Policy learning and Universal Health Coverage in low- and middle-income countries

Abstract

Learning is increasingly seen as an essential component to spur progress towards universal health coverage (UHC) in low-and middle-income countries (LMICs). However, learning remains an elusive concept, with different understandings and uses that vary from one person or organisation to another. Specifically, it appears that 'learning for UHC' is dominated by the teacher modenotably scientists and experts as 'teachers' conveying to local decision/policy-makers as 'learners' what to do. This article shows that, to meet countries' needs, it is important to acknowledge that UHC learning situations are not restricted to the most visible epistemic learning approach practiced today. This article draws on an analytical framework proposed by Dunlop and Radaelli, whereby they identified four learning modes that can emerge according to the specific characteristics of the policy process: epistemic learning, learning in the shadow of hierarchy, learning through bargaining and reflexive learning. These learning modes look relevant to help widen the learning prospects that LMICs need to advance their UHC agenda. Actually, they open up new perspectives in a research field that, until now, has appeared scattered and relatively blurry.

Israeli COVID lockdowns mildly reduced overall use of preventive health services, but exacerbated some disparities

“…The sort of data collection that we report here is more characteristic of wealthier nations, such as those in the OECD. However, low- and middle-income countries are also increasingly moving toward universal healthcare and universal data collection [ 16 , 17 ]. Therefore, while our results may be most comparable to OECD nations presently, it is likely that within a decade they can be compared with almost any country.…”

Working in low- and middle-income countries: Learning from each other

“…Many countries are making progress toward achieving Universal Health Coverage, with most LMICs being in the process of implementing strategies for essential healthcare ( Reid et al., 2020 ; Kiendrébéogo et al., 2020 ). Data suggests that in many LMICs the quality of care is sub-optimal.…”

Policymakers’ perspective on the importance of procedural fairness to implement and sustain health financing reforms

“…Once a reform is adopted and implemented, both political and technical concerns need to be fed into a continuous evaluation and redesign phase ( Roberts et al. , 2008 ) and procedural fairness should guide the process ( Kiendrébéogo et al. , 2020 ).…”