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A landscape analysis of universal health coverage for mothers and children in South Asia
  1. Katy Scammell1,
  2. Douglas J Noble1,
  3. Kumanan Rasanathan2,
  4. Thomas O'Connell2,
  5. Aishath Shahula Ahmed3,
  6. Genevieve Begkoyian4,
  7. Tania Goldner5,
  8. Renuka Jayatissa6,
  9. Lianne Kuppens7,
  10. Hendrikus Raaijmakers8,
  11. Isabel Vashti Simbeye9,
  12. Sherin Varkey10,
  13. Mickey Chopra2
  1. 1UNICEF Regional Office for South Asia, Kathmandu, Nepal
  2. 2UNICEF Headquarters, New York, New York, USA
  3. 3UNICEF Maldives, Male, Maldives
  4. 4UNICEF India, New Delhi, India
  5. 5UNICEF Pakistan, Islamabad, Pakistan
  6. 6UNICEF Sri Lanka, Colombo, Sri Lanka
  7. 7UNICEF Bangladesh, Dhaka, Bangladesh
  8. 8UNICEF Nepal, Kathmandu, Nepal
  9. 9UNICEF Bhutan, Thimpu, Bhutan
  10. 10UNICEF Afghanistan, Kabul, Afghanistan
  1. Correspondence to Dr Douglas J Noble; djnoble{at}unicef.org

Abstract

The United Nations made universal health coverage (UHC) a key health goal in 2012 and it is one of the Sustainable Development Goals' targets. This analysis focuses on UHC for mothers and children in the 8 countries of South Asia. A high level overview of coverage of selected maternal, newborn and child health services, equity, quality of care and financial risk protection is presented. Common barriers countries face in achieving UHC are discussed and solutions explored. In countries of South Asia, except Bhutan and Maldives, between 42% and 67% of spending on health comes from out-of-pocket expenditure (OOPE) and government expenditure does not align with political aspirations. Even where reported coverage of services is good, quality of care is often low and the poorest fare worst. There are strong examples of ongoing successes in countries such as Bhutan, the Maldives and Sri Lanka. Related to this success are factors such as lower OOPE and higher spending on health. To make progress in achieving UHC, financial and non-financial barriers to accessing and receiving high-quality healthcare need to be reduced, the amount of investment in essential health services needs to be increased and allocation of resources must disproportionately benefit the poorest.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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