Is the progress of universal health care associated with changes in childhood vaccination rates? Study analyzed how childhood immunization coverage differed during the COVID-19 pandemic among countries with varying universal health coverage – ScienceDaily

A new study published August 16 in the journal Open Access PLOS medicine By Yesim Tozan, New York University School of Global Public Health, USA, and colleagues.

Several previous studies have indicated that UHC strategies improve health service coverage, utilization and outcomes, and lead to improvements in population health. However, a robust quantitative assessment of the effects of UHC on health system performance and outcomes has been challenging, given that many systems-level contextual factors confound the relationship.

In the new study, the researchers used the COVID-19 pandemic as a natural experiment to compare differences in childhood immunization coverage based on countries’ progress toward universal health coverage. The immunization data was derived from the WHO-UNICEF Joint Estimates data set on national immunization coverage, which includes information on 195 countries and 14 vaccinated children between 1997 and 2020. The 2019 Universal Health Coverage Service Coverage Index (UHC SCI), a measure that represents Coverage indicators for a range of health services over the lifespan, it was used to divide countries into the Universal Health Coverage Index group and the rest.

The researchers found that countries with the UHC index were associated with a 2.7% lower decline in childhood immunization coverage during 2020 than countries with the UHC index, after adjusting for potential confounders (95% CI 0.75-4.65, p = 0.007). In the pre-pandemic period, countries with a high UHC index had a childhood vaccination coverage rate of 92.7% while countries with a lower health coverage index had a coverage rate of 86.2%. During the 2020 epidemiological year, the coverage rate of countries with a high UHC index was 91.9%, while the coverage rate in countries with a low UHC index was 81.7%.

“Our findings strongly suggest that policymakers should continue to advocate for policies aimed at achieving UHC in the coming years,” the authors say. “This study also paves the way for future research in understanding the synergistic impact of investments in global health security and universal health coverage strategies on health system resilience in countries.”

“The COVID-19 pandemic has affected the delivery of essential health services across countries all over the world,” adds Tozan. “This study provided much-needed quantitative evidence for the protective effects of UHC in times of public health crisis, supporting policy recommendations for sustained political commitment and investments for UHC to build resilient health systems.”

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