Quality first for effective universal health coverage in low-income and middle-income countries

The UN has set universal health coverage (UHC) as a target for Sustainable Development Goal (SDG) 3.8, to be achieved by 2030.1 The dimensions of UHC run along three axes: the population that is covered by pooled funds, the proportion of direct health costs covered by pooled funds, and the health services included. However, as use of health services increases and, at the same time, the burden of disease in low-income and middle-income countries (LMICs) shifts greatly to more complex conditions such as non-communicable diseases (NCDs), quality of health services rather than access alone appears as a key determinant for improving population health and reducing disease burden.