title: Summary indices for monitoring universal coverage in maternal and child health care.
abstract: OBJECTIVE
  To compare two summary indicators for monitoring universal coverage of reproductive, maternal, newborn and child health care.
  
  
  METHODS
  Using our experience of the Countdown to 2015 initiative, we describe the characteristics of the composite coverage index (a weighted average of eight preventive and curative interventions along the continuum of care) and co-coverage index (a cumulative count of eight preventive interventions that should be received by all mothers and children). For in-depth analysis and comparisons, we extracted data from 49 demographic and health surveys. We calculated percentage coverage for the two summary indices, and correlated these with each other and with outcome indicators of mortality and undernutrition. We also stratified the summary indicators by wealth quintiles for a subset of nine countries.
  
  
  RESULTS
  Data on the component indicators in the required age range were less often available for co-coverage than for the composite coverage index. The composite coverage index and co-coverage with 6+ indicators were strongly correlated (Pearsonr= 0.73,P< 0.001). The composite coverage index was more strongly correlated with under-five mortality, neonatal mortality and prevalence of stunting (r=  -0.57, -0.68 and -0.46 respectively) than was co-coverage (r= -0.49, -0.43 and -0.33 respectively). Both summary indices provided useful summaries of the degrees of inequality in the countries' coverage. Adding more indicators did not substantially affect the composite coverage index.
  
  
  CONCLUSIONS
  The composite coverage index, based on the average value of separate coverage indicators, is easy to calculate and could be useful for monitoring progress and inequalities in universal health coverage.
authors.affiliation: Federal University of Pelotas, Rua Marechal Deodoro 1160, 3 piso. Pelotas, 96020-220, Rio Grande do Sul, Brazil .
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Wehrmeister
authors.affiliation: International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil .
authors.forename: Maria-Clara
authors.initials: MC
authors.lastname: Restrepo-Mendez
authors.affiliation: Federal University of Pelotas, Rua Marechal Deodoro 1160, 3 piso. Pelotas, 96020-220, Rio Grande do Sul, Brazil .
authors.forename: Giovanny Va
authors.initials: GV
authors.lastname: Franca
authors.affiliation: Federal University of Pelotas, Rua Marechal Deodoro 1160, 3 piso. Pelotas, 96020-220, Rio Grande do Sul, Brazil .
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
authors.affiliation: Federal University of Pelotas, Rua Marechal Deodoro 1160, 3 piso. Pelotas, 96020-220, Rio Grande do Sul, Brazil .
authors.forename: Aluisio Jd
authors.initials: AJ
authors.lastname: Barros
mesh_terms: D046688:Child Mortality; D015362:Child Nutrition Disorders; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D014943:Global Health; D006304:Health Status; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008428:Maternal Mortality; D000068101:Maternal-Child Health Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D009026:Mortality / Q000639:trends*; D019984:Quality Indicators, Health Care / Q000458:organization & administration; D034121:Reproductive Health Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019472:Universal Health Insurance / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data