Background and Objective: The extent of fragmentation in risk pooling is a major concern of health financing and also a challenging barrier to reaching
universal health coverage. This study aimed to review different approaches in risk pooling and their effects on universal health coverage.
Materials and Methods: Relevant materials were extracted from officially published reports, journal articles, books, and slides in domestic and foreign
databases, as well as such websites as World Bank and WHO. The keywords including health insurance, social health insurance, universal coverage, resource pooling, fragmentation in resource pooling, and single or multiple insurances were used for finding relevant documents for the purpose of the study.
Results: Different models of health financing systems used in various countries with their own specific historical, political, and economical backgrounds have resulted in different kinds of resource pooling with different levels of fragmentation. Different fragmentation models in resources have various effects on the dimensions of universal health coverage and moving towards it, equity in health financing, risk distribution among different groups of populations, access to healthcare services, and finally achieving the key objectives of universal coverage, which is removing
the financial barriers to services for all who need them.
Conclusion: Different kinds of fragmentation in resource pooling will cause diverse barriers to reaching universal health coverage which in turn entails different strategies to solve those obstacles while moving toward universal health coverage. This is important to note that in the fragmented financing system and in any conditions, reducing fragmentation and strengthening resource pooling must be taken into consideration for attaining universal health coverage.