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Effective coverage measurement in maternal, newborn, child and adolescent health and nutrition

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Research snapshot1

Monitoring progress towards achieving universal health coverage requires an understanding of the proportion of the population in need of care who received health services at a sufficient level of quality to result in the intended health benefits. Intervention coverage does not include metrics on intervention quality and thus potentially overestimates the health benefits of the services provided to populations. In response, in 2019, the World Health Organization (WHO) and UNICEF convened the Effective Coverage Think Tank Group, a group of 98 experts in the fields of quality-of-care measurement, monitoring and evaluation, epidemiology and research. The purpose of the group was to establish standardised definitions and measurements on effective coverage indicators (coverage that also explores quality of care) for maternal, newborn, child and adolescent health and nutrition (MNCAHN).

Through a series of video teleconferences and face-to-face meetings, the group recommended that effective coverage be defined as the proportion of a population in need of a service that resulted in a positive health outcome from the service. Cascade steps to explain effective coverage were defined that can be applied to a broad range of MNCAHN services. These cascading steps are identifying the target population with a specific health need, determining service contact coverage (the proportion of the population who come into contact with a service), establishing input-adjusted coverage (the proportion of the population in need who come into contact with a health service that is ready to provide care), intervention coverage (the proportion of the population who receives service), quality-adjusted coverage (the proportion of the population receiving service according to quality-of-care standards), user adherence-adjusted coverage (the proportion of users adhering to provider instructions) and outcome-adjusted coverage (the proportion of users who have the expected health outcomes).

Although important research gaps remain, the outcomes of the meetings are a step further towards improving effective coverage measurement and enabling the assessment of health outcomes of proven interventions.  

 

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Endnotes

1 Marsh A. D, Muzigaba M, Diaz T, Requejo J, Jackson D, Chou D, Cresswell J A, Guthold R, Moran A C, Strong K L, Banerjee A, Soucat A. 2020. Effective coverage measurement in maternal, newborn, child, and adolescent health and nutrition: progress, future prospects, and implications for quality health systems, The Lancet Global Health, Volume 8, Issue 5, 2020, Pages e730-e736, https://doi.org/10.1016/S2214-109X(20)30104-2. (http://www.sciencedirect.com/science/article/pii/S2214109X20301042)

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Effective coverage measurement in maternal, newborn, child and adolescent health and nutrition. Field Exchange 64, January 2021. p78. www.ennonline.net/fex/64/coveragemncahnprogrammes

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