Background: The World Health Organization (WHO) adopted Universal health coverage (UHC) as a target of the Sustainable Development Goal (SDG) 3. In 2018, Egypt issued the Universal Health Insurance Law (UHI), which aimed to achieve the UHC for its population and provide them with the needed health services without financial hardship. The Universal Health Insurance System (UHIS), applied in six governorates as Phase I, has achieved multiple successes covering all levels of medical care (primary, secondary, and tertiary). There are a group of implementation challenges; including the problems of overpopulation besides thousands of refugees and asylum-seekers, the dual burden of diseases, brain-drain of physicians, and the pricing of healthcare services, that have recently put the successful completion of subsequent UHC phases in great danger. This review article aims to provide recommendations to ensure the sustainability of the UHIS and gain its targeted benefits.

Conclusion: A group of challenges threatens the successful completion and sustainability of the subsequent UHC phases, so it is important to address them using well-tailored targeted strategies and interventions.