A New Approach to Measuring Health Development: From National Income Toward Health Coverage (and Beyond)

This chapter proposes an alternative approach to identify and constraints in countries, based on indicators that are broader than national income and more relevant to assess the stage of national development in health. A conceptual framework of “health coverage” underpins the construction of sub-indices of national performance in the dimensions of access to care, financial risk protection in health and domestic financial constraints, which are then used to construct overall indices of national health development. Country rankings in the health development scale vary substantially when the conditions of access to care, financial protection and domestic capacity to finance the health system are considered, compared to conventional income rankings. Furthermore, the decomposition of our health development indices sheds light on important aspects for health policy, including the identification of cases where there is a need for external support to maintain and expand current health coverage levels, as well as preliminary insights into specific support modalities by donor agencies that may be more efficient to promote health development in a particular setting. This chapter also demonstrates how our proposed indices can inform policy decisions at a higher granularity level subject to the availability of subnational level data.