Health Procurement and Universal Health Coverage: A Narrative Review on Equity from Policy to Patients
Article Sidebar
Main Article Content
Abstract
Universal Health Coverage (UHC) is a global goal that seeks to ensure everyone can access quality healthcare without facing financial strain. A key factor in achieving this is strong health system governance, especially in how drugs, vaccines, and medical technologies are procured. In practice, however, procurement often encounters challenges that limit patient access. For example, in Indonesia, policies favoring a single supplier and prioritizing the lowest price have led to substandard medicines, shortages, and uneven distribution, worsening healthcare inequalities. Emerging procurement strategies offer promising solutions. Pooled procurement can lower costs and improve the availability of essential health products, while e-procurement increases transparency and streamlines administrative processes. Strategic purchasing allows resources to be allocated more effectively, focusing on priority health needs, service quality, and financial protection for the public. Strengthening these procurement systems is crucial for connecting policy intentions with real-world healthcare access and advancing UHC.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
[1] World Health Organization. (n.d.). Strategic purchasing for universal health coverage: Key policy issues and questions. WHO. Retrieved from https://www.who.int/publications/i/item/strategic-purchasing-for-universal-health-coverage-key-policy-issues-and-questions
[2] World Health Organization. (n.d.). Equity. WHO. Retrieved from https://www.who.int/health-topics/universal-health-coverage/equity?utm_source=chatgpt.com#tab=tab_1
[3] Mbwasi, R., Mbepera, D., Mfuko, W., Makanzo, J., Kikwale, M., Canavan, R., Stoermer, M., & Wiedenmayer, K. (2022). Assessing public–private procurement practices for medical commodities in Dar es Salaam: A situation analysis. BMC Health Services Research, 22, Article 1523. https://doi.org/10.1186/s12913-022-08923-1
[4] Parmaksiz, K., Pisani, E., Bal, R., et al. (2022). A systematic review of pooled procurement of medicines and vaccines: Identifying elements of success. Global Health, 18, Article 59. https://doi.org/10.1186/s12992-022-00847-z
[5] Gatome-Munyua, A., Sieleunou, I., Sory, O., & Cashin, C. (2022). Why is strategic purchasing critical for universal health coverage in Sub-Saharan Africa? Health Systems & Reform, 8(2), e2051795. https://doi.org/10.1080/23288604.2022.2051795
[6] Wulandari, L. P., Aung, K. T., & Wahyuni, S. (2021). Challenges in maintaining medicine quality while aiming for universal health coverage: A qualitative analysis from Indonesia. BMJ Global Health, 6(4), Article e006873. DOI: 10.1136/bmjgh-2020-003663
[7] Mbwasi, R., Mbepera, D., Mfuko, W., Makanzo, J., Kikwale, M., Canavan, R., Stoermer, M., & Wiedenmayer, K. (2022). Assessing public–private procurement practices for medical commodities in Dar Es Salaam: A situation analysis. BMC Health Services Research, 22, Article 1523. https://doi.org/10.1186/s12913-022-08923-1
[8] Kohler, J. C., & Wright, T. (2020). The urgent need for transparent and accountable procurement of medicine and medical supplies in times of COVID-19 pandemic. Journal of Pharmaceutical Policy and Practice, 13, Article 58. https://doi.org/10.1186/s40545-020-00256-w
[9] Griffore, K. A., Bowra, A., Guilcher, S. J. T., & Kohler, J. (2023). Corruption risks in health procurement during the COVID-19 pandemic and anti-corruption, transparency and accountability (ACTA) mechanisms to reduce these risks: A rapid review. Globalization and Health, 19, Article 91. https://doi.org/10.1186/s12992-023-00994-x
[10] Parmaksiz, K., Pisani, E., Bal, R., & Kok, M. O. (2022). A systematic review of pooled procurement of medicines and vaccines: Identifying elements of success. Globalization and Health, 18, Article 59. https://doi.org/10.1186/s12992-022-00847-z
[11] Zhao, B. (2025). Impact of pooled procurement of medicines on patient adherence and economic burden: Evidence from China. Journal of Global Health, 15, Article 04229. https://doi.org/10.7189/jogh.15.04229
[12] Carter of Coles, L. (2016, February). Operational productivity and performance in English NHS acute hospitals: Unwarranted variations [Independent report for the Department of Health]. Department of Health, UK. Retrieved from
[13] World Health Organization. (n.d.). Strategic purchasing for universal health coverage: Key policy issues and questions. WHO.
[14] Tangcharoensathien, V., Limwattananon, S., Patcharanarumol, W., Thammatacharee, J., Jongudomsuk, P., & Sirilak, S. (2015). Achieving universal health coverage goals in Thailand: The vital role of strategic purchasing. Health Policy and Planning, 30(9), 1152–1161. https://doi.org/10.1093/heapol/czu120
[15] Ekirapa-Kiracho, E., Ssennyonjo, A., Cashin, C., Gatome-Munyua, A., Olalere, N., Ssempala, R., Mayora, C., & Ssengooba, F. (2022). Strategic purchasing arrangements in Uganda and their implications for universal health coverage. Health Systems & Reform, 8(2), Article e2084215. https://doi.org/10.1080/23288604.2022.2084215
[16] Gatome-Munyua, A., Sieleunou, I., Sory, O., & Cashin, C. (2022). Why is strategic purchasing critical for universal health coverage in sub-Saharan Africa? Health Systems & Reform, 8(2), e2051795. https://doi.org/10.1080/23288604.2022.2051795