|Short Summary (max 1000 chars):
Universal coverage is a process, not a fixed point that can eventually be achieved. It is important to consider the trajectory of universal coverage over time. It is especially critical to put in place early the necessary elements, if only because of the political economy of trying to introduce more universal arrangements once there are many adherents to separate arrangements within a country. These elements include the appropriate combination of financing sources, putting in place a strong purchasing role encompassing both public and private providers and including emphasis on health promotion and prevention, payment systems with appropriate incentives for cost containment and quality of care, and strong primary-care and “district-” (local-) level infrastructure with good geographical access. In the absence of this strong local infrastructure, universal coverage will not sufficiently benefit the poorer groups in a population. As the whole purpose of universal health coverage is to cover the entire population with a good degree of equity, giving initial priority to improving access to a local infrastructure of services is critical.