and 29.14% without PPP-supported health facilities. With PPP-support, the GSR index score was 87% while it was 82% without PPP-support. This implies, with PPP-support, progress towards UHC attainment can be accelerated. There was no significant association between accessing services in PPP-supported or government health facilities by perceived service delivery quality and service affordability.ConclusionPPP-supported and government health facilities co-existence is essential at hastening the progress towards UHC in the study area. The government should strengthen policies and regulations to promote more PPPs in improving health facilities’ operations.Rwanda J Med Health Sci 2022;5(2):216-232