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Access, utilization, quality, and effective coverage: An integrated conceptual framework and measurement strategy

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  • Shengelia, Bakhuti
  • Tandon, Ajay
  • Adams, Orvill B.
  • Murray, Christopher J.L.

Abstract

Health systems can primarily improve the health of individuals and populations by delivering high-quality interventions to those who may benefit from them. We propose a concept of effective coverage as the probability that individuals will receive health gain from an intervention if they need it. Understanding the extent to which health systems are delivering key interventions to those who will benefit from them and the factors that explain gaps in delivery are a critical input to decision-making at the local, national and global levels. We develop an integrated conceptual framework for monitoring and analyzing the delivery of high-quality interventions to those who need them. This framework can help clarify the inter-relationships between notions of access, demand for care, utilization, and coverage on the one hand and highlight the requirements for health information systems that can sustain this type of analysis. We discuss measurement strategies and demonstrate the concept by means of a simple simulation model.

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  • Shengelia, Bakhuti & Tandon, Ajay & Adams, Orvill B. & Murray, Christopher J.L., 2005. "Access, utilization, quality, and effective coverage: An integrated conceptual framework and measurement strategy," Social Science & Medicine, Elsevier, vol. 61(1), pages 97-109, July.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:1:p:97-109
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    2. Solveig Danielsen & Frank B. Matsiko, 2016. "Using a plant health system framework to assess plant clinic performance in Uganda," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 8(2), pages 345-359, April.
    3. Trani, Jean-Francois & Bakhshi, Parul & Noor, Ayan A. & Lopez, Dominique & Mashkoor, Ashraf, 2010. "Poverty, vulnerability, and provision of healthcare in Afghanistan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1745-1755, June.
    4. Fernández, Andrés & Oviedo, Enrique, 2010. "Information and communication technologies in the health sector: opportunities and challenges for the reduction of inequalities in Latin America and the Caribbean," Políticas Sociales 6178, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    5. de Timoteo Mavimbe, Joao Carlos & Muquingue, Humberto Nelson & Braa, Jorn & Bjune, Gunnar, 2006. "Immunization coverage in Mozambique: From concepts to decision-making," Health Policy, Elsevier, vol. 79(1), pages 92-100, November.
    6. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 32(1), pages 147-189.
    7. Meng-Chuan Tsai & Chin-Tsai Lin, 2012. "Selecting an Optimal Region by Fuzzy Group Decision Making: Empirical Evidence from Medical Investors," Group Decision and Negotiation, Springer, vol. 21(3), pages 399-416, May.

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