Reviews of available data on unmet needs for healthcare and social care among older people in the WHO Regions

The measurement, understanding and monitoring of unmet needs for healthcare and social care are important for accelerating global progress towards universal health coverage. WKC conducted reviews of the unmet needs of older populations including a global systematic review and meta-analysis and secondary analysis of survey data covering 83 countries. As a next step, in-depth reviews of available data and information on unmet needs of older persons at the WHO Regional level were considered necessary.

To provide evidence-based assessments of the feasibility of measuring unmet healthcare and social care needs of older persons using available data and information at the WHO Regional level.

A competitively selected research team with expertise on the topic and familiarity with the geographic region was assigned to each WHO Region to undertake a systematic literature review, survey mapping and, where possible, secondary analysis of available survey data for one or more countries in the assigned WHO Region. The research teams carried out their studies in consultation with WKC as well as a focal person from each WHO Regional Office. Data on unmet health care needs in the WHO Region of the Americas was already being systematically collected by the unit responsible for Health Systems and Services Analysis, Monitoring and Evaluation in the Regional Office. Thus, a study was not commissioned to cover the Americas; instead, this unit directly provided relevant information to this project. On 10-11 June 2024, a technical meeting was held with all the research teams and focal persons from WHO Regional Offices and WHO headquarters, where progress and challenges were discussed.

• Unmet needs for health care are driven by system-level barriers such as availability, accessibility and acceptability of services. Financial accessibility, involving out-of-pocket payments for health care, is highlighted as a significant barrier, particularly in low- and middle-income countries.
• There is a notable lack of published literature and population-based surveys on unmet needs and access barriers, especially for social care. 
• The availability of information on unmet needs varies widely across regions. The WHO European Region has more comprehensive data while other regions,　particularly the WHO Eastern Mediterranean Region, have significant evidence gaps.

Unmet health and social care needs are important indicators of progress towards UHC but are not included in the current global monitoring indicators for SDG 3.8 on UHC. Standardizing survey questions and analytical methods, enhancing research efforts and making data publicly accessible will help to better understand and address barriers to care that lead to unmet needs, ultimately strengthening health systems and improving health outcomes and wellbeing for all people of all ages.

Organized session on “State of the art of measuring unmet need for healthcare: strengthening monitoring of service coverage and financial protection for UHC”, 8th Global Symposium on Health Systems Research (HSR2024) in Nagasaki, Japan, 20 November 2024.

Meeting Report

Technical meeting on strengthening data on the unmet care needs of older persons: meeting report, Kobe, Japan, 10-11 June 2024. Geneva: World Health Organization; 2024. https://iris.who.int/handle/10665/378976

Research Reports

• Evidence gaps on unmet health and social care needs in the WHO European Region: research report. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/381522
• Evidence gaps on unmet health and social care needs in the WHO African Region: research report. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/381642
• Evidence gaps on unmet health and social care needs in the WHO South-East Asia Region: research report. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/381778
• Evidence gaps on unmet health and social care needs in the WHO Eastern Mediterranean Region: research report. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382154
• Evidence gaps on unmet health and social care needs in the WHO Western Pacific Region: research report. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382292 

Executive Summaries

• Cross-regional study of evidence gaps on unmet needs for health and social care. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382469
• Evidence gaps on unmet health and social care needs in the WHO European Region: executive summary. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382315
• Evidence gaps on unmet health and social care needs in the WHO African Region: executive summary. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382312
• Evidence gaps on unmet health and social care needs in the WHO South-East Asia Region: executive summary. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382313
• Evidence gaps on unmet health and social care needs in the WHO Eastern Mediterranean Region: executive summary. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382468
• Evidence gaps on unmet health and social care needs in the WHO Western Pacific Region: executive summary. Geneva: World Health Organization; 2025 (Monitoring universal health coverage in ageing populations). https://iris.who.int/handle/10665/382659