Trend analysis and modelling of universal health coverage, Ethiopia

Child and Adolescent Health

Mental Health

Author

Assefa, Y., Gelaw, Y. A., Endalamaw, A., Wolka, E., & Zewdie, A

Doi

http://dx.doi.org/10.2471/BLT.24.292995

Citation (Vancouver)

Assefa Y, Gelaw YA, Endalamaw A, Wolka E, Zewdie A. Trend analysis and modelling of universal health coverage, Ethiopia. Health System. 2025; doi: http://dx.doi.org/10.2471/BLT.24.292995.

Abstract

Objectives

To investigate the attainability of the 2030 universal health coverage (UHC) target of 80% using Ethiopia as a case study.

Methods

We examined trends in Ethiopia’s universal health service coverage index and its subindices between 2000 and 2021 in Ethiopia. To assess long-term progress, we projected coverage to 2030 and 2040 using Bayesian mode

Findings

Ethiopia’s universal health service coverage index increased steadily from 2000 to 2015 and slowed between 2015 and 2019 before progress stalled between 2019 and 2021. Projections indicate the country will achieve a UHC index of 64.7% by 2030, failing to meet the 80% target. Projected subindex values for 2030 were 68.4% for reproductive, maternal, neonatal and child health and 66.1% for infectious diseases but only 58.5% for noncommunicable diseases. Simulation modelling indicated that doubling health system inputs would only modestly increase UHC and that the 80% target is unlikely to be reached before 2040. ### Conclusions

The trajectory of UHC in Ethiopia reflects both achievements and persistent gaps in health services. Modelling suggests that boosting health system inputs alone will be insufficient to reach the 80% coverage target by 2030. Structural reforms, better governance and greater system integration are required. The modelling framework used could help other countries assess progress and design context-specific, equitable pathways towards UHC.