追踪全民健康覆盖：2025年全球监测报告

© World Health Organization and the International Bank for Reconstruction andDevelopment / The World Bank, 2025. All rights reserved. This is an advance proof. The content of this document is not final, and the text may be subjectto revisions before publication. The document may not be reviewed, abstracted, quoted,reproduced, transmitted, distributed, translated or adapted, in part or in whole, in any formor by any means without the permission of the World Health Organization. © World Health Organization and the International Bank for Reconstruction andDevelopment / The World Bank, 2025. All rights reserved. This is an advance proof. The content of this document is not final, and the text may be subjectto revisions before publication. The document may not be reviewed, abstracted, quoted,reproduced, transmitted, distributed, translated or adapted, in part or in whole, in any formor by any means without the permission of the World Health Organization. Contents Acknowledgementsvii Introduction: A revised and improved monitoring frameworkfor universal health coverageDRAFT Chapter 1: Progress towards UHC11 1.1.The world progressed on both UHC pillars, but progress has slowed in the SDG era121.2.Progress on indicator components was uneven131.3.Despite global progress, large UHC shortfalls persist151.4.Results across country income groups converged slowly, but importantdisparities remain181.5.All regions raised service coverage, and half reduced financial hardship191.6.The revision of indicators influences findings in both UHC dimensions21 Chapter 2: Deep dive on service coverage25 2.1.Infectious disease indicators drove progress on the UHC service coverage index262.2.Between-country inequalities in service coverage narrowed, but more slowly after 2015 282.3.Inequalities in forgone care and unmet need hamper UHC progress30 Chapter 3: Deep dive on financial hardship35 3.1.Poverty reduction drove progress in reducing impoverishing OOPhealth spending, but gains were uneven363.2.Socio-demographic factors amplify disparities413.3.Sex of household head and rural-urban residence443.4.In most countries, spending on medicines is the largest componentof OOP health spending45 Conclusions49 Annexes Annex 1. Methods to calculate the UHC service coverage index, SDG 3.8.1,additional analyses and data availability61Annex 2. Data availability and global/regional aggregation methods for financial hardship68Annex 3. Sustainable Development Goal (SDG) indicators of universal healthcoverage (UHC) by location, most recent year available74Annex references82 List of tables Table 0.1. Revisions to UHC service coverage index tracer indicator3Table 0.2. Revisions to SDG indicator 3.8.2 and complementary indicators5Table 1.1. After 2015, 3 out of 4 country-income groups made gains in service coverage andreduced financial hardship, with the fastest progress in low-income countries18Table 1.2. From 2015 to 2022/2023, half of the WHO regions progressed or held steadyin all components of the SDG UHC indicators20Table A1.1. Data sources used in the calculation of the UHC SCI (SDG 3.8.1)61Table A1.2. Availability of primary data by WHO region and globally, 2019–202367Table A2.1. Availability of survey-based estimates for financial hardship (SDG 3.8.2)68Table A2.2. Average number and frequency of survey-based estimatesfor financial hardship (SDG 3.8.2)69Table 1.3. Comparison of trends presented in Global monitoring reports, 2023 and 202522DRAFT List of figures Fig. 1. Global trends in UHC service coverage index (top) and financial hardship (bottom),2000–2022/2023xvFig. 2. Global annual rates of progress, 2000–2015 and 2015–2022/2023xviFig. 3. Global estimates and projected values of UHC pillars to 2030xviFig. 0.1. Financial hardship and financial barriers to accessing health care6Fig. 1.1. UHC progress is too slow: at the current pace, service coverage will remainunder 80, and nearly 1 in 4 people will face financial hardship in 203012Fig. 1.2. Since 2000, infectious disease control and lower impoverishing OOP have drivenUHC gains – but progress in both slowed after 201514Fig. 1.3. Midway through the SDG era, over half of the world was not yet fully coveredby essential health services, and more than a quarter of all people facedfinancial hardship16Fig. 1.4. Since 2000, more than half of countries have improved service coverage andreduced financial hardship – but since 2015, fewer than 4 in 10 have done so17Fig. 2.1. Three tracer indicators accounted for more than three-quarters of changein the global SCI, 2000 to 202327 Fig. 2.2. Progress in basic sanitation led SCI gains in half of WHO regions, 2000 to 202328 Fig. 2.3. Between-country inequalities in service coverage narrowed globallyand across WHO regions, but gains have slowed after 201529Fig. 2.4. Change in inequalities in the proportion of women experiencing problems inaccessing health care across 38 low- and middle-income countries, 2004–2013and 2014–202331Fig. 2.5. Inequ