Progress towards universal health coverage and health-system performance in ECSAHC member states (2015-2025)

Abstract

Universal Health Coverage (UHC) is a central indicator of health-system performance and equitable access to essential services. This paper assessed progress towards UHC across nine member states of the East, Central, and Southern Africa Health Community (ECSA-HC) between 2015 and 2025. We conducted a regional comparative descriptive analysis using secondary data from global databases and national surveys from the nine ECSA-HC member states. Results indicate improvements in life expectancy, maternal and child health outcomes, and HIV treatment coverage, alongside steady economic growth in several countries. However, persistent challenges remain, including health workforce shortages, high out-of-pocket expenditures, and a rising burden of non-communicable diseases. Strengthening domestic health financing, workforce capacity, and integrated health services will be essential to accelerate progress toward UHC in the region.