Examining the association between service coverage of UHC and global disease burden: A cross-country panel analysis

Tisha Chakma, Suzana Karim and Atonu Rabbani

Social Science & Medicine, 2025, vol. 369, issue C

Abstract: Over the past two decades, numerous countries have enhanced their Universal Health Coverage (UHC), as indicated by the UHC Service Coverage Index (SCI), alongside a global reduction in the disease burden measured by Disability-Adjusted Life Years (DALYs). This paper uses a cross-country panel of 190 countries from 2000 to 2019 to identify the association between UHC SCI and DALYs gain. We find that a one-unit increase in the UHC SCI was associated with a significant decrease in total DALYs. Furthermore, UHC SCI was mostly associated with lowering DALYs from communicable, maternal, neonatal, and nutritional diseases but showed little to no significant association with non-communicable diseases or injuries. These results are robust to various robustness tests. Notable reasons include governments spending more on communicable, maternal, neonatal, and nutritional diseases than on non-communicable diseases and injuries, which is also the case for external aid. Our results also suggest that moving towards UHC helps lower-income countries more than higher-income countries, as developed nation-states have already established a well-functioning health system. Addressing non-communicable diseases and injuries will be essential to improve health outcomes and achieve SDGs in future.

Keywords: Universal health coverage; Disability-adjusted life years; Communicable disease; Non-communicable disease; Injuries; Cross-country panel data (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1016/j.socscimed.2025.117832

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