When The Rockefeller Foundation launched its Transforming Health Systems (THS) initiative in 2008, the concept of Universal Health Coverage (UHC) was controversial and often misunderstood. At the same time, health policy experts were increasingly questioning the prevailing focus on disease-specific interventions, with renewed attention to strengthening health systems as a whole. This trend, together with a nascent and growing movement to promote UHC, came together in the THS initiative. Yet the controversy loomed largely. To ensure success, it was clear from the start that the Foundation, through THS, would have to be a global advocate for UHC. We believed that this was an essential to meet our overall commitment to equity – so that the health systems that countries build truly cover everyone, rich and poor alike.
This case study, part of an evaluation conducted on THS by Mathematica Policy Research, assesses how the activities of the initiative impacted the trajectory of UHC over its decade-long march from misunderstood concept to full acceptance as an issue of global concern. It examines how and how well the initiative strategically executed its approach – disseminating UHC evidence and information, promoting UHC dialogue, identifying and supporting UHC champions, and promoting UHC at the country level.