World health report

Main messages from World health report 2013: Research for universal health coverage

What is universal health coverage?

Universal health coverage means that everyone has access to quality health services that they need without risking financial hardship from paying for them.

This requires a strong, efficient, well-run health system; access to essential medicines and technologies; and sufficient, motivated health workers.

The challenge for most countries is how to expand health services to meet growing needs with limited resources.

Why is research important for universal health coverage?

Despite a multinational commitment to universal coverage, there are many unsolved questions on how to provide access to health services and financial risk protection to all people in all settings.

Currently most research is invested in new technologies rather than in making better use of existing knowledge. Much more research is needed to turn existing knowledge into practical applications.

Many questions about universal coverage require local answers (e.g. how the system should be structured, health-seeking behaviours, how to measure progress). All countries need to be producers of research as well as consumers.

Three examples among many in the report to help progress towards universal health coverage

Bednets reduce child deaths

Surveys in 22 African countries showed that household ownership of at least one insecticide-treated mosquito net was associated with a 13-31% reduction in the mortality of children under five years of age.

Cash payments improve child health

Review of evidence from 6 countries found that conditional cash transfers, in which cash payments are made in return for using health services, resulted in an 11-20% increase in children being taken to health centres and 23-33% more children making visits for preventive healthcare.

Health care is affordable for ageing European populations

Between 2010 and 2060, the estimated annual increases in health expenditure due to ageing will be less than 1% and falling in five European countries. While the number of older people suffering chronic diseases and disability is expected to grow, the costs of health care were found to be substantial only in the last year of life.

What research trends are highlighted in the report?

More research is being done in more creative ways and the process of doing research is becoming more robust:

  • Most low- and middle-income countries now have research foundations to build on.
  • Research investment in low- and middle-income countries has grown rapidly (5% per year during the 2000s compared to zero growth in high-income countries).
  • More authors of published research are coming from emerging economies, in particular China, but also Brazil and India.
  • Increasing partnerships between universities, governments, international organizations and the private sector.

What is needed now?

The World health report 2013 calls for:

  • Increased international and national investment and support in research aimed specifically at improving coverage of health services within and between countries.
  • Closer collaboration between researchers and policymakers, i.e. research needs to be taken outside the academic institutions and into public health programmes that are close to the supply of and demand for health services.
  • Countries to build research capacity by developing a local workforce of well-trained, motivated researchers.
  • Every country to have comprehensive codes of good research practice in place.
  • Global and national research networks to coordinate research efforts by fostering collaboration and information exchange.