About the Project
Funded by the Global Health Policy and Systems Research Programme by the National Institute for Health and Care Research, the Health System Fragmentation and Universal Health Coverage in Brazil, Colombia, Mexico and India is a four-year research programme that began in 2022 and is rooted in Brazil, Colombia, Mexico and India, which are global exemplars for studying how financing fragmentation impacts health system goals, including UHC.
The way health systems are structured and financed has major implications for the quality and comprehensiveness of the services they deliver, whether patients use those services, how much they cost and who pays, and whether they deliver improvements in health outcomes. In many low- and middle-income countries (LMICs) health financing is highly fragmented. This can produce different health sub-systems within a country, each with different organizations, eligibility criteria to access services, benefit packages and premiums, payment systems and mechanisms to manage financial risk across patient populations.
This fragmentation can negatively impact health system goals including ensuring access to high quality care to all patients, irrespective of their ability to pay. Despite high levels of health financing fragmentation in LMICs, there is little evidence on its nature, drivers, consequences, and potential solutions.
Our research programme seeks to fill these evidence gaps through a range of research activities across four countries which have high levels of poverty and inequality.
Our Aims
Our research programme is especially focused on understanding the implications of financing fragmentation for vulnerable groups and how health policy can be better designed to improve their health and well-being.
In the long term, this work aims to support health system strengthening efforts not just in the four countries, but in other countries where health systems are fragmented, by building a body of translatable research practices and outputs with important insights to address fragmentation, reduce inequity in access to high-quality healthcare, and improve the health of vulnerable populations globally.
