Universal Health Coverage and the Public Good in Africa

This project, funded by an ERC Starting Grant, will critically approach moves towards Universal Health Coverage in 3 African countries, and associated debates about the public good. Led by an anthropologist, it will explore how African governments are experimenting with universal health coverage and what this means for the relationship between the state and its citizens.

Hospital Kenya

How are seemingly universal concepts such as solidarity, obligation and the public good defined and contested in local contexts? Photo: Ruth Prince

About the Project

Universal Health Coverage is a WHO policy that has gained much attention since it appeared in 2010. UNIVERSAL HEALTH is an anthropological project that will critically examine moves towards Universal Health Coverage, and particularly the expansion of health insurance, in three African countries. Approaching UHC as a lens to explore the social contract between citizens and the state, it will follow the frictions that universal concepts accompanying UHC, such as obligation, solidarity and the public good, may have among policy-makers, state bureaucrats, health workers and citizens. Moves towards UHC present interesting sites to explore the social and political collectives forming around struggles for health-care in Africa.

Explore the project


Theoretically ambitious and comparatively driven, the project aspires to a critically engaged anthropology that addresses both the politics of the possible –struggles for social transformation and the public good— and the ways progressive policies may be limited by specific social, economic and political contexts. We will focus on four main research questions:

  1. Do moves towards UHC engage with the state and with citizenship in new ways?
  2. How are seemingly universal concepts such as solidarity, obligation and the public good defined and contested in local contexts?
  3. How do UHC reforms, such as new forms of health insurance, intersect with formal social protection policies?
  4. How do UHC reforms intersect with informal networks of social support, such as those composed through kinship, religious or neighborhood affiliations?
Newspaper with Health Workers on strike
Team members will study the media coverage of topics related to UHC, including debates on social media. Clipping from The Standard in Kenya, January 20, 2017.


Defined by the WHO as ensuring that all people can use the health services they need without financial hardship, UHC is a powerful concept that approaches public health as a matter of justice and obligation and is included in the Sustainable Development Goals. While UHC reforms are being experimented with across the globe, UHC is particularly important in Africa given the recent history of public health on the continent. Here, the past three decades have seen fundamental shifts in the relations between the public and the private in health-care financing and provision. Structural adjustment policies undermined the role of the state and its responsibility for public health and encouraged market-based solutions to health-care, while ‘cost-sharing’ policies have pushed the burden of health-care costs onto the poor.

More about the background


European Research Council (ERC), Starting Grant (StG)


To be developed

Start - finish

2018 - 2023

Published Oct. 16, 2017 5:00 PM - Last modified Dec. 7, 2017 12:04 PM


Project leader Ruth J. Prince

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