Effective coverage of primary care services in eight high-mortality countries

摘要: Introduction Measurement of effective coverage (quality-corrected coverage) essential health services is critical to monitoring progress towards the Sustainable Development Goal for health. We combine facility and household surveys from eight low-income middle-income countries examine maternal child services. Methods developed indices clinical actions antenatal care, family planning care sick children existing guidelines used data direct observations visits conducted in Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania Uganda between 2007 2015 measure quality delivered. calculated healthcare each service nationally representative combined with utilisation estimates at subnational level quantify coverage. Results Health yielded over 40 000 100 000 individual reports utilisation. Coverage varied services, much greater use any than or sick-child as well within countries. Quality was poor, few regions demonstrating more 60% average performance basic practices service. Effective across all averaged 28% 26% 21% care. were not strongly correlated level; by 20% a country. Conclusion three primary women substantially lower crude due major deficiencies quality. Better performing can serve examples improvement. Systematic increases delivered—not just gains—will be necessary truly beneficial universal