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  • Fair financing for UHC


Fair Financing for Universal Health Coverage (UHC) - project description


The project addresses procedural fairness in all areas of health financing for universal health coverage (UHC).


The project’s primary objective is to set of criteria that can be used to examine, reform and build fair processes for decision making in health financing and offer options for institutional arrangements that can be implemented to strengthen such processes across revenue generation, pooling and purchasing.

The project’s main outputs will provide country policy makers, civil society stakeholders, and health partners with guidance that support them in improving the fairness and legitimacy of decision-making processes in health financing.

'Through case studies of implementation in real-world decision situations in health financing, this project is designed to assist policymakers, policy advisors and civil society stakeholders in identifying institutional gaps that prevent fair processes in health financing for UHC and provide options for designing such processes.

Case studies

Country Decision
India (Kerala) Financing a new model for primary care delivery
Mexico Introducing a tax on sugar-sweetened beverages
South Africa Introducing a tax on sugar-sweetened beverages
Tanzania Increasing the size of the community health fund (CHF) pools from district to regional level and harmonisation of provider payment methods and benefits across CHFs
Thailand Inclusion of diagnostics and treatments for 24 rare diseases in the UHC scheme
The Gambia Decisions about the types of taxes and setting of contribution and ce payment rates to finance a new health insurance scheme.
Ukraine Funding the programme of medical guarantees through general taxation
United Kingdom Decision-making about covid-19 vaccines


UHC Project timeline 2022.
UHC Project timeline 2022.


Norwegian Institute of Public Health
The World Bank
The World Health Organization
Bergen Centre for Ethics and Priority Setting

Project events

28 April 2022 13:30 – 14:25 CET: 
Deciding fairly: examining health financing decisions for universal health coverage in four different country contexts

This is a session event at the conference 'Fair Priorities in Unjust Circumstances' by the International Society for Priorities in Health Conference.

Policy makers, interest groups, and the public can have serious disagreements about what the fair choices are when determining the financing of health care systems. In this situation, a fair decision-making process becomes crucial for increasing the trust and legitimacy of governments and their policies. Despite this essential role of process, what criteria decision-making processes in health financing should meet to produce trusted and legitimate decisions has been a neglected area theoretically and practically.

The aim of the session is to critically discuss novel theoretical and empirical contributions to this neglected area of financing for UHC. The session will:

  • present guiding principles and practical criteria, based on ongoing expert consultations and a comprehensive literature review, that can be used to examine, reform and build fairer processes for decision-making in health financing.
  • present four case studies—from India, Mexico, Tanzania and Thailand—that have applied these criteria to health financing decisions in their settings. These presentations will especially pay attention to the opportunities and constraints to giving voice to the public and to diverse perspectives during the decision-making process, a critical feature of producing fairer processes in health financing.

More information on this session event 28 April 2022

Registration for free digital participation


Project participants

Project leader

Unni Gopinathan

Project participants

Elina Dale
Espen Movik
Steve French
Trygve Ottersen

Project number










Project manager

Project manager

Unni Gopinathan