A Nomenclature of Health Services for Universal Health Coverage Monitoring in Low and Middle-Income Countries

To support implementation of Universal Health Coverage, several low- and middle-income countries (LMIC) have begun digitization of their health care systems. Despite the successes achieved, digitization still poses several challenges such as lack of technical interoperability between information systems and lack of an internationally standardized nomenclature for billable health care services, although WHO states that this should be the basis for information exchange in the healthcare sector. Several international classifications and nomenclatures are available for sub-areas of care, but the question remains whether and how these can be merged into a single comprehensive nomenclature. Research was done in Burundi to develop Universal Nomenclature of Health Services (UNHS), a generic, comprehensive nomenclature for billable health services, based on international classifications and adapted to the context of LMIC. The need was clear as it was found that 2 or more different codes were used for billing of identical care services in 100% of the sampled health facilities. The UNHS succeeded to standardize 97.7% of common care services and for the remaining 2.3% of health services, national codes remain in use, mostly for operational reasons.