Current situation and projection of universal health coverage for 66 countries participating in the Belt and Road Initiative

  Objective  To evaluate the performance of universal health coverage (UHC) in 65 countries participating in the Belt and Road Initiative (BRI).

  Methods  Using the open access data of Global Burden of Disease (GBD) study, we first got the UHC index values of the 66 countries (including China) from 1990 – 2017 and transformed the values into a scale of 0 – 100 in percentile. We then examined the association of UHC index scores with socio-demographic index (SDI) values. Finally, we used annualised rates of change during 1990 – 2017 to forecast achievement of the United Nation (UN) UHC target by 2030 for sustainable development goals (SDG) in each country.

  Results  The integral median of UHC index score in 2017 was 75.3 for the 66 countries. China was scored as 80.8, ranking 22th in the countries. The country with the highest UHC index (100) was Cyprus and that with the lowest (40) was Afghanistan. A significant positive correlation (r = 0.89) between UHC index scores and SDI values was observed. It is estimated that only Cyprus and Singapore would meet the SDG target on UHC by 2030, and China would meet the SDG by 2031.

  Conclusion  The performance of UHC is unbalanced by country among countries participating in BRI. In general, the countries with higher development have a better UHC.