Canada is the leading country worldwide for essential healthcare coverage, according to the World Health Organization. The WHO ranked 195 countries and territories based on a selection of indicators of key health concerns such as reproductive, maternal, newborn and child health, infectious diseases, noncommunicable diseases and service capacity and access. This ranking focuses on coverage of services and not necessarily the entire system's performance, which means it does not take into account issues such as long wait times for primary and specialist care.
The WHO is monitoring universal health coverage by tracking two main indicators worldwide: the coverage of essential health services (SDG 3.8.1) and the lack of financial protection (SDG 3.8.2), which is defined as the “proportion of a country’s population with large household expenditures on health relative to their total household expenditure.”
This is in order to support the UN's aim of achieving universal health coverage by 2030, which includes financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines. As the WHO explains, this is because "protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because the cost of needed services and treatments requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children."
While this chart only reflects the coverage element of UHC, it still serves to highlight how global inequalities persist in terms of that access. Where Canada received a total score of 92 index points out of 100 in 2023, followed by Iceland with 90 points and then Norway, New Zealand and Australia, each with 89 points, this is a stark contrast to countries at the other end of the spectrum such as Ethiopia (33), Madagascar (33), Papua New Guinea (32), Chad (26) and Somalia (30).
It’s also important to note here that since this data focuses on a nationwide level, it hides regional inequalities within countries and communities. For example, according to the WHO, coverage of reproductive, maternal, child and adolescent health services tends to be higher among those who are richer, more educated and living in urban areas, especially in low-income countries, while people living in poorer households, rural areas and in households with older family members are more likely to be further pushed into poverty by out-of-pocket health spending.
In terms of tracking overall global trends, WHO researchers outline how improvements to health services coverage have slowed since 2015, rising only three index points to 68 by 2019, before climbing up to 71 points in 2023. This is the equivalent to about 4.6 billion people living without full coverage of essential health services in 2023. Meanwhile, in 2022, out-of-pocket health spending pushed 2.1 billion into financial hardship in health.
December 12 marks the UN's International Universal Health Coverage Day.
