What’s In, What’s Out: Designing Benefits for Universal Health Coverage – Key Messages for Donors and Advocates

Many low- and middle-income countries are aspiring to transition towards universal health coverage: where everyone can receive quality health services without the risk of facing financial hardship. For universal health care to work in practice, the health services offered by a country must be in line with the available funds in a health budget. For low- and middle-income countries, where resources and budgets are constrained, difficult decisions have to be made about which health services to offer as demand for high-quality health services and technologies is increasing rapidly.  The Center for Global Development (CGD) and the International Decision Support Initiative (iDSI) have collaborated to produce the book ' What's In, What's Out: Designing Benefits for Universal Health Coverage '. The book focuses on showing how a defined list of services that will be funded with public monies (called a “health benefits package” or HBP—known in the US as “essential benefits”) can help to fill the gap between the aspirations of achieving universal health care and the real budgetary limitations that many countries face. This policy brief shows how a good HBP can be the blueprint for health system reform and strengthening, as a HBP should be practical and made in consideration of the fiscal, human resource, infrastructural, and geographic constraints of that setting. In addition, this document speaks to donors and funders, suggesting ways they can support HBP design by providing technical and financial resources.