Equity-oriented monitoring in the context of universal health coverage.

Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodo...

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Main Authors: Ahmad Reza Hosseinpoor, Nicole Bergen, Theadora Koller, Amit Prasad, Anne Schlotheuber, Nicole Valentine, John Lynch, Jeanette Vega
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-09-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.1001727
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author Ahmad Reza Hosseinpoor
Nicole Bergen
Theadora Koller
Amit Prasad
Anne Schlotheuber
Nicole Valentine
John Lynch
Jeanette Vega
author_facet Ahmad Reza Hosseinpoor
Nicole Bergen
Theadora Koller
Amit Prasad
Anne Schlotheuber
Nicole Valentine
John Lynch
Jeanette Vega
author_sort Ahmad Reza Hosseinpoor
collection DOAJ
description Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.
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spelling doaj-art-415984087fad4d37aeb0737ddbcfda212025-08-20T02:22:20ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762014-09-01119e100172710.1371/journal.pmed.1001727Equity-oriented monitoring in the context of universal health coverage.Ahmad Reza HosseinpoorNicole BergenTheadora KollerAmit PrasadAnne SchlotheuberNicole ValentineJohn LynchJeanette VegaMonitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.https://doi.org/10.1371/journal.pmed.1001727
spellingShingle Ahmad Reza Hosseinpoor
Nicole Bergen
Theadora Koller
Amit Prasad
Anne Schlotheuber
Nicole Valentine
John Lynch
Jeanette Vega
Equity-oriented monitoring in the context of universal health coverage.
PLoS Medicine
title Equity-oriented monitoring in the context of universal health coverage.
title_full Equity-oriented monitoring in the context of universal health coverage.
title_fullStr Equity-oriented monitoring in the context of universal health coverage.
title_full_unstemmed Equity-oriented monitoring in the context of universal health coverage.
title_short Equity-oriented monitoring in the context of universal health coverage.
title_sort equity oriented monitoring in the context of universal health coverage
url https://doi.org/10.1371/journal.pmed.1001727
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