Being Fair in Universal Health Coverage: Prioritize Public Health Services for Low- and Middle-Income Countries

Universal health coverage (UHC) is attaining greater significance because of the importance attributed to it by leading global health agencies at the global level and its potential to improve population health across nations. UHC is achieved when “all people receive quality health services that meet their needs without exposing them to financial hardship in paying for them.”1 The needs are relative and can mean different things for different nations. The scope of UHC is its authority to (1) expand services, (2) increase coverage, and (3) ensure financial protection for those accessing services, popularly known as the depth, breadth, and height, respectively, of the “UHC box.”1(p4) The challenge is to decide the basis by which services are prioritized among these three aspects as well as within each aspect, because UHC can be truly universal only if it caters to the real needs of nations. This is because the social, economic, cultural, epidemiological, and political context of nations should be considered while prioritizing the contents of UHC. By interpreting the needs as they pertain to low- and middle-income countries (LMICs), public health services must be prioritized over ensuring financial risk protection for exclusive inpatient services