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IJERPH
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2nd Edition: Health Equity and Universal Health Coverage
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2nd Edition: Health Equity and Universal Health Coverage

A Special Issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601) belonging to the section "Global Health".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 2031

Editors

Prof. Dr. Inmaculada Mateo-Rodríguez

E-Mail Website
Guest Editor
1. Andalusian School of Public Health, 18011 Granada, Spain
2. Department of Social and Organizational Psychology, Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
Interests: public health; mental health; health inequalities; gender inequalities; occupational health; healthy ageing
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Antonio Daponte-Codina

E-Mail Website
Guest Editor
Andalusian School of Public Health, 18011 Granada, Spain
Interests: public health; environmental health; health inequalities; determinants of health; epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce the second edition of our Special Issue, titled “2nd Edition: Health Equity and Universal Health Coverage”. 

According to the World Health Organization (WHO), Universal Health Coverage (UHC) implies that "all people and communities receive the health services they need without limitations due to their economic situation”. Universal health coverage must include not only the treatment of acute and chronic diseases but also activities focused on the prevention of health problems, rehabilitation and palliative care, health protection, and health promotion, including physical and mental health across the life course. 

Achieving UHC is one of the targets nations set when they adopted the 2030 Sustainable Development Goals (SDGs) in 2015. Additionally, it is a prerequisite for health equity; hence, the importance of scientific studies on the progress being made towards this goal and on whether all types of health services are affected to the same extent. It is also important to collect evidence on how advances in UHC affect health outcomes across different social groups (defined by gender, age, social class, race, etc.). Lastly, it is also of interest to know proposals and reflections on how to achieve and implement sustainable policies that bring us closer to the objective of equity in health and UHC.

Prof. Dr. Inmaculada Mateo-Rodríguez
Prof. Dr. Antonio Daponte-Codina
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • universal health coverage
  • mental and physical health services
  • health equity
  • health inequalities
  • social determinants of health

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Related Special Issue

Published Papers (3 papers)

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Research

19 pages, 9000 KB  
Article
Service Coverage and Financial Hardship Under Universal Health Coverage: Uneven Associations Across 159 Countries (2000–2023)
by Anderson Díaz-Pérez and Wendy Acuña Pérez
Int. J. Environ. Res. Public Health 2026, 23(8), 1069; https://doi.org/10.3390/ijerph23081069 - 18 Aug 2026
Viewed by 333
Abstract
Universal health coverage requires simultaneous progress in service coverage and financial protection, yet these dimensions are commonly assessed separately. We conducted a secondary ecological panel analysis using official World Health Organization/World Bank indicators. A document-oriented workflow preserved irregular subgroup structures before conversion to [...] Read more.
Universal health coverage requires simultaneous progress in service coverage and financial protection, yet these dimensions are commonly assessed separately. We conducted a secondary ecological panel analysis using official World Health Organization/World Bank indicators. A document-oriented workflow preserved irregular subgroup structures before conversion to an unbalanced country–year panel comprising 981 observations from 159 countries/economies between 2000 and 2023. The primary inferential specification was a two-way fixed-effects model with country and year effects and country-clustered standard errors; a country fixed-effects model with a linear time trend, a random-intercept model, and generalized estimating equations were complementary robustness analyses. We also examined service domains, wealth- and rural-urban inequalities, beta convergence, and exploratory country typologies. Mean service coverage rose from 58.9 in 2000 to 74.0 in 2023, whereas mean financial hardship fell from 24.0% to 17.3%. In the primary model, each one-point increase in service coverage was associated with a 0.441-percentage-point reduction in hardship (95% confidence interval, −0.707 to −0.175; p = 0.001). Mean poorest–richest and rural–urban hardship gaps were 53.7 and 12.5 percentage points, respectively. The inverse association was largest in low-income settings, where socioeconomic gradients were also steepest. Service coverage gains should therefore not be interpreted as sufficient evidence of equitable universal health coverage; monitoring systems and financing reforms should jointly target access, financial protection, and distributional gaps. Full article
(This article belongs to the Special Issue 2nd Edition: Health Equity and Universal Health Coverage)
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16 pages, 818 KB  
Article
Availability and Access to Palliative Sedation Medications in Ecuador: A National Survey of Palliative Care Physicians
by Patricia Bonilla-Sierra and Luz Damaris Villalta-Tandazo
Int. J. Environ. Res. Public Health 2026, 23(7), 901; https://doi.org/10.3390/ijerph23070901 - 14 Jul 2026
Viewed by 412
Abstract
Palliative sedation is a key intervention to relieve refractory suffering at the end of life; however, its implementation depends on access to essential medications. This study aimed to evaluate the availability and access to palliative sedation medications and to identify associated barriers among [...] Read more.
Palliative sedation is a key intervention to relieve refractory suffering at the end of life; however, its implementation depends on access to essential medications. This study aimed to evaluate the availability and access to palliative sedation medications and to identify associated barriers among physicians affiliated with the Ecuadorian Association of Palliative Care (ASECUP). A quantitative, cross-sectional study was conducted using a structured, validated questionnaire administered to 82 eligible ASECUP-affiliated physicians. Descriptive and bivariate analyses were performed to assess associations between medication availability and institutional variables. Midazolam was the most frequently used medication (82.0%); however, availability was inconsistent, with only 54.9% reporting constant access. The main barriers identified were regulatory restrictions (53.7%), distribution problems (36.6%), and the absence of clear access policies (41.5%). Administrative difficulties were also common: 40.2% of participants reported modifying clinical protocols due to medication shortages, and 48.8% observed adverse clinical consequences. Significant disparities were found according to the type of institution and level of care, as indicated by chi-square p-values (institution type: p = 0.002; level of care: p < 0.001), with lower medication availability in public and primary care settings. These findings indicate that access to palliative sedation medications in Ecuador is limited by structural and systemic barriers rather than economic factors alone. Improving access requires system-level interventions, including stronger regulatory frameworks, optimized supply chains, and integration of palliative care across all levels of the health system. Ensuring continuous and equitable access to essential medications is essential to reduce preventable suffering and guarantee dignified end-of-life care. Full article
(This article belongs to the Special Issue 2nd Edition: Health Equity and Universal Health Coverage)
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13 pages, 289 KB  
Article
High Prevalence of Problematic Health Literacy and Its Associated Sociodemographic Factors Among Community-Dwelling Individuals in Northern Thailand: A Cross-Sectional Study
by Uratcha Sadjapong, Nattapon Harnsamut, Patipat Vongruang and Sakesun Thongtip
Int. J. Environ. Res. Public Health 2026, 23(6), 752; https://doi.org/10.3390/ijerph23060752 - 3 Jun 2026
Viewed by 629
Abstract
Health literacy (HL) is an important factor associated with individuals’ capacity to manage their health effectively. This cross-sectional study assessed HL and its associated factors among 327 community-dwelling individuals in Northern Thailand. Data were collected through face-to-face interviews using the 47-item European Health [...] Read more.
Health literacy (HL) is an important factor associated with individuals’ capacity to manage their health effectively. This cross-sectional study assessed HL and its associated factors among 327 community-dwelling individuals in Northern Thailand. Data were collected through face-to-face interviews using the 47-item European Health Literacy Questionnaire (HLS-EU-Q47). The participants were predominantly female (59.9%), with a mean age of 59.0 ± 11.7 years. Overall, 60.2% of the participants exhibited problematic HL across all domains. In bivariate analyses, overall HL was significantly associated with sex, age, body mass index (BMI), education, marital status, and hypertension. Age was negatively correlated with overall HL (r = −0.250, p < 0.001), whereas BMI was positively correlated with overall HL (r = 0.130, p = 0.019). In the multivariable linear regression model, higher education (β = 4.251, p < 0.001), female sex (β = 2.310, p = 0.002), and alcohol consumption (β = 1.411, p = 0.047) were independently associated with higher HL scores. Conversely, marital status (β = −1.747, p = 0.033) was associated with lower HL scores. Problematic HL was highly prevalent in this population and was associated with sociodemographic and health-related factors. These findings highlight the need for targeted, context-specific health communication and education strategies to improve HL among vulnerable community-dwelling populations, particularly older adults and individuals with lower educational attainment. Full article
(This article belongs to the Special Issue 2nd Edition: Health Equity and Universal Health Coverage)
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