Health Financing

Universal Health Care
in Challenging Times:
Leaving No-one Behind

Adapting policies & programmes for resilient, equitable & sustained progress towards UHC – emphasizing poor & left-behind populations in Brazil, India, Indonesia & South Africa.


Universal health coverage (UHC) is where all people have access to the health services they need, when and where they need them, and without financial hardship. Although strides towards UHC have been made, many challenges remain owing to recent global events.

The COVID-19 pandemic has highlighted at the global level the social and economic importance of health and UHC. The collaborative research programme builds directly on the work of the University of York’s NIHR Global Health Econometrics and Economics Group (GHE2), which focused upon Brazil, Indonesia and South Africa. For the Unit, India is included as an additional research location. These four ‘middle-income’ countries comprise nearly two billion people and 45% of the world’s population living in absolute poverty.

HFACT will use the tools and perspectives of health financing and economics to carry out in-depth, policy-relevant analyses on specific health finance, related topics, engage with communities and stakeholders, and conduct capacity building.

The Unit’s research will comprise the analysis of existing data, modelling, primary data collection and policy evaluation, shared across four policy themes and four cross-cutting methodological areas.

Our Aims

The long-term aim of HFACT is the strengthening of capacity in Brazil, India, Indonesia and South Africa to adapt health financing policies and programmes for resilient, equitable and sustained progress towards UHC. We will place particular emphasis on the poor and left-behind populations in the four large middle-income countries.

HFACT will pursue four objectives to achieve the overall aim:

Our research

Strengthening access to UHC

Our research centres around the question: How can countries’ health financing and resource allocation strategies be strengthened to accelerate the achievement of UHC objectives, with a focus on left-behind groups?

Health financing is a key means to achieving UHC, and it is more than just raising money for health services. It involves deciding how to spend money in the health system, setting the right financial incentives for healthcare providers, and ensuring access to healthcare for all. While crucial to achieving UHC, health financing is often insufficient in LMICs. Sometimes economic resources are not appropriately prioritized for health financing, and sometimes decision makers have limited expertise.

HFACT will deliver a programme of novel research involving:

Our programme of research will be shared across four policy themes and four methodological areas. The Policy themes and methods areas will work together to ensure the application and development of rigorous, innovative methods to address the challenges identified.

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