Most Countries Are Advancing Toward Universal Health Coverage, but Deep Gaps Remain

The drive toward universal health coverage continues to shape global health priorities, and the latest WHO–World Bank report released on 6 December 2025 offers a clear picture of both progress and persistent challenges. While most countries have strengthened access to essential services since 2000, deep inequalities remain, especially for the poorest and most vulnerable. For Ghana, these findings carry important lessons as the country works to expand access and build a resilient health system capable of protecting every household.

Globally, service coverage has grown from an index score of 54 to 71 over the past two decades, reflecting improvements in essential services such as immunization, maternal care, infectious disease control and treatment for noncommunicable diseases. The share of people facing financial hardship from out-of-pocket health payments has also dropped from 34 percent to 26 percent. These shifts point to stronger systems and, in many places, improved sanitation, rising incomes and wider social protection.

Yet the report raises serious concerns. Around 4.6 billion people still lack access to essential health services. About 2.1 billion continue to face financial hardship when seeking care, including 1.6 billion who are either living in poverty or being pushed deeper into it due to health expenses. Medicines remain one of the biggest drivers of these costs. In most countries, more than half of household out-of-pocket spending goes toward medicines, and among poorer families the share is even higher.

These global patterns mirror many realities in Ghana. Although the National Health Insurance Scheme has expanded access for millions, gaps persist, especially in rural communities and among low-income households. High out-of-pocket spending—particularly for medicines, diagnostics and specialist services—continues to place financial strain on families. For households already managing limited resources, even modest health expenses can derail essential needs, deepen vulnerability and delay timely care.

The report also shows that inequalities between population groups are widening worldwide. In 2022, three out of four people in the poorest segments faced financial hardship from health costs, compared with fewer than one in twenty among the richest. For Ghana, this highlights the need to close gaps between urban and rural populations, improve the availability of health workers in underserved areas and address barriers faced by women, youth, people with disabilities and those with lower levels of education. As in many other countries, the most vulnerable groups—including displaced populations and those in informal settlements—are often not fully captured in national monitoring data.

Progress has been strongest in infectious disease control globally, while improvements in reproductive, maternal, newborn and child health have been modest. Ghana has made notable gains in reducing maternal and child mortality, but sustaining these achievements requires consistent investment in primary care, emergency referral systems and essential commodities. As the burden of noncommunicable diseases grows, the health system must also adapt to provide long-term, affordable and continuous care.

Looking ahead to 2030, the report notes that the world is not on track. Even with ongoing efforts, the global service coverage index is projected to reach only 74 out of 100. Nearly one in four people will still face financial hardship from health costs. For Ghana, this is a reminder that maintaining progress will require both political commitment and targeted reforms.

The report outlines six core actions to accelerate progress. Several of these align directly with Ghana’s health priorities:

Remove cost barriers for the poorest households by ensuring essential services are free at the point of care and by strengthening exemptions under the NHIS.

• Increase public investment in health systems, particularly at the primary care level where the majority of health needs are met.
• Address the high cost of medicines by improving procurement systems, reducing stockouts and expanding access to affordable generics.
• Scale up essential services for noncommunicable diseases, including screening, early detection and consistent treatment.
• Strengthen primary health care to improve equity, efficiency and continuity of care, especially in rural districts.
• Promote multisectoral action, recognizing that determinants of health—such as education, water and sanitation, income security and environmental safety—extend beyond the health sector.

For Turning Point Foundation, this report reinforces the ongoing need for advocacy, community education and policy engagement. Ghana’s commitment to universal health coverage is clear, but the next phase of progress will depend on protecting households from financial hardship and ensuring that quality services reach every community.

As Ghana moves toward 2030, the goal remains unchanged: a health system that delivers equitable, affordable and reliable care for all. The data shows that progress is possible, but it also reminds us that achieving true universality requires sustained leadership, informed reforms and strong community partnerships.