School of Medicine, University of California San Francisco, San Francisco, California, United States of America.
Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America.
PLoS One. 2020 Mar 4;15(3):e0229666. doi: 10.1371/journal.pone.0229666. eCollection 2020.
Despite increasing political will to achieve Universal Health Coverage (UHC), there is a paucity of empiric data describing what health system indicators are useful surrogates of country-level progress towards UHC. We sought to determine what public health interventions were useful tracers of country-level UHC progress.
Across 183 countries we evaluated the extent to which 16 service delivery indicators explained variability in the UHC Service Coverage Index, (UHC SCI) a WHO-validated indicator of country-level health coverage. Dominance analyses, stratifying countries by World Bank income criteria, were used to determine which indicators were most important in in predicting UHC SCI scores.
Health workforce density ranked first overall, provision of basic sanitation and access to clean water ranked second, and provision of basic antenatal services ranked third. In analysis stratified by World Bank income criteria, health workforce density ranked first in Lower Middle Income-Countries (LMICs) (n = 45) and third in Upper Middle Income-Countries (UMICs) (n = 51).
While each country will have a different approach to achieving UHC, strengthening the health workforce will need to be a key priority if they are to be successful in achieving UHC.
尽管实现全民健康覆盖（UHC）的政治意愿不断增强，但缺乏描述哪些卫生系统指标可用作衡量国家一级向 UHC 迈进的有用替代指标的经验数据。我们试图确定哪些公共卫生干预措施可作为国家一级 UHC 进展的有用追踪指标。
我们在 183 个国家评估了 16 项服务提供指标在多大程度上可以解释 UHC 服务覆盖指数（UHC SCI）的变异性，UHC SCI 是世卫组织验证的国家一级卫生覆盖范围的指标。通过对各国进行世界银行收入标准分层的主导分析，确定哪些指标在预测 UHC SCI 得分方面最重要。
卫生人力密度总体排名第一，基本卫生设施的提供和清洁水的获取分别排名第二和第三，基本产前服务的提供排名第三。在按世界银行收入标准分层的分析中，卫生人力密度在中低收入国家（LMICs）（n=45）中排名第一，在中高收入国家（UMICs）（n=51）中排名第三。
虽然每个国家实现 UHC 的方法都不同，但如果要成功实现 UHC，加强卫生人力将是一个关键优先事项。
