The P4H Leadership for Universal Health Coverage Programme

Madagascar team at L4UHC module in Rabat, 2017

This article is also available in French.

The global movement for Universal Health Coverage (UHC) seeks to ensure that people everywhere have access to the health services they need without fear of financial hardship. While there is widespread support for the idea of UHC, actually realising UHC at country level is contentious. Key players and groups hold divergent interests, and technical efforts to advance reform often stall when these interests cannot be aligned. Skilled leadership is required to work through competing views, unite diverse groups behind a shared vision, and broker the trade-offs and compromises that are needed to keep complex UHC reform processes on track. The Leadership for Universal Health Coverage Programme (L4UHC) was developed to address this leadership challenge.

A new approach to capacity development from the Providing for Health network (P4H)

L4UHC is a capacity development programme which aims to move the UHC process forward in participating countries and to help build effective and sustainable coalitions for UHC. The year-long programme is based on peer-to-peer exchange, facilitated by experienced coaches and resource persons who bring in leadership and change theory, as well as UHC-related technical expertise. L4UHC is organised around a sequence of modules which take place in different host countries that have UHC-relevant reform experiences to share. Between modules, participants jointly prepare for and carry out a short-term initiative in their own countries. High-level representatives of the main UHC stakeholder groups are invited to take part in L4UHC and are expected to participate throughout the entire programme.

An innovative approach to building and supporting UHC leaders

L4UHC builds both the individual and collective capacities of people who are in a position to move UHC forward in their countries.

During the programme, individual participants drawn from diverse backgrounds are gradually transformed into the nucleus of a national UHC coalition. L4UHC does this by providing a safe space for participants to work together intensively and to test out ideas outside their normal daily roles. Participants are challenged to examine their existing views and to deepen their understanding of others’ values, needs, beliefs and interests.

L4UHC is organised in a series of three modules and two practical phases. During each module, participants undertake field visits to immerse themselves in the details of the host country’s UHC experience, including meetings with reform leaders who represent different institutions and stakeholder groups. During the practical phases in their home countries, participants meet and work together as country teams, with support from local coaches.

Course Structure

Learn more

L4UHC is gaining momentum. As the approach demonstrates its ability to create space for progress on UHC, more and more countries and organisations, both national and international, are interested in becoming involved. Would you like to know more? Contact David Scheerer (, Michael Adelhardt ( or Claude Meyer (

Key Resources

  • Leadership for Universal Health Coverage: Image brochure (GIZ, 2017) (EN), (FR)

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