Achieving universal healthcare in 52 countries


Through the Achieving Sustainability through Local Health Systems (ASLHS) activity, Abt and its partners will focus on improving access to essential health services by:

  • reducing financial barriers;
  • ensuring equitable access by poor, underserved and socially excluded populations; and
  • improving service quality for patients and ensuring that care meets minimum standards. 

Throughout the project, Abt and its partners will work with local public and private sector organisations to co-design solutions that address impediments to health system performance. The project will use a country-led implementation approach that accelerates progress toward UHC and establishes countries capacity to sustain that progress. 

Low- and middle-income countries are committed to universal health cover (UHC) and better primary health care, but steps must be taken to support their getting there. Governments and health providers have to become more accountable. Health financing needs to be improved so people don’t risk financial crisis when they seek health care. Poor, underserved, and socially excluded groups must be ensured equitable access to health care. And more attention must be paid to quality, so that essential health services do what they’re meant to do: improve health and survival.

Interventions will focus on reducing financial barriers, holding health services accountable for meeting all clients’ needs and making sure that the care patients receive meets minimum standards. With an eye toward empowering countries to transition away from donor support, the project will team with local organisations to conduct joint capacity assessments and co-design interventions, with local organisations leading implementation.

The US$209 million, five-year project began in August 2019 and runs through 2024. Results will be reported as they are achieved.  It is unlikely this will significantly affect medical travel in the short term.  In terms of global healthcare access, currently:

  • At least half of the world’s population still do not have full coverage of essential health services.
  • About 100 million people are still being pushed into extreme poverty (defined as living on US$1.90 or less a day) because they have to pay for health care.
  • Over 800 million people (almost 12% of the world’s population) spent at least 10% of their household budgets to pay for health care.
  • All UN Member States have agreed to try to achieve universal health coverage by 2030, as part of the Sustainable Development Goals.



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