Annual report on monitoring progress on UHC and health-related SDGs

This tenth annual report on monitoring progress towards universal health coverage (UHC) andthe health-related Sustainable Development Goals (SDGs) in the WHO SE Asia Regionresponds to the mandate from the Seventieth Session of the WHO Regional Committee forSE Asia in 2017.The report presents the latest evidence in tracking the progress towards UHC via SDGtarget 3.8, which aims to ensure that all individuals and communities receive the healthservices they need without financial hardship. It is based on the two UHC indicators: 3.8.1,the UHC Service Coverage Index (UHC SCI), and 3.8.2, the proportion of the populationfacing catastrophic health expenditures. Between 2010 and 2021, the regional UHC SCIimproved from 47 to 62, reflecting progress in service delivery. However, this trajectoryremains insufficient to reach the global targeted benchmark of 80 by 2030. Meanwhile,financial protection has deteriorated, with the percentage of the population incurringcatastrophic out-of-pocket spending rising from 13.1% in 2010 to 16.1% in 2019.While the SE Asia Region continues to show significant progress in maternal, neonatal,and child health, immunization coverage, and the control of select infectious diseases such asHIV/AIDS and malaria, overall progress remains uneven. Major challenges persist particularlyin the burden of noncommunicable diseases (NCDs) and mental health conditions, and apersistently high tuberculosis (TB) incidence. Regrettably, the Region is also off track toachieve universal access to clean water and safely managed sanitation services by 2030,posing incremental risks to public health and equity.The thematic focus of this year’s report is on the regional progress in ’Strengtheningthe role of the health sector for improving civil registration and vital statistics (CRVS) in the SEAsia Region (2015–2024)’. CRVS systems are the cornerstone of population health monitoringand most essential to track progress across multiple SDG targets. Over the past decade, trendsin birth registration have varied: some countries reached close to univeral or sustained highcoverage, while others faced stagnation or setbacks, particularly during the COVID-19pandemic period.Completeness of death registration remains inconsistent across the Region, withcomprehensive data available in only a few countries. This hampers tracking of measurementof mortality related to maternal and child (SDG 3.1 and SDG 3.2), communicable (SDG 3.3),noncommunicable diseases (SDG 3.4), road traffic injuries (SDG 3.6), and environmentalhealth risks (SDG 3.9). Without complete and reliable death data, countries cannot fully assessor respond to their public health challenges.A key impediment is the lack of timely, medically-certified, cause of death (CoD) data,especially for deaths occurring outside health facilities. WHO SEARO continues to supportMember States in addressing these gaps through the adoption of ICD-11, strengtheningcertification practices, and expanding the use of verbal autopsy methods. A robust healthsector role in CRVS — including routine notification, certification, and integration with healthinformation platforms — is essential to ensure that every birth and death is counted, andmedical cause of death recorded. This informs policy, programmes and planning.The evidence presented in this report supports the extension of the mandate of theRegional CRVS Strategy to 2030, with a final report to be submitted in 2031 to the Eighty-Fourth Regional Committee. This will mark the conclusion of the Asian and Pacific CivilRegistration and Vital Statistics Decade. Member States’ concurrence with this proposal willenable WHO to continue supporting their vision and policy actions for building inclusive andresilient CRVS systems, and for advancing the realization of population rights to equitableand responsive health care.The attached Working Paper was presented to the High-Level Preparatory (HLP)Meeting/Meeting of the Subcommittee for Policy and Programme Development andManagement (SPPDM) for its review and recommendations. The HLP/SPPDM Meetingsreviewed the paper, deliberated in detail on the Agenda, and made the followingrecommendations for consideration by the Seventy-eighth Session of the RegionalCommittee:Actions by Member States(1) Enhance public investments, and strengthen financial protection mechanisms.(2) Strengthen comprehensive quality PHC to accelerate progress towards UHC andother health-related SDGs.(3) Scale up equitable access to essential services, particularly in underserved areasincluding use of mechanisms such as tele-medicine.(4) Expand NCD prevention and treatment, and mental health support systems.(5) Sustain gains in CRVS including cause of death registration, health workforce, andinfrastructure.(6) Strengthen interoperable health information systems to guide policy andprogramme.Actions by WHO(1) Provide technical support for ICD-11 implementation and CRVS strengtheningincluding for cause of death recording for domiciliary deaths.(2) Facilitate cross-country learning and experience sharing (e.g. Thailand’s reforms,Maldives’ financing model).(3) In the report, indicate clearly the alignment of the UHC and SDG efforts withGPW14 priorities.(4) As much as possible to present trend analyses on the progress on the healthindicators and health-related SDGs.The Working Paper along with the HLP Meeting recommendations are placed beforethe Seventy-eighth Session of the WHO Regional Committee for South-East Asia for itsconsideration, as appropriate.