Browsing by Author "Megan Knight"

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Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019
(Elsevier Ltd, 2022) Annie Haakenstad; Jamal Akeem Yearwood; Nancy Fullman; Corinne Bintz; Kelly Bienhoff; Marcia R Weaver; Vishnu Nandakumar; Jonah N Joffe; Kate E LeGrand; Megan Knight; Cristiana Abbafati; Mohsen Abbasi-Kangevari; Amir Abdoli; Roberto Ariel Abeldaño Zuñiga; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Olatunji O Adetokunboh; Muhammad Sohail Afzal; Saira Afzal; Marcela Agudelo-Botero; Bright Opoku Ahinkorah; Sajjad Ahmad; Ali Ahmadi; Sepideh Ahmadi; Ali Ahmed; Tarik Ahmed Rashid; Budi Aji; Wuraola Akande-Sholabi; Khurshid Alam; Hanadi Al Hamad; Robert Kaba Alhassan; Liaqat Ali; Vahid Alipour; Syed Mohamed Aljunid; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Hubert Amu; Dickson A Amugsi; Robert Ancuceanu; Pedro Prata Andrade; Afifa Anjum; Jalal Arabloo; Morteza Arab-Zozani; Hany Ariffin; Judie Arulappan; Zahra Aryan; Tahira Ashraf; Desta Debalkie Atnafu; Alok Atreya; Marcel Ausloos; Leticia Avila-Burgos; Getinet Ayano; Martin Amogre Ayanore; Samad Azari; Ashish D Badiye; Atif Amin Baig; Mohan Bairwa; Shankar M Bakkannavar; Shrikala Baliga; Palash Chandra Banik; Till Winfried Bärnighausen; Fabio Barra; Amadou Barrow; Sanjay Basu; Mohsen Bayati; Rebuma Belete; Arielle Wilder Bell; Devidas S Bhagat; Akshaya Srikanth Bhagavathula; Pankaj Bhardwaj; Nikha Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Zulfiqar A Bhutta; Sadia Bibi; Ali Bijani; Boris Bikbov; Antonio Biondi; Obasanjo Afolabi Bolarinwa; Aime Bonny; Hermann Brenner; Danilo Buonsenso; Katrin Burkart; Reinhard Busse; Zahid A Butt; Nadeem Shafique Butt; Florentino Luciano Caetano Dos Santos; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Rosario Cárdenas; Vera L A Carneiro; Ferrán Catalá-López; Joht Singh Chandan; Jaykaran Charan; Prachi P Chavan; Simiao Chen; Shu Chen; Sonali Gajanan Choudhari; Enayet Karim Chowdhury; Mohiuddin Ahsanul Kabir Chowdhury; Massimo Cirillo; Barbara Corso; Omid Dadras; Saad M A Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; William James Dangel; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Keshab Deuba; Meghnath Dhimal; Mandira Lamichhane Dhimal; Shirin Djalalinia; Huyen Phuc Do; Leila Doshmangir; Bruce B Duncan; Andem Effiong; Elham Ehsani-Chimeh; Islam Y Elgendy; Muhammed Elhadi; Iman El Sayed; Maha El Tantawi; Daniel Asfaw Erku; Sharareh Eskandarieh; Jawad Fares; Farshad Farzadfar; Simone Ferrero; Lorenzo Ferro Desideri; Florian Fischer; Nataliya A Foigt; Masoud Foroutan; Takeshi Fukumoto; Peter Andras Gaal; Santosh Gaihre; William M Gardner; Tushar Garg; Abera Getachew Obsa; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Syed Amir Gilani; Paramjit Singh Gill; Salime Goharinezhad; Mahaveer Golechha; Jenny S Guadamuz; Yuming Guo; Rajat Das Gupta; Rajeev Gupta; Vivek Kumar Gupta; Veer Bala Gupta; Mohammad Hamiduzzaman; Asif Hanif; Josep Maria Haro; Ahmed I Hasaballah; Md Mehedi Hasan; M Tasdik Hasan; Abdiwahab Hashi; Simon I Hay; Khezar Hayat; Mohammad Heidari; Golnaz Heidari; Nathaniel J Henry; Claudiu Herteliu; Ramesh Holla; Sahadat Hossain; Sheikh Jamal Hossain; Mohammad Bellal Hossain Hossain; Mehdi Hosseinzadeh; Sorin Hostiuc; Soodabeh Hoveidamanesh; Vivian Chia-Rong Hsieh; Guoqing Hu; Junjie Huang; M Mamun Huda; Susan C Ifeagwu; Kevin S Ikuta; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Rakibul M Islam; Sheikh Mohammed Shariful Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Ramaiah Itumalla; Masao Iwagami; Mohammad Ali Jahani; Nader Jahanmehr; Rajesh Jain; Mihajlo Jakovljevic; Manthan Dilipkumar Janodia; Sathish Kumar Jayapal; Shubha Jayaram; Ravi Prakash Jha; Jost B Jonas; Tamas Joo; Nitin Joseph; Mikk Jürisson; Ali Kabir; Leila R Kalankesh; Rohollah Kalhor; Aruna M Kamath; Kaloyan Kamenov; Himal Kandel; Rami S Kantar; Neeti Kapoor; Marina Karanikolos; Srinivasa Vittal Katikireddi; Taras Kavetskyy; Norito Kawakami; Gbenga A Kayode; Leila Keikavoosi-Arani; Mohammad Keykhaei; Yousef Saleh Khader; Himanshu Khajuria; Rovshan Khalilov; Mohammad Khammarnia; Md Nuruzzaman Khan; Moien A B Khan; Maseer Khan; Mehdi Khezeli; Min Seo Kim; Yun Jin Kim; Sezer Kisa; Adnan Kisa; Vitalii Klymchuk; Kamrun Nahar Koly; Oleksii Korzh; Soewarta Kosen; Parvaiz A Koul; Barthelemy Kuate Defo; G Anil Kumar; Dian Kusuma; Hmwe Hmwe Kyu; Anders O Larsson; Savita Lasrado; Wei-Chen Lee; Yo Han Lee; Chiachi Bonnie Lee; Shanshan Li; Giancarlo Lucchetti; Preetam Bhalchandra Mahajan; Azeem Majeed; Alaa Makki; Reza Malekzadeh; Ahmad Azam Malik; Deborah Carvalho Malta; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Adolfo Martinez-Valle; Francisco Rogerlândio Martins-Melo; Seyedeh Zahra Masoumi; Manu Raj Mathur; Richard James Maude; Pallab K Maulik; Martin McKee; Walter Mendoza; Ritesh G Menezes; George A Mensah; Atte Meretoja; Tuomo J Meretoja; Tomislav Mestrovic; Irmina Maria Michalek; Erkin M Mirrakhimov; Awoke Misganaw; Sanjeev Misra; Babak Moazen; Mokhtar Mohammadi; Shafiu Mohammed; Modhurima Moitra; Ali H Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Ghobad Moradi; Rafael Silveira Moreira; Jonathan F Mosser; Ebrahim Mostafavi; Simin Mouodi; Ahamarshan Jayaraman Nagarajan; Chie Nagata; Mohsen Naghavi; Vinay Nangia; Sreenivas Narasimha Swamy; Aparna Ichalangod Narayana; Bruno Ramos Nascimento; Hasan Nassereldine; Biswa Prakash Nayak; Javad Nazari; Ionut Negoi; Samata Nepal; Sandhya Neupane Kandel; Josephine W Ngunjiri; Huong Lan Thi Nguyen; Cuong Tat Nguyen; Dina Nur Anggraini Ningrum; Jean Jacques Noubiap; Bogdan Oancea; Onome Bright Oghenetega; In-Hwan Oh; Andrew T Olagunju; Babayemi Oluwaseun Olakunde; Ahmed Omar Bali; Emad Omer; Obinna E Onwujekwe; Adrian Otoiu; Jagadish Rao Padubidri; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Seithikurippu R Pandi-Perumal; Shahina Pardhan; Deepak Kumar Pasupula; Praveen Kumar Pathak; George C Patton; Shrikant Pawar; Jeevan Pereira; Manju Pilania; Bakhtiar Piroozi; Vivek Podder; Khem Narayan Pokhrel; Maarten J Postma; Sergio I Prada; Zahiruddin Quazi Syed; Navid Rabiee; Raghu Anekal Radhakrishnan; Md. Mosfequr Rahman; Mosiur Rahman; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Amir Masoud Rahmani; Chhabi Lal Ranabhat; Chythra R Rao; Sowmya J Rao; Davide Rasella; Salman Rawaf; David Laith Rawaf; Lal Rawal; Andre M N Renzaho; Bhageerathy Reshmi; Serge Resnikoff; Aziz Rezapour; Seyed Mohammad Riahi; Rezaul Karim Ripon; Simona Sacco; Masoumeh Sadeghi; Umar Saeed; Amirhossein Sahebkar; Biniyam Sahiledengle; Harihar Sahoo; Maitreyi Sahu; Joseph S Salama; Payman Salamati; Abdallah M Samy; Juan Sanabria; Milena M Santric-Milicevic; Brijesh Sathian; Monika Sawhney; Maria Inês Schmidt; Abdul-Aziz Seidu; Sadaf G Sepanlou; Allen Seylani; Masood Ali Shaikh; Aziz Sheikh; Adithi Shetty; Mika Shigematsu; Rahman Shiri; K.M. Shivakumar; Azad Shokri; Jasvinder A Singh; Dhirendra Narain Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ahmad Sofi-Mahmudi; Raúl A R C Sousa; Jacqueline H Stephens; Jing Sun; Miklós Szócska; Rafael Tabarés-Seisdedos; Hooman Tadbiri; Animut Tagele Tamiru; Kavumpurathu Raman Thankappan; Roman Topor-Madry; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Bach Xuan Tran; Niharika Tripathi; Jaya Prasad Tripathy; Christopher E Troeger; Deinzel Robles Uezono; Saif Ullah; Anayat Ullah; Bhaskaran Unnikrishnan; Marco Vacante; Sahel Valadan Tahbaz; Pascual R Valdez; Milena Vasic; Massimiliano Veroux; Dominique Vervoort; Francesco S Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Bay Vo; Yasir Waheed; Richard G Wamai; Yuan-Pang Wang; Yanzhong Wang; Paul Ward; Taweewat Wiangkham; Lalit Yadav; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Sanni Yaya; Vahid Yazdi-Feyzabadi; Siyan Yi; Vahit Yiǧit; Naohiro Yonemoto; Mustafa Z Younis; Chuanhua Yu; Ismaeel Yunusa; Sojib Bin Zaman; Mikhail Sergeevich Zastrozhin; Zhi-Jiang Zhang; Chenwen Zhong; Yves Miel H Zuniga; Stephen S Lim; Christopher J L Murray; Rafael Lozano
Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) Cristiana Abbafati; Kaja M. Abbas; Mohammad Abbasi; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Foad Abd-Allah; Ahmed Abdelalim; Mohammad Abdollahi; Ibrahim Abdollahpour; Aidin Abedi; Parisa Abedi; Kedir Hussein Abegaz; Hassan Abolhassani; Akine Eshete Abosetugn; Victor Aboyans; Elissa M. Abrams; Lucas Guimarães Abreu; Michael R.M. Abrigo; Abdulaziz Khalid Abu Haimed; Ahmed Abualhasan; Eman Abu-Gharbieh; Laith Jamal Abu-Raddad; Abdelrahman I. Abushouk; Alyssa Acebedo; Ilana N. Ackerman; Maryam Adabi; Tim Adair; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Jaimie D. Adelson; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Shailesh M. Advani; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Emilie E. Agardh; Gina Agarwal; Pradyumna Agasthi; Kareha M. Agesa; Mohammad Aghaali; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Alireza Ahmadi; Keivan Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Ehsan Ahmadpour; Muktar Beshir Ahmed; Budi Aji; Temesgen Yihunie Akalu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Blessing Akombi; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Noore Alam; Samiah Alam; Tahiya Alam; Fahad Mashhour Alanezi; Turki M. Alanzi; Samuel B. Albertson; Jacqueline Elizabeth Alcalde-Rabanal; Niguse Meles Alema; Biresaw Wassihun Alemu; Yihun Mulugeta Alemu; Khalid F. Alhabib; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Gianfranco Alicandro; Mehran Alijanzadeh; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; François Alla; Peter Allebeck; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A. Almasri; Hesham M. Al-Mekhlafi; Abdulaziz M. Almulhim; Jordi Alonso; Rajaa M. Al-Raddadi; Khalid A. Altirkawi; Arwa Khalid Alumran; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Azmeraw T. Amare; Bekalu Amare; Saeed Amini; Mostafa Amini-Rarani; Arya Aminorroaya; Fatemeh Amiri; Arianna Maever L. Amit; Dickson A. Amugsi; Gianna Gayle Herrera Amul; Etsay Woldu Anbesu; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Sofia Androudi; Colin Angus; Mina Anjomshoa; Fereshteh Ansari; Iman Ansari; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Carl Abelardo T. Antonio; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y. Aravkin; Aseb Arba Kinfe Arba; Olatunde Aremu; Filippo Ariani; Timur Aripov; Bahram Armoon; Johan Ärnlöv; Oluwaseyi Olalekan Arowosegbe; Krishna K. Aryal; Afsaneh Arzani; Malke Asaad; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Samaneh Asgari; Babak Asghari; Mohammad Asghari Jafarabadi; Charlie Ashbaugh; Michael Assmus; Zahra Atafar; Seyyed Shamsadin Athari; Desta Debalkie Atnafu; Maha Moh'd Wahbi Atout; Sachin R. Atre; Madhu Sudhan Atteraya; Floriane Ausloos; Marcel Ausloos; Leticia Avila-Burgos; Euripide Frinel Gbenato Arthur Avokpaho; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Getie Lake Aynalem; Yared Asmare Aynalem; Muluken Altaye Ayza; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Gulrez Azhar; Peter S. Azzopardi; B.B. Darshan; Ebrahim Babaee; Alaa Badawi; Ashish D. Badiye; Mojtaba Bagherzadeh; Eleni Bagli; Mohammad Amin Bahrami; Atif Amin Baig; Mohan Bairwa; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M. Bakkannavar; Arun Balachandran; Senthilkumar Balakrishnan; Shivanthi Balalla; Shelly Balassyano; Alberto Baldasseroni; Kylie Ball; Shoshana H. Ballew; Daniela Balzi; Maciej Banach; Srikanta K. Banerjee; Palash Chandra Banik; Marlena S. Bannick; Agegnehu Bante Bante; Simachew Animen Bante; Adhanom Gebreegziabher Baraki; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Lingkan Barua; Akbar Barzegar; Huda Basaleem; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Mohsen Bayati; Bayisa Abdissa Baye; Gholamreza Bazmandegan; Jacob S. Becker; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Yannick Béjot; Tariku Tesfaye Tesfaye Bekuma; Michelle L. Bell; Aminu K. Bello; Rose G. Bender; Derrick A. Bennett; Fiona B. Bennitt; Isabela M. Bensenor; Catherine P. Benziger; Kidanemaryam Berhe; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Akshaya Srikanth Bhagavathula; Reshmi Bhageerathy; Neeraj Bhala; Dinesh Bhandari; Pankaj Bhardwaj; Anusha Ganapati Bhat; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A. Bhutta; Sadia Bibi; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Muhammad Shahdaat Bin Sayeed; Antonio Biondi; Binyam Minuye Birihane; Donal Bisanzio; Catherine Bisignano; Raaj Kishore Biswas; Helen Bitew; Tone Bjørge; Moses John Bockarie; Somayeh Bohlouli; Mehdi Bohluli; Hunduma Amensisa Bojia; Srinivasa Rao Bolla; Archith Boloor; Alexandra S. Boon-Dooley; Guilherme Borges; Antonio Maria Borzì; Shiva Borzouei; Dipan Bose; Cristina Bosetti; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Dejana Braithwaite; Michael Brauer; Carol Brayne; Nicholas J.K. Breitborde; Susanne Breitner; Hermann Brenner; Alexey V. Breusov; Paul Svitil Briant; Andrew M. Briggs; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle B. Britton; Traolach Brugha; Dana Bryazka; Rachelle Buchbinder; Blair R. Bumgarner; Katrin Burkart; Richard Thomas Burnett; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A. Butt; Florentino Luciano Caetano dos Santos; Leah E. Cahill; Lucero Cahuana-Hurtado; Tianji Cai; Charlton S.K.H. Callender; Luis Alberto Cámera; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jackie Cao; Josip Car; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Chris D. Castle; Emma Castro; Franz Castro; Ferrán Catalá-López; Kate Causey; Christopher R. Cederroth; Kelly M. Cercy; Ester Cerin; Julian Chalek; Joht Singh Chandan; Alex R. Chang; Angela Y. Chang; Jung-Chen Chang; Kai-Lan Chang; Jaykaran Charan; Fiona J. Charlson; Vijay Kumar Chattu; Sarika Chaturvedi; Nicolas Cherbuin; Odgerel Chimed-Ochir; Ken Lee Chin; Jesus Lorenzo Chirinos-Caceres; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T. Chung; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Beniamino Cislaghi; Thomas Khaled Dwayne Classen; Aaron J. Cohen; Emma L. Collins; Haley Comfort; Kelly Compton; Sara Conti; Owen R. Cooper; Barbara Corso; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Benjamin C. Cowie; Elizabeth A. Cromwell; Andrew J. Croneberger; Di H. Cross; Marita Cross; Christopher Stephen Crowe; Jessica A. Cruz; Steven Cummins; Matthew Cunningham; Saad M.A. Dahlawi; Haijiang Dai; Hancheng Dai; Albertino Antonio Moura Damasceno; Giovanni Damiani; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; William James Dangel; Anna-Karin Danielsson; Jiregna Darega Gela; Paul I. Dargan; Aso Mohammad Darwesh; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; José das Neves; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Adrian C. Davis; Dragos Virgil Davitoiu; Kairat Davletov; Diego De Leo; Jan-Walter De Neve; Frances E. Dean; Nicole K. DeCleene; Amanda Deen; Louisa Degenhardt; Marissa DeLang; Robert Paul Dellavalle; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Desalegn Getnet Demsie; Edgar Denova-Gutiérrez; Nebiyu Dereje Dereje; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Assefa Desalew; Getenet Ayalew Dessie; Keshab Deuba; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Martin Dichgans; Alireza Didarloo; Zachary V. Dingels; Ilse N. Dippenaar; M. Ashworth Dirac; Shirin Djalalinia; Hoa Thi Do; Klara Dokova; David Teye Doku; Christiane Dolecek; Andrew J. Dolgert; Fariba Dorostkar; Chirag P. Doshi; Pratik P. Doshi; Leila Doshmangir; Abdel Douiri; Matthew C. Doxey; Kerrie E. Doyle; Tim Robert Driscoll; Eleonora Dubljanin; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; Hedyeh Ebrahimi; Mohammad Ebrahimi Kalan; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Nevine El Nahas; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Islam Y. Elgendy; Hala Rashad Elhabashy; Shaimaa I. El-Jaafary; Aisha Elsharkawy; Iqbal R.F. Elyazar; Mohammad Hassan Emamian; Sophia Emmons-Bell; Holly E. Erskine; Babak Eshrati; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Firooz Esmaeilzadeh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Arash Etemadi; Atkilt Esaiyas Etisso; Oluchi Ezekannagha; Jessica Fanzo; Tamer Farag; Mohammad Farahmand; Anwar Faraj; Emerito Jose A. Faraon; Mohammad Fareed; Roghiyeh Faridnia; Carla Sofia e Sá Farinha; Andrea Farioli; Pawan Sirwan Faris; Andre Faro; Mithila Faruque; Farshad Farzadfar; Nazir Fattahi; Ali Akbar Fazaeli; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Giannina Ferrara; Pietro Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L. Fisher; Ryan Fitzgerald; Carsten Flohr; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Masoud Foroutan; Jack T. Fox; Joel Msafiri Francis; Tahvi D. Frank; Richard Charles Franklin; Marisa Freitas; Weijia Fu; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Nancy Fullman; João M. Furtado; Mohamed M. Gad; Abhay Motiramji Gaidhane; Emmanuela Gakidou; Natalie C. Galles; Silvano Gallus; Amiran Gamkrelidze; Alberto L. Garcia-Basteiro; William M. Gardner; Biniyam Sahiledengle Geberemariyam; Abiyu Mekonnen Gebrehiwot; Ketema Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Leake G. Gebremeskel; Begashaw Melaku Gebresillassie; Assefa Ayalew Ayalew Ayalew Gebreslassie; Yilma Chisha Dea Geramo; Abraham Geremew; Anna Gershberg Hayoon; Hailay Abrha Gesesew; Peter W. Gething; Kebede Embaye Gezae; Maryam Ghadimi; Keyghobad Ghadiri; Fatemeh Ghaffarifar; Mansour Ghafourifard; Alireza Ghajar; Farhad Ghamari; Ahmad Ghashghaee; Hesam Ghiasvand; Nermin Ghith; Asadollah Gholamian; Rakesh Ghosh; Simona Giampaoli; Syed Amir Gilani; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Themba G. Ginindza; Mojgan Gitimoghaddam; Giorgia Giussani; Mustefa Glagn; Ekaterina Vladimirovna Glushkova; Elena V. Gnedovskaya; Myron Anthony Godinho; Salime Goharinezhad; Mahaveer Golechha; Srinivas Goli; Ricardo Santiago Gomez; Philimon N. Gona; Sameer Vali Gopalani; Emily Goren; Giuseppe Gorini; Taren M. Gorman; Harrison Chase Gottlich; Houman Goudarzi; Amir Hossein Goudarzian; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Felix Greaves; Michal Grivna; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Nachiket Gudi; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Rafael Alves Guimarães; Rashid Abdi Guled; Teklemariam Gultie; Gaorui Guo; Yuming Guo; Rahul Gupta; Rajeev Gupta; Subodh Sharan Gupta; Tarun Gupta; Juanita A. Haagsma; Vladimir Hachinski; Beatrix Haddock; Nima Hafezi-Nejad; Abdul Hafiz; Hailey Hagins; Lydia M. Haile; Teklehaimanot Gereziher Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Sajid Hameed; Samer Hamidi; Erin B. Hamilton; Melanie S. Hammer; Chieh Han; Hannah Han; Demelash Woldeyohannes Handiso; Asif Hanif; Graeme J. Hankey; Hamidreza Haririan; Josep Maria Haro; James D. Harvey; Ahmed I. Hasaballah; Md Mehedi Hasan; Edris Hasanpoor; Amir Hasanzadeh; Maryam Hashemian; Abdiwahab Hashi; Amr Hassan; Shoaib Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Roderick J. Hay; Simon I. Hay; Khezar Hayat; Behzad Heibati; Behnam Heidari; Golnaz Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Kiana Henny; Andualem Henok; Hannah J. Henrikson; Nathaniel J. Henry; Molly E. Herbert; Claudiu Herteliu; Fatemeh Heydarpour; Thomas R. Hird; Hung Chak Ho; Hans W. Hoek; Michael K. Hole; Ramesh Holla; Bruce Hollingsworth; Praveen Hoogar; Kathleen Pillsbury Hopf; Nobuyuki Horita; H. Dean Hosgood; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Vivian Chia-Rong Hsieh; Guoqing Hu; Kejia Hu; Tanvir M. Huda; Fernando N. Hugo; Ayesha Humayun; Rabia Hussain; Chantal K. Huynh; Bing-Fang Hwang; Vincent C. Iannucci; Ivo Iavicoli; Charles Ugochukwu Ibeneme; Segun Emmanuel Ibitoye; Nayu Ikeda; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mohammad Hasan Imani-Nasab; Leeberk Raja Inbaraj; Helen Ippolito; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M. Mofizul Islam; Md. Mohaimenul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Hiroyasu Iso; Rebecca Q. Ivers; Chidozie C.D. Iwu; Chinwe Juliana Iwu; Ihoghosa Osamuyi Iyamu; Jalil Jaafari; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Hussain Jafari; Morteza Jafarinia; Deepa Jahagirdar; Mohammad Ali Jahani; Nader Jahanmehr; Mihajlo Jakovljevic; Amir Jalali; Farzad Jalilian; Spencer L. James; Hosna Janjani; Manthan Dilipkumar Janodia; Tahereh Javaheri; Javad Javidnia; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Peng Jia; Lars Johansson; Oommen John; Yetunde O. John-Akinola; Catherine Owens Johnson; Sarah Charlotte Johnson; Jost B. Jonas; Tamas Joo; Ankur Joshi; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Zubair Kabir; Hamed Kalani; Rizwan Kalani; Leila R. Kalankesh; Rohollah Kalhor; Aruna M. Kamath; Zahra Kamiab; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; Marina Karanikolos; André Karch; Mohd Anisul Karim; Salah Eddin Karimi; Seyed Asaad Karimi; Seyed M. Karimi; Ayele Semachew Kasa; Getachew Mullu Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Norito Kawakami; Gbenga A. Kayode; Ali Kazemi Karyani; Suzanne H. Keddie; Peter Njenga Keiyoro; Cathleen Keller; Laura Kemmer; Parkes J. Kendrick; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Nauman Khalid; Mohammad Khammarnia; Ejaz Ahmad Khan; Gulfaraz Khan; Maseer Khan; Young-Ho Khang; Khaled Khatab; Amir M. Khater; Mona M. Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Salman Khazaei; Habibolah Khazaie; Mohammad Taghi Khodayari; Abdullah T. Khoja; Jagdish Khubchandani; Roba Khundkar; Neda Kianipour; Christian Kieling; Cho-Il Kim; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika Kivimäki; Cameron J. Kneib; Luke D. Knibbs; Megan Knight; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; David S.Q. Koh; Stefan Kohler; Tufa Kolola; Hamidreza Komaki; Jacek A. Kopec; Anna V. Korotkova; Vladimir Andreevich Korshunov; Soewarta Kosen; Anirudh Kotlo; Parvaiz A. Koul; Ai Koyanagi; Moritz U.G. Kraemer; Michael A. Kravchenko; Kewal Krishan; Kris J. Krohn; Hans Kromhout; K.S. Shaji; Barthelemy Kuate Defo; Burcu Bicer Kucuk; Nuworza Kugbey; Vaman Kulkarni; G. Anil Kumar; Manasi Kumar; Nithin Kumar; Pushpendra Kumar; Vivek Kumar; Girikumar Kumaresh; Om P. Kurmi; Dian Kusuma; Hmwe Hmwe Kyu; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Jennifer O. Lam; Faris Hasan Lami; Qing Lan; Iván Landires; Justin J. Lang; Sinéad M. Langan; Van Charles Lansingh; Sonia Lansky; Heidi Jane Larson; Samantha Leigh Larson; Anders O. Larsson; Savita Lasrado; Zohra S. Lassi; Kathryn Mei-Ming Lau; Paolo Lauriola; Pablo M. Lavados; Jeffrey V. Lazarus; Lisiane F. Leal; Janet L. Leasher; Jorge R. Ledesma; Paul H. Lee; Shaun Wen Huey Lee; Andrew T. Leever; Kate E. LeGrand; James Leigh; Matilde Leonardi; Haley Lescinsky; Janni Leung; Miriam Levi; Sarah Lewington; Bingyu Li; Shanshan Li; Lee-Ling Lim; Christine Lin; Ro-Ting Lin; Christine Linehan; Shai Linn; Stefan Listl; Hung-Chun Liu; Shiwei Liu; Simin Liu; Xuefeng Liu; Yang Liu; Zichen Liu; Justin Lo; Rakesh Lodha; Giancarlo Logroscino; Katharine J. Looker; Alan D. Lopez; Jaifred Christian F. Lopez; Platon D. Lopukhov; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Alton Lu; Tim C.D. Lucas; Alessandra Lugo; Raimundas Lunevicius; Ronan A. Lyons; Jianing Ma; Daiane Borges Machado; Jennifer H. MacLachlan; Mohammed Madadin; Emilie R. Maddison; Ralph Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Phetole Walter Mahasha; Mokhtar Mahdavi Mahdavi; Morteza Mahmoudi; Hue Thi Mai; Azeem Majeed; Jeadran N. Malagón-Rojas; Venkatesh Maled; Afshin Maleki; Shokofeh Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Amir Manafi; Navid Manafi; Ana Laura Manda; Helena Manguerra; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Ana M. Mantilla Herrera; Chabila Christopher Mapoma; Joemer C. Maravilla; Ashley Marks; Randall V. Martin; Santi Martini; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Anthony Masaka; Seyedeh Zahra Masoumi; João Massano; Benjamin Ballard Massenburg; Claudia I. Mastrogiacomo; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Erin A. May; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Carlo Eduardo Medina-Solís; Birhanu Geta Meharie; Man Mohan Mehndiratta; Entezar Mehrabi Nasab; Fereshteh Mehri; Ravi Mehrotra; Kala M. Mehta; Wahengbam Bigyananda Meitei; Teferi Mekonnen; Addisu Melese; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Meresa Berwo Mengesha; George A. Mensah; Alibek Mereke; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Kebadnew Mulatu Mihretie; Ted R. Miller; Edward J. Mills; George J. Milne; G.K. Mini; Mohammad Miri; Andreea Mirica; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Awoke Temesgen Misganaw; Philip B. Mitchell; Prasanna Mithra; Babak Moazen; Masoud Moghadaszadeh; Bahram Mohajer; Osama Mohamad; Efat Mohamadi; Dara K. Mohammad; Yousef Mohammad
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Lancet Publishing Group, 2020) Rafael Lozano; Nancy Fullman; John Everett Mumford; Megan Knight; Celine M Barthelemy; Cristiana Abbafati; Hedayat Abbastabar; Foad Abd-Allah; Mohammad Abdollahi; Aidin Abedi; Hassan Abolhassani; Akine Eshete Abosetugn; Lucas Guimarães Abreu; Michael R M Abrigo; Abdulaziz Khalid Abu Haimed; Abdelrahman I Abushouk; Maryam Adabi; Oladimeji M Adebayo; Victor Adekanmbi; Jaimie Adelson; Olatunji O Adetokunboh; Davoud Adham; Shailesh M Advani; Ashkan Afshin; Gina Agarwal; Pradyumna Agasthi; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Rufus Olusola Akinyemi; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Samuel B Albertson; Yihun Mulugeta Alemu; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Vahid Alipour; Syed Mohamed Aljunid; François Alla; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A Almasri; Hesham M Al-Mekhlafi; Abdulaziz M Almulhim; Jordi Alonso; Rajaa M Al-Raddadi; Khalid A Altirkawi; Nelson Alvis-Guzman; Nelson J Alvis-Zakzuk; Saeed Amini; Mostafa Amini-Rarani; Fatemeh Amiri; Arianna Maever L Amit; Dickson A Amugsi; Robert Ancuceanu; Deanna Anderlini; Catalina Liliana Andrei; Sofia Androudi; Fereshteh Ansari; Alireza Ansari-Moghaddam; Carl Abelardo T Antonio; Catherine M Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y Aravkin; Olatunde Aremu; Johan Ärnlöv; Malke Asaad; Mehran Asadi-Aliabadi; Ali A Asadi-Pooya; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Marcel Ausloos; Leticia Avila-Burgos; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Yared Asmare Aynalem; Getie Lake Aynalem; Muluken Altaye Ayza; Samad Azari; Peter S Azzopardi; Darshan B B; Ebrahim Babaee; Ashish D Badiye; Mohammad Amin Bahrami; Atif Amin Baig; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M Bakkannavar; Arun Balachandran; Maciej Banach; Srikanta K Banerjee; Palash Chandra Banik; Agegnehu Bante Bante; Simachew Animen Bante; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H Barrero; Quique Bassat; Sanjay Basu; Bernhard T Baune; Mohsen Bayati; Bayisa Abdissa Baye; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Tariku Tesfaye Tesfaye Bekuma; Michelle L Bell; Isabela M Bensenor; Adam E Berman; Eduardo Bernabe; Robert S Bernstein; Akshaya Srikanth Bhagavathula; Dinesh Bhandari; Pankaj Bhardwaj; Anusha Ganapati Bhat; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A Bhutta; Ali Bijani; Boris Bikbov; Ver Bilano; Antonio Biondi; Binyam Minuye Birihane; Moses John Bockarie; Somayeh Bohlouli; Hunduma Amensisa Bojia; Srinivasa Rao Rao Bolla; Archith Boloor; Oliver J Brady; Dejana Braithwaite; Andrew M Briggs; Nikolay Ivanovich Briko; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A Butt; Florentino Luciano Caetano dos Santos; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Rosario Cárdenas; Giulia Carreras; Juan J Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A Castañeda-Orjuela; Giulio Castelpietra; Franz Castro; Ferrán Catalá-López; Christopher R Cederroth; Ester Cerin; Joht Singh Chandan; Angela Y Chang; Jaykaran Charan; Vijay Kumar Chattu; Sarika Chaturvedi; Ken Lee Chin; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T Chung; Liliana G Ciobanu; Massimo Cirillo; Kelly Compton; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Saad M A Dahlawi; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Jiregna Darega Gela; Aso Mohammad Darwesh; Ahmad Daryani; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Jan-Walter De Neve; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Ilse N Dippenaar; Hoa Thi Do; Fariba Dorostkar; Leila Doshmangir; Bruce B Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; David Edvardsson; Iman El Sayed; Maha El Tantawi; Islam Y Elgendy; Iqbal RF Elyazar; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Alireza Esteghamati; Oluchi Ezekannagha; Tamer Farag; Mohammad Farahmand; Emerito Jose A Faraon; Carla Sofia e Sá Farinha; Andrea Farioli; Pawan Sirwan Faris; Andre Faro; Mehdi Fazlzadeh; Valery L Feigin; Eduarda Fernandes; Pietro Ferrara; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L Fisher; Luisa Sorio Flor; Nataliya A Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Masoud Foroutan; Joel Msafiri Francis; Weijia Fu; Takeshi Fukumoto; João M Furtado; Mohamed M Gad; Abhay Motiramji Gaidhane; Emmanuela Gakidou; Natalie C Galles; Silvano Gallus; William M Gardner; Biniyam Sahiledengle Geberemariyam; Abiyu Mekonnen Gebrehiwot; Leake G Gebremeskel; Gebreamlak Gebremedhn Gebremeskel; Hailay Abrha Gesesew; Keyghobad Ghadiri; Mansour Ghafourifard; Ahmad Ghashghaee; Nermin Ghith; Asadollah Gholamian; Syed Amir Gilani; Paramjit Singh Gill; Tiffany K Gill; Themba G Ginindza; Mojgan Gitimoghaddam; Giorgia Giussani; Mustefa Glagn; Elena V Gnedovskaya; Myron Anthony Godinho; Salime Goharinezhad; Sameer Vali Gopalani; Amir Hossein Goudarzian; Bárbara Niegia Garcia Goulart; Mohammed Ibrahim Mohialdeen Gubari; Rafael Alves Guimarães; Rashid Abdi Guled; Teklemariam Gultie; Yuming Guo; Rahul Gupta; Nima Hafezi-Nejad; Abdul Hafiz; Teklehaimanot Gereziher Haile; Randah R Hamadeh; Sajid Hameed; Samer Hamidi; Chieh Han; Hannah Han; Demelash Woldeyohannes Handiso; Asif Hanif; Graeme J Hankey; Josep Maria Haro; Ahmed I Hasaballah; Md Mehedi Hasan; Abdiwahab Hashi; Shoaib Hassan; Amr Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J Havmoeller; Simon I Hay; Khezar Hayat; Golnaz Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Claudiu Herteliu; Thomas R Hird; Hung Chak Ho; Michael K Hole; Ramesh Holla; Praveen Hoogar; Kathleen Pillsbury Hopf; Nobuyuki Horita; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Vivian Chia-rong Hsieh; Guoqing Hu; Tanvir M Huda; Ayesha Humayun; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Nayu Ikeda; Olayinka Stephen Ilesanmi; Milena D Ilic; Leeberk Raja Inbaraj; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M Mofizul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Hiroyasu Iso; Chinwe Juliana Iwu; Jalil Jaafari; Farhad Jadidi-Niaragh; Morteza Jafarinia; Deepa Jahagirdar; Mohammad Ali Jahani; Nader Jahanmehr; Mihajlo Jakovljevic; Hosna Janjani; Tahereh Javaheri; Achala Upendra Jayatilleke; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S Ji; Peng Jia; Yetunde O John-Akinola; Jost B Jonas; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Zubair Kabir; Leila R Kalankesh; Rohollah Kalhor; Aruna M Kamath; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; Marina Karanikolos; Seyed M Karimi; Nicholas J Kassebaum; Srinivasa Vittal Katikireddi; Gbenga A Kayode; Peter Njenga Keiyoro; Yousef Saleh Khader; Mohammad Khammarnia; Maseer Khan; Ejaz Ahmad Khan; Young-Ho Khang; Khaled Khatab; Amir M Khater; Mona M Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Jagdish Khubchandani; Neda Kianipour; Yun Jin Kim; Ruth W Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Cameron J Kneib; Jonathan M Kocarnik; Sonali Kochhar; Stefan Kohler; Jacek A Kopec; Anna V Korotkova; Vladimir Andreevich Korshunov; Soewarta Kosen; Anirudh Kotlo; Parvaiz A Koul; Ai Koyanagi; Kewal Krishan; Kris J Krohn; Nuworza Kugbey; Vaman Kulkarni; G Anil Kumar; Nithin Kumar; Manasi Kumar; Om P Kurmi; Dian Kusuma; Hmwe Hmwe Kyu; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Iván Landires; Van Charles Lansingh; Anders O Larsson; Savita Lasrado; Kathryn Mei-Ming Lau; Paolo Lauriola; Jeffrey V Lazarus; Jorge R Ledesma; Paul H Lee; Shaun Wen Huey Lee; Andrew T Leever; Kate E LeGrand; James Leigh; Matilde Leonardi; Shanshan Li; Stephen S Lim; Lee-Ling Lim; Xuefeng Liu; Giancarlo Logroscino; Alan D Lopez; Platon D Lopukhov; Paulo A Lotufo; Alton Lu; Jianing Ma; Mohammed Madadin; Phetole Walter Mahasha; Morteza Mahmoudi; Azeem Majeed; Jeadran N Malagón-Rojas; Shokofeh Maleki; Deborah Carvalho Malta; Borhan Mansouri; Mohammad Ali Mansournia; Santi Martini; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Benjamin Ballard Massenburg; Claudia I Mastrogiacomo; Manu Raj Mathur; Colm McAlinden; Martin McKee; Carlo Eduardo Medina-Solís; Birhanu Geta Meharie; Man Mohan Mehndiratta; Entezar Mehrabi Nasab; Fereshteh Mehri; Ravi Mehrotra; Teferi Mekonnen; Addisu Melese; Peter T N Memiah; Walter Mendoza; Ritesh G Menezes; George A Mensah; Tuomo J Meretoja; Atte Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Irmina Maria Michalek; Erkin M Mirrakhimov; Maryam Mirzaei; Mehdi Mirzaei-Alavijeh; Philip B Mitchell; Babak Moazen; Masoud Moghadaszadeh; Efat Mohamadi; Yousef Mohammad; Dara K Mohammad; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Jemal Abdu Mohammed; Ali H Mokdad; Lorenzo Monasta; Stefania Mondello; Masoud Moradi; Maziar Moradi-Lakeh; Rahmatollah Moradzadeh; Paula Moraga; Joana Morgado-da-Costa; Shane Douglas Morrison; Abbas Mosapour; Jonathan F Mosser; Amin Mousavi Khaneghah; Moses K Muriithi; Ghulam Mustafa; Ashraf F Nabhan; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Behshad Naghshtabrizi; Mukhammad David Naimzada; Vinay Nangia; Jobert Richie Nansseu; Vinod C Nayak; Javad Nazari; Rawlance Ndejjo; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Kiirithio N Ngari; Georges Nguefack-Tsague; Josephine W Ngunjiri; Cuong Tat Nguyen; Diep Ngoc Nguyen; Huong Lan Thi Nguyen; Chukwudi A Nnaji; Shuhei Nomura; Ole F Norheim; Jean Jacques Noubiap; Christoph Nowak; Virginia Nunez-Samudio; Adrian Otoiu; Felix Akpojene Ogbo; Onome Bright Oghenetega; In-Hwan Oh; Emmanuel Wandera Okunga; Morteza Oladnabi; Andrew T Olagunju; Jacob Olusegun Olusanya; Bolajoko Olubukunola Olusanya; Mojisola Morenike Oluwasanu; Ahmed Omar Bali; Muktar Omer Omer; Kanyin L Ong; Obinna E Onwujekwe; Doris V V Ortega-Altamirano; Alberto Ortiz; Sergej M Ostojic; Nikita Otstavnov; Stanislav S Otstavnov; Simon Øverland; Mayowa O Owolabi; Jagadish Rao. Padubidri; Smita Pakhale; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Helena Ullyartha Pangaribuan; Mona Pathak; George C Patton; Sagun Paudel; Hamidreza Pazoki Toroudi; Spencer A Pease; Amy E Peden; Alyssa Pennini; Emmanuel K Peprah; Jeevan Pereira; David M Pigott; Thomas Pilgrim; Tessa M Pilz; Marina Pinheiro; Michael A Piradov; Meghdad Pirsaheb; Khem Narayan Pokhrel; Maarten J Postma; Hadi Pourjafar; Farshad Pourmalek; Reza Pourmirza Kalhori; Akram Pourshams; Sergio I Prada; Dimas Ria Angga Pribadi; Elisabetta Pupillo; Zahiruddin Quazi Syed; Amir Radfar; Ata Rafiee; Alireza Rafiei; Alberto Raggi; Fakher Rahim; Muhammad Aziz Rahman; Ali Rajabpour-Sanati; Saleem Muhammad Rana; Chhabi Lal Ranabhat; Sowmya J Rao; Davide Rasella; Vahid Rashedi; Goura Kishor Rath; Priya Rathi; Salman Rawaf; David Laith Rawaf; Lal Rawal; Reza Rawassizadeh; Christian Razo; Vishnu Renjith; Andre M N Renzaho; Bhageerathy Reshmi; Nima Rezaei; Seyed Mohammad Riahi; Daniel Cury Ribeiro; Jennifer Rickard; Nicholas L S Roberts; Leonardo Roever; Michele Romoli; Luca Ronfani; Gholamreza Roshandel; Enrico Rubagotti; Godfrey M Rwegerera; Siamak Sabour; Perminder S Sachdev; Basema Saddik; Masoumeh Sadeghi; Ehsan Sadeghi; Yahya Safari; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; S. Mohammad Sajadi; Mohammad Reza Salahshoor; Marwa R Rashad Salem; Hosni Salem; Joshua Salomon; Hossein Samadi Kafil; Abdallah M Samy; Juan Sanabria; Milena M Santric-Milicevic; Sivan Yegnanarayana Iyer Saraswathy; Rodrigo Sarmiento-Suárez; Benn Sartorius; Arash Sarveazad; Brijesh Sathian; Thirunavukkarasu Sathish; Davide Sattin; Miloje Savic; Susan M Sawyer; Deepak Saxena; Alyssa N Sbarra; Lauren E Schaeffer; Silvia Schiavolin; Maria Inês Schmidt; Aletta Elisabeth Schutte; David C Schwebel; Falk Schwendicke; Soraya Seedat; Feng Sha; Saeed Shahabi; Amira A Shaheen; Masood Ali Shaikh; Morteza Shamsizadeh; Mohammed Shannawaz; Kiomars Sharafi; Fablina Sharara; Hamid Sharifi; David H Shaw; Aziz Sheikh; Abbas Sheikhtaheri; B Suresh Kumar Shetty; Kenji Shibuya; Wondimeneh Shibabaw Shiferaw; Mika Shigematsu; Jae Il Shin; Rahman Shiri; Reza Shirkoohi; K.M. Shivakumar; Mark G Shrime; Kerem Shuval; Soraya Siabani; Radoslaw Sierpinski; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Diego Augusto Santos Silva; João Pedro Silva; Biagio Simonetti; Kyle E Simpson; Jasvinder A Singh; Pushpendra Singh; Dhirendra Narain Sinha; Valentin Yurievich Skryabin; Emma U R Smith; Amin Soheili; Shahin Soltani; Moslem Soofi; Reed J.D. Sorensen; Joan B Soriano; Muluken Bekele Sorrie; Ireneous N Soyiri; Emma Elizabeth Spurlock; Chandrashekhar T Sreeramareddy; Jeffrey D Stanaway; Nicholas Steel; Caroline Stein; Mark A Stokes; Mu'awiyyah Babale Sufiyan; Hafiz Ansar Rasul Suleria; Iyad Sultan; Łukasz Szumowski; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Biruk Wogayehu Taddele; Degena Bahrey Tadesse; Amir Taherkhani; Animut Tagele Tamiru; Frank C Tanser; Md Ismail Tareque; Ingan Ukur Tarigan; Whitney L Teagle; Fabrizio Tediosi; Yonas Getaye Getaye Tefera; Freweini Gebrearegay Tela; Zemenu Tadesse Tessema; Bhaskar Thakur; Mariya Vladimirovna Titova; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Marcos Roberto Roberto Tovani-Palone; Bach Xuan Tran; Ravensara Travillian; Christopher E Troeger; Lorainne Tudor Car; Riaz Uddin; Irfan Ullah; Chukwuma David Umeokonkwo; Bhaskaran Unnikrishnan; Era Upadhyay; Olalekan A Uthman; Marco Vacante; Pascual R Valdez; Santosh Varughese; Tommi Juhani Vasankari; Yasser Vasseghian; Narayanaswamy Venketasubramanian; Francesco S Violante; Vasily Vlassov; Stein Emil Vollset; Avina Vongpradith; Theo Vos; Yasir Waheed; Magdalene K Walters; Richard G Wamai; Haidong Wang; Yuan-Pang Wang; Robert G Weintraub; Jordan Weiss; Andrea Werdecker; Ronny Westerman; Lauren B Wilner; Gebremariam Woldu; Charles D A Wolfe; Ai-Min Wu; Sarah Wulf Hanson; Yang Xie; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Yuichiro Yano; Sanni Yaya; Vahid Yazdi-Feyzabadi; Jamal A Yearwood; Yordanos Gizachew Yeshitila; Paul Yip; Naohiro Yonemoto; Mustafa Z Younis; Zabihollah Yousefi; Taraneh Yousefinezhadi; Hasan Yusefzadeh; Siddhesh Zadey; Telma Zahirian Moghadam; Syed Saoud Zaidi; Leila Zaki; Sojib Bin Zaman; Maryam Zamanian; Hamed Zandian; Mikhail Sergeevich Zastrozhin; Kaleab Alemayehu Zewdie; Yunquan Zhang; Xiu-Ju George Zhao; Yingxi Zhao; Peng Zheng; Cong Zhu; Arash Ziapour; Bianca S Zlavog; Sanjay Zodpey; Christopher J L Murray
Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation. © 2020 Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license