Systematic Review of Financing Functions for Universal Health Coverage in Low- and Middle-Income Countries: Reforms, Challenges, and Lessons Learned

Abstract

Objective: The systematic review reveals a lack of research on financing universal health coverage (UHC) in low- and middle-income countries (LMICs). This study aims to examine the financing mechanisms used, identify the main challenges faced, and gather insights from successful experiences to inform future reforms in LMICs. Methods: We conducted a literature search across seven academic databases, limiting our systematic review to studies published in English and French between 2010 and 2022, which were then included in our qualitative analysis. Results: A total of 45 studies met the inclusion criteria-most used qualitative (n = 23) or documentary (n = 15) approaches. The majority (n = 37) were published between 2015 and 2022. Using Kutzin's framework, we analyzed health financing functions in LMICs. Key challenges and lessons learned were summarized to improve understanding of ongoing financing issues and opportunities for reform. Conclusion: This study emphasizes key financing strategies and ongoing challenges in LMICs and provides specific recommendations for countries to prioritize reforms and address health financing gaps. The goal is to speed up progress toward UHC.

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