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February 26, 2026Communications Medicine0 citationsOpen Access

Towards a nomenclature of health services for implementing universal health coverage in low- and middle-income countries

ANAlain NdayikundaRBRonald BuylFVFrank Verbeke

Key Points

  • The aim is to create a standardized nomenclature for billable healthcare services in order to facilitate Universal Health Coverage in low- and middle-income countries.
  • Conducted a needs assessment and literature review
  • Selected relevant international classification standards
  • Adapted classifications to national needs and integrated operational sub-codes
  • Validated nomenclature through stakeholder engagement
  • Developed a meta-classification producing 82,433 codes
  • Achieved coverage of 97.7% of health services relevant to UHC tracking
  • Aligned international classifications with local operational needs

Abstract

Abstract Background Achieving Universal Health Coverage (UHC) in low- and middle-income countries (LMICs) requires a robust digital infrastructure capable of monitoring healthcare services and associated costs. A major barrier is the absence of a standardized and comprehensive nomenclature for billable healthcare services. Assessment across five hospitals in Burundi confirmed this problem by showing significant inconsistencies in service naming and coding. This study presents the development of a Universal Nomenclature of Health Services (UNHS) for Burundi, a meta-classification for billable health services, designed to align international classification systems with local operational needs. Methods The methodology comprised a need assessment, literature review, the selection of relevant international standards, national adaptation, integration of operational sub-codes, and validation through stakeholder engagement. Results The developed meta-classification based on six international standards (ICD-10-PCS, CPT, HCPCS, LOINC, RxNorm, and UB04) produces 82,433 codes covering 97.7% of health services relevant to UHC tracking. Conclusions This paper details the methodology, structure, coverage, and implementation of the UNHS, offering a scalable model for improving health information system interoperability and UHC monitoring in LMICs.

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Cite This Study

Ndayikunda et al. (2026) studied this question.

synapsesocial.com/papers/699fe40c95ddcd3a253e83behttps://doi.org/10.1038/s43856-026-01455-3
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