Peer-reviewed article
Effective coverage measurement in maternal, newborn, child, and adolescent health and nutrition: progress, future prospects, and implications for quality health systems
Andrew D. Marsh, Moïse Muzigaba, Theresa Diaz, Jennifer Harris Requejo, Debra J. Jackson et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper addresses how to measure whether health services for mothers, newborns, children, and adolescents actually work and improve health outcomes, not just whether people receive them. An expert group convened by WHO and UNICEF developed a standard definition of 'effective coverage' that combines access to care with quality and health results. The framework is designed to help countries better monitor progress toward universal health coverage and improve their health systems.
Key points
- Intervention coverage alone (measuring who receives care) can overestimate health benefits by not accounting for quality of care
- Effective coverage is defined as the proportion of people needing a service who receive it and achieve a positive health outcome
- Multiple definitions and measurement approaches previously existed, creating confusion in monitoring and interpretation
- The proposed measures and care cascade steps can be applied across a range of maternal, newborn, child, and adolescent health services
- Advances in effective coverage measurement can improve monitoring toward universal health coverage achievement
Limitations
This is a consensus document and methodological framework rather than an evaluation of actual health outcomes. It does not provide empirical data on the effectiveness of specific health interventions or demonstrate how the framework performs when applied in different health systems or countries.
Abstract
Intervention coverage-the proportion of the population with a health-care need who receive care-does not account for intervention quality and potentially overestimates health benefits of services provided to populations. Effective coverage introduces the dimension of quality of care to the measurement of intervention coverage. Many definitions and methodological approaches to measuring effective coverage have been developed, resulting in confusion over definition, calculation, interpretation, and monitoring of these measures. To develop a consensus on the definition and measurement of effective coverage for maternal, newborn, child, and adolescent health and nutrition (MNCAHN), WHO and UNICEF convened a group of experts, the Effective Coverage Think Tank Group, to make recommendations for standardising the definition of effective coverage, measurement approaches for effective coverage, indicators of effective coverage in MNCAHN, and to develop future effective coverage research priorities. Via a series of consultations, 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. The proposed effective coverage measures and care cascade steps can be applied to further develop effective coverage measures across a broad range of MNCAHN services. Furthermore, advances in measurement of effective coverage could improve monitoring efforts towards the achievement of universal health coverage.