Service Delivery Transformation for UHC in Asia and the Pacific

This article was drafted as part of a review of strategiesfor making progress toward universal health coverage in the coun-tries of Asia and the Pacific. It focuses on strengthening thedelivery of services, in the context of population aging. It arguesthat it is important to take into account big differences in develop-ment contexts and also the rapid, interconnected changes that manycountries are experiencing. The article focuses especially on coun-tries with relatively undeveloped institutions and pluralistic andhighly segmented health sectors. It argues that attempts by thesecountries to import institutional arrangements from outside arelikely to be complicated. It argues that government needs to focuson both short-term measures to meet immediate needs and thelonger-term aim of establishing effective institutional arrangements.This means that they need to take into account the political factorsthat influence the direction of health system change. The articleemphasizes the need to strengthen the capacity of the health systemto address the growing challenge of chronic noncommunicablediseases to avoid heavy political pressure to expand hospital ser-vices. It then explores the opportunities and challenges associatedwith the rapid expansion of digital health services. It concludeswith a discussion of government stewardship and management ofhealth system transformation to address the major challenges asso-ciated with population aging.