Healthcare Coverage and Sector Reforms

**3**

**Chapter 1**

Reforms

**Abstract**

healthcare system.

**1. Introduction**

low- and middle-income countries

Making Universal Health

Coverage Effective in Low- and

Health sector reforms not only require attention to specific components but also a supportive environment. In low- and middle-income countries (LMICs), there is still much to be done on ensuring that people receive prioritized healthcare services. Despite LIMCs spending an average of 6% of their GDP on health, there have been minimal impacts compared to high-income countries. Health sector reform is a gradual process with complex systems; hence, the need for a vision and long-term strategies to realize the desired goals. In this chapter, we present our proposal to advance universal health coverage (UHC) in LMICs. Overall, our main aim is to provide strategies for achieving actual UHC and not aspirational UHC in LMICs by strengthening health systems, improving health insurance coverage and financial protection, and reducing disparities in healthcare coverage especially on prioritized health problems, and enhancing a primary care-oriented

**Keywords:** universal health coverage, health sector reform, health systems,

More than three-quarters of the world's population now live in low- and middle-income countries with the largest burden of infectious and non-communicable diseases [1]. Unlike the developed countries, LMICs are characterized by inadequate resources and lack of pragmatic interventions to tackle this crippling yet increasing disease burden [2]. Demographic and epidemiological transitions are fast shifting the disease burden from communicable to NCDs with LMICs contributing to more than two-thirds of the global burden of NCDs [3]. The preparedness of most LMICs to respond to these changes is questionable, with most countries still grappling with inequities in access to healthcare resulting from the pluralistic and fragmented healthcare systems [2]. As a result, most LMICs countries are currently undergoing profound health sector reforms as strongly influenced by international bodies such as the World Health Organization (WHO), World Bank,

Middle-Income Countries: A

Blueprint for Health Sector

*Peter O. Otieno and Gershim Asiki*
