Trend analysis and modelling of universal health coverage, Ethiopia

Abstract

9 p.Universal health coverage (UHC) remains a central global health objective, yet many countries face persistent challenges in achieving equitable access to essential services. This research article examines the attainability of the UHC service coverage target of 80% by 2030, using Ethiopia as a case study, through analysis of historical trends and projections of the universal health service coverage index and estimates the probability of achieving the target. The study analyses changes in the composite UHC index and its subindices between 2000 and 2021, and applies Bayesian projection modelling and simulation techniques to estimate future trajectories up to 2030 and 2040. Findings indicate a trajectory marked by early gains followed by recent stagnation, with steady improvements until 2015 and limited progress thereafter. Projections suggest that coverage will reach approximately 64.7% by 2030, falling short of the global target, with particularly limited gains in noncommunicable diseases and service capacity. Simulation results show that even substantial increases in health system inputs, including financing, infrastructure and workforce, would yield only modest improvements in coverage. The article highlights the need for structural reforms, strengthened governance and integrated health system approaches to accelerate progress and provides an analytical framework to inform context-specific strategies towards achieving UHC.81