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Accountability mechanisms will be decisive in determining whether the needs of marginalised and vulnerable communities are met as countries, and other stakeholders, work to attain the goal of Universal Health Coverage (UHC). While equity is inherent in the definition of UHC – whereby all people receive the (preventive, promotive, curative, and rehabilitative) health services that they need without risk of financial hardship – there are inevitable trade-offs in policy and programming choices along the pathway towards UHC. Such decisions are highly political and they determine who benefits and who is left behind. This makes multi-stakeholder accountability mechanisms – that facilitate the cycle of monitoring, review and remedial action, and advance the principles of human rights, transparency, and participation – ever more important to ensure that UHC is de facto a movement for health equity.

The International Health Partnership for UHC 2030 (UHC2030) is committed to strengthening accountability for UHC, and we welcome this IDS Bulletin that brings to the fore concrete experiences that advance our understanding of the complex nature of accountability for health equity. This IDS Bulletin makes clear the importance of political economy that determines how choices are made and the longitudinal patterns of change. It acknowledges the proliferation of actors with divergent interests that influence power dynamics and can distort the social contract. And it showcases country experiences of navigating and negotiating these complex contextual realities to advance accountability for health equity. As a multi-stakeholder partnership we look to learn from this evidence in our efforts to strengthen accountability for transformational, pro-equity progress towards UHC.

The International Health Partnership for UHC 2030 (UHC2030) Core Team


© 2018 The Authors. IDS Bulletin © Institute of Development Studies | DOI: 10.19088/1968-2018.130

This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited. http://creativecommons.org/licenses/by/4.0/legalcode

The IDS Bulletin is published by Institute of Development Studies, Library Road, Brighton BN1 9RE, UK

This article is part of IDS Bulletin Vol. 49 No. 2 March 2018: 'Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage'; the Introduction is also recommended reading.