title: Effective coverage: a metric for monitoring Universal Health Coverage.
abstract: A major challenge in monitoring universal health coverage (UHC) is identifying an indicator that can adequately capture the multiple components underlying the UHC initiative. Effective coverage, which unites individual and intervention characteristics into a single metric, offers a direct and flexible means to measure health system performance at different levels. We view effective coverage as a relevant and actionable metric for tracking progress towards achieving UHC. In this paper, we review the concept of effective coverage and delineate the three components of the metric - need, use, and quality - using several examples. Further, we explain how the metric can be used for monitoring interventions at both local and global levels. We also discuss the ways that current health information systems can support generating estimates of effective coverage. We conclude by recognizing some of the challenges associated with producing estimates of effective coverage. Despite these challenges, effective coverage is a powerful metric that can provide a more nuanced understanding of whether, and how well, a health system is delivering services to its populations.
authors.affiliation: Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
authors.forename: Marie
authors.initials: M
authors.lastname: Ng
authors.affiliation: Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
authors.forename: Nancy
authors.initials: N
authors.lastname: Fullman
authors.affiliation: Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Dieleman
authors.affiliation: Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
authors.forename: Abraham D
authors.initials: AD
authors.lastname: Flaxman
authors.affiliation: Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
authors.forename: Christopher J L
authors.initials: CJ
authors.lastname: Murray
authors.affiliation: Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Lim
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000639:trends*; D006297:Health Services Accessibility / Q000191:economics / Q000639:trends*; D006301:Health Services Needs and Demand / Q000191:economics / Q000639:trends*; D006801:Humans; D019472:Universal Health Insurance / Q000191:economics / Q000639:trends*