A composite index representing coverage of essential health services based on 14 tracer indicators in the areas of reproductive, maternal, newborn and child health, infectious diseases, noncommunicable diseases and service capacity and access. It is presented on a scale of 0 to 100 index points.
Aggregation method:
Weighted average
Statistical concept and methodology:
Methodology: The UHC service coverage index is computed as the weighted geometric means of 14 tracer indicators, as follows, organized by four broad categories of service coverage:
I. Reproductive, maternal, newborn and child health
- Family planning: Percentage of women of reproductive age (15-49 years) who have their need for family planning satisfied with modern methods (SDG indicator 3.7.1, metadata available at https://unstats.un.org/sdgs/metadata/files/Metadata-03-07-01.pdf)
- Pregnancy care: Percentage of women aged 15-49 years with a live birth in a given time period who received antenatal care four or more times
- Child immunization: Percentage of infants receiving three doses of diphtheria-tetanus-pertussis containing vaccine
- Child treatment: Percentage of children younger than 5 years with symptoms of acute respiratory infection (cough and fast or difficult breathing due to a problem in the chest and not due to a blocked nose only) in the 2 weeks preceding the survey for whom advice or treatment was sought from a health facility or provider
II. Infectious diseases
- Tuberculosis: Percentage of incident TB cases that are detected and treated
- HIV/AIDS: Percentage of adults and children living with HIV currently receiving antiretroviral therapy
- Malaria: Percentage of population in malaria-endemic areas who slept under an insecticide-treated net the previous night [only for countries with high malaria burden]
- Water, sanitation and hygiene: Percentage of population using at least basic sanitation services.
III. Noncommunicable diseases
- Hypertension: Coverage of treatment (taking medicine) for hypertension among adults aged 30-79 years with hypertension (age-standardized estimate) (%)
- Diabetes: Coverage of treatment (taking medication) for diabetes among adults aged 30 years and over with diabetes (age-standardized estimate) (%)
- Tobacco: Age-standardized prevalence of adults >=15 years currently using any tobacco product (smoked and/or smokeless tobacco) on a daily or non-daily basis (SDG indicator 3.a.1, metadata available at https://unstats.un.org/sdgs/metadata/files/Metadata-03-0a-01.pdf)
IV. Service capacity and access
- Hospital access: Hospital beds density, relative to a maximum threshold of 18 per 10,000 population?
- Health workforce: Health workers (medical doctors, nursing and midwifery personnel) per capita, relative to a combined maximum thresholds (overlap with SDG indicator 3.c.1, see metadata at https://unstats.un.org/sdgs/metadata/files/Metadata-03-0C-01.pdf)
- Health security: International Health Regulations (IHR) core capacity index, which is the average percentage of attributes of 13 core capacities that have been attained?(SDG indicator 3.d.1, see metadata at https://unstats.un.org/sdgs/metadata/files/Metadata-03-0D-01.pdf)
Refer to Other notes for the Statistical Concept(s).
Development relevance:
SDG Target 3.8 is defined as “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. The objective is for all people and communities to receive the quality health services they need (including medicines and other health products), without financial hardship. Two indicators have been chosen to monitor target 3.8 within the SDG framework. Indicator 3.8.1, the universal health service coverage index, is for service coverage of essential health services while indicator 3.8.2 focuses on financial hardship caused by out-of-pocket health expenditure.
Indicators of service coverage – defined as people receiving the service they need – are the best way to track progress in providing services under universal health coverage (UHC). Since a single health service indicator does not suffice for monitoring UHC, the UHC service coverage index is constructed from?14?tracer indicators (further organized into 4 health service areas) selected based on epidemiological and statistical criteria. This includes several indicators that are already included in other SDG targets, thereby minimizing the data collection and reporting burden.?The index is reported on a?unitless?scale of 0 to 100, with 100 being the?optimal?value.
Other notes:
Statistical concept(s): The calculation the UHC service coverage index requires first standardizing the 14 tracer indicators so that they can be combined into the index, and then computing the index from those values.
The 14 tracer indicators are first all placed on the same scale, with 0 being the lowest value and 100 being the optimal value. For most indicators, this scale is the natural scale of measurement, e.g., the percentage of infants who have been immunized ranges from 0 to 100 percent. However, for a few indicators, conversion and/or rescaling is required to obtain appropriate values from 0 to 100. Once all tracer indicator values are on a scale of 0 to 100, weighted geometric means are computed within each of the four health service areas, and then a geometric mean is taken of those four values. Each tracer is weighted on an indicator specific population based on the denominator of the indicator using United Nations population estimates where applicable.
Many of the tracer indicators of health service coverage are measured by household surveys. However, administrative data, facility data, facility surveys, and sentinel surveillance systems are utilized for certain indicators. Underlying data sources for each of the 14 tracer indicators are explained in Annex 1 (https://unstats.un.org/sdgs/metadata/files/Metadata-03-08-01.pdf)
