Universality of Universal Health Coverage: a Scoping Review

AbstractBackgroundUniversal health coverage (UHC) is achieved in the primary healthcare pathways. UHC is about population coverage, services coverage and financial protection. Tracer indicators are used to measure the progress towards UHC. There is inadequate evidence that assess the extent of the universality of UHC. Evidence is, therefore, needed to map the existing literature and summarize the issues covered in the dimensions of UHC.MethodsA systematic search was carried out in the Web of Science and PubMed databases. Hand searches were also conducted to find articles from Google Scholar, the World Bank Library, the World Health Organization Library, the United Nations Digital Library Collections, and Google. Articles on UHC coverage, financial risk protection, quality of care, and inequity were included. A stepwise approach was used to identify and select relevant studies, conduct data charting, collation and summarization, as well as report results. Simple descriptive statistics and narrative synthesis were used to present the findings.ResultsForty-seven papers were included in the final review. One-fourth of the articles (25.5%) were from the African region and 29.8% were from lower-middle-income countries. More than half of the articles (54.1%) used a quantitative research approach. Of included articles, coverage was assessed by 53.2% of articles; financial risk protection by 27.7%, inequity by 25.5% and quality by 6.4% of the articles as their main research objectives or mentioned in result section. Most (42.5%) of articles investigated health promotion and 2.1% palliation and rehabilitation services. Policy and health care level and cross-cutting barriers were identified in the progress of UHC.ConclusionsThe results of the study showed that majorities of evidence were from Africa’s region. Methodologically, the quantitative approach was a more frequently used research design to investigate UHC. Palliation and rehabilitation health care services need attention in the analysis of the progress towards UHC. The finding of the current evidence is noteworthy to focus on quality and inequity of health services in the future UHC research. Comprehensive evidence is needed to fully understand and progressively realize UHC.