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Prior to the Sustainable Development Goals (SDG) era, considerable progress was made toward the Millennium Development Goals (MDGs) health indicators. Despite these achievements, many countries failed to meet the MDG target levels, between-country inequalities in health outcomes did not improve, and many countries making progress in average indicator levels did so while at the same time seeing increasing within-country inequalities. We build on the existing literature documenting levels and trends in health inequalities by expanding the number of data-points under focus, and we contribute to this literature by analyzing the extent to which inequalities in child health outcomes are related to socioeconomic inequalities, and to aggregate income growth. The objective of this paper is to examine long-run trends in average population levels and within-country inequalities for two child health outcomes—the under-five mortality rate (U5MR) and stunting—in 102 countries across 6 regions. We find that only about a third of countries in our sample managed to both reduce U5MR levels and inequalities, and only a quarter did so for stunting. The fact that inequality in service coverage seems to follow a more favorable trend than inequality in health outcomes suggests that policies aiming to reduce health inequities should not only foster more equitable service coverage but also focus on the social determinants of health. Moreover, there is no strong correlation between changes in health inequalities and income growth, suggesting that income generating development policies alone will typically not suffice to improve health outcomes and reduce health inequalities.

Universal Health Coverage is one of the key targets of the Sustainable Development Goals and it implies that everyone can access the healthcare they need without suffering financial hardship. In this paper, we use a large set of household surveys to examine if older populations are facing different degrees of financial hardship compared to younger populations. We find that while differences in average age structures between countries are not systematically associated with higher financial risk related to out-of-pocket health expenditures, there are large differences in financial hardship between younger and older households within countries. Households with more elderly members are more likely to face catastrophic and impoverishing out-of-pocket health payments compared to younger households, and this age gradient is stronger for the poorest segments of the population. Making progress toward Universal Health Coverage will require extension and improved targeting of benefit packages and financial protection to meet the health needs of older adults, and especially the poorest and most vulnerable segments of elderly populations.