Defining Pathways and Trade-offs Toward Universal Health CoverageComment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage"

Abstract

The World Health Organization's (WHO's) World Health Report 2010, "Health systems financing, the path to universal coverage, " promoted universal health coverage (UHC) as an aspirational objective for country health systems. Yet, in addition to the dimensions of services and coverage, distribution of coverage in the population, and financial risk protection highlighted by the report, the consideration of the budget constraint should be further strengthened in the ensuing debate on resource allocation toward UHC. Beyond the substantial financial constraints faced by low-and middle-income countries, additional considerations, such as the geographical context, the underlying country infrastructure, and the architecture of health systems, determine the feasibility, effectiveness, quality and cost of healthcare delivery. Therefore, increased production and use of local evidence tied to the criteria of health benefits, equity, financial risk protection, and costs accompanying health delivery are needed so that to highlight pathways and acceptable trade-offs toward UHC.

Activity-based costing of health-care delivery, Haiti

“…Understanding the cost of health-care delivery is essential for guiding resource allocation decisions that have direct implications for patient care and health outcomes. 1 Optimizing resources available for patients is particularly important in low-resource settings. In these settings, tough decisions are unavoidable as human and financial resources allocated to one particular programme necessarily, if implicitly, reduces the availability of resources for other programmes.…”