Ng Marie, Fullman Nancy, Dieleman Joseph L, Flaxman Abraham D, Murray Christopher J L, Lim Stephen S
Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, Washington, United States of America.
PLoS Med. 2014 Sep 22;11(9):e1001730. doi: 10.1371/journal.pmed.1001730. eCollection 2014 Sep.
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.
监测全民健康覆盖（UHC）的一项重大挑战是确定一个能够充分体现UHC倡议背后多个组成部分的指标。有效覆盖率将个体和干预特征整合为一个单一指标，为衡量不同层面的卫生系统绩效提供了一种直接且灵活的方法。我们将有效覆盖率视为追踪实现UHC进展的一个相关且可操作的指标。在本文中，我们回顾有效覆盖率的概念，并通过几个例子阐述该指标的三个组成部分——需求、利用和质量。此外，我们解释了该指标如何用于监测地方和全球层面的干预措施。我们还讨论了当前卫生信息系统支持生成有效覆盖率估计值的方式。我们最后认识到在生成有效覆盖率估计值方面存在的一些挑战。尽管存在这些挑战，但有效覆盖率是一个强大的指标，它能更细致入微地了解卫生系统是否以及在多大程度上为其民众提供服务。
