Governance Functions to Accelerate Progress toward Universal Health Coverage (UHC) in the Asia-Pacific Region

Abstract

Many countries in the Asia-Pacific region have committed to universal health coverage (UHC), which is reflected in both their political commitment and the governance actions they have taken in steering their health systems toward the goals of universal access to care and protection from financial hardship. Countries throughout the region are at different stages of development and have different political and governance contexts, which in turn shape how they pursue governance for UHC. This article reviews the governance functions deployed in the Asia-Pacific and finds that, in many, governance reforms adapting their health systems toward greater regulation, accountability, oversight, and stewardship of the health system have been part of their wider move toward UHC. Countries have not followed a set pattern, but shared aspects include establishing UHC as a goal in national policy making and priority setting; the creation of new roles and/or new institutions within the health system; establishing systems of monitoring and evaluation; and putting in place mechanisms to facilitate collaboration and ensure greater accountability. The relationship between governance and UHC in the Asia-Pacific region is found to be complex, negotiated, and shaped by a number of factors in both the internal and external environment, including broader governance arrangements in the public sector (institutional changes and decentralization are particularly prominent factors) and the ability of governments to implement policies and steer the health system.