Abstract Introduction As the World Health Organization’s 2030 Universal Health Coverage (UHC) deadline nears, many emerging economies remain trapped in “institutional isomorphism,” mimicking high-income structures incompatible with local financial or institutional realities. This review introduces a translational pathway to move beyond descriptive benchmarking and towards context-specific reform roadmaps. Methods Applying a dual clinical-economic lens, design principles from five high-performing systems were filtered through four dimensions: fiscal feasibility, political economy, institutional capacity, and digital maturity. This framework was applied to four anchor cases—India, Brazil, Thailand, and Rwanda—chosen to represent the diverse challenges across the Global South Results The analysis identifies “leapfrogging” pathways bypassing traditional institutional trajectories. Results prioritize primary care as the most feasible entry point, followed by national digital health identifiers and AI-augmented task-shifting. These “efficiency frontiers” allow resource-constrained systems to scale delivery and lower transaction costs without following the high-cost evolutionary paths of Western systems. Conclusion Universal Health Coverage progress depends on translating, rather than mimicking, high-income principles. By adopting phased roadmaps focused on digital–primary care integration, ministries can achieve contextually grounded, fiscally sustainable outcomes.
Anurag Markanday (Thu,) studied this question.