Measurement Approaches for Effective Coverage Estimation [MR31]

The concept of effective coverage refers to the proportion of the target population that receives a specific health service, such as antenatal care (ANC) or sick child care, and receives the full benefit of that service. This report presents measurement approaches for effective coverage estimation, with a focus on ANC and sick child care. The report begins by introducing the concept of effective coverage and its importance in program evaluation. It then discusses the data and methods used in the analysis, including the surveys and indicators used to construct the effective coverage cascade. The effective coverage cascade is a framework that estimates the proportion of the target population that receives a specific health service and receives the full benefit of that service. The report presents three measurement approaches for effective coverage estimation: the DHS-only approach, the DHS and SPA approach, and the expanded SPA measures approach. The DHS-only approach uses data from the Demographic and Health Surveys (DHS) to estimate effective coverage, while the DHS and SPA approach combines DHS and Service Provision Assessment (SPA) data to estimate effective coverage. The expanded SPA measures approach includes additional indicators to estimate effective coverage. The report presents results from the analysis of ANC and sick child care in five countries: Haiti, Malawi, Nepal, Senegal, and Tanzania. The results show that the effective coverage cascade varies across countries and measurement approaches. For example, in Haiti, the ANC effective coverage cascade ranged from 34% to 64% across the three measurement approaches, while in Malawi, the ANC effective coverage cascade ranged from 25% to 55%. The report also presents a discussion and conclusion, which highlights the importance of effective coverage estimation in program evaluation and the need for further research on this topic. The report recommends the use of the expanded SPA measures approach for effective coverage estimation, as it provides a more comprehensive estimate of effective coverage. The report includes several tables and figures that present the results of the analysis, including tables that describe the measures used to construct the effective coverage cascade and figures that show the effective coverage cascade for each country and measurement approach. The report also includes appendices that provide additional information on the data and methods used in the analysis. Overall, this report provides a comprehensive overview of measurement approaches for effective coverage estimation and presents results from the analysis of ANC and sick child care in five countries. The report highlights the importance of effective coverage estimation in program evaluation and provides recommendations for further research on this topic. The effective coverage cascade is a framework that estimates the proportion of the target population that receives a specific health service and receives the full benefit of that service. The cascade consists of several components, including the proportion of the target population that receives the service, the proportion of those who receive the service that receives the full benefit, and the proportion of those who receive the full benefit that achieves the desired health outcome.