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 thesame time, health policy experts were increasingly questioning the prevailing focus on disease-specificinterventions, with renewed attention to strengthening health systems as a whole. This trend, togetherwith a nascent and growing movement to promote UHC, came together in the THS initiative. Yet thecontroversy loomed large. To ensure success, it was clear from the start that the Foundation, throughTHS, would have to be a global advocate for UHC. We believed that this was an essential to meet ouroverall commitment to equity – so that the health systems that countries build truly cover everyone, richand poor alike.
This case study, part of an evaluation conducted on THS by Mathematica Policy Research, assesseshow the activities of the initiative impacted the trajectory of UHC over its decade-long march frommisunderstood concept to full acceptance as an issue of global concern. It examines how and howwell the initiative strategically executed its approach – disseminating UHC evidence and information,promoting UHC dialogue, identifying and supporting UHC champions, and promoting UHC at thecountry level.