The WHO Service Coverage Indicator
The WHO Global Reference List: Service Coverage Indicator is a core component of global health monitoring, specifically designed to track progress toward Universal Health Coverage (UHC), which is a key target (Target 3.8) of the Sustainable Development Goals (SDGs). This indicator forms part of a broader set of core health indicators maintained by the World Health Organization (WHO) to harmonize data collection and reporting across member states.
What is the Service Coverage Indicator?
The primary indicator for monitoring the service coverage dimension of UHC is the UHC Service Coverage Index (SDG Indicator 3.8.1).
This index is a composite measure that combines data from a select set of tracer interventions (essential health services) to represent a country's average coverage of essential health services on a scale of 0 to 100. A higher score indicates better service coverage.
The index is constructed as the geometric mean of the selected tracer indicators, which are grouped into four main categories.
.jpg "The WHO Service Coverage Indicator")
Purpose and Significance
The Service Coverage Index serves several critical purposes:
Tracking UHC Progress: It provides a single, summary measure for countries and the global community to track their progress towards ensuring that all people have access to the quality health services they need.
Harmonization of Data: By using a standard set of indicators, it helps to rationalize and align reporting requirements for countries, reducing reporting burden and improving the quality and comparability of health data globally.
Guiding Policy: It highlights where gaps in service provision exist, enabling governments and partners to prioritize health sector investments and strategies.
Equity Monitoring (Disaggregation): Though disaggregation is often limited by data availability, the index is intended to capture coverage among both the general population and the most disadvantaged, reflecting the equity goal of UHC.
Components of the UHC Service Coverage Index
The index is calculated using a basket of approximately 14 tracer indicators organized into four broad categories, which together cover a wide spectrum of essential health services:
| Category | Representative Tracer Indicators (Examples) | Focus |
| I. Reproductive, Maternal, Newborn and Child Health (RMNCH) | Demand for family planning satisfied with modern methods, Antenatal care (4+ visits), Child immunization (DTP3), Skilled birth attendance. | Essential services for women and children. |
| II. Infectious Diseases | Tuberculosis treatment coverage, HIV treatment coverage (ART), Care seeking for pneumonia symptoms in children. | Prevention and treatment of major communicable diseases. |
| III. Non-Communicable Diseases (NCDs) | Cervical cancer screening, Hypertension treatment coverage, Tobacco non-use prevalence. | Prevention, screening, and management of chronic conditions. |
| IV. Service Capacity and Access | Access to essential medicines (or proxy indicators), Coverage of basic sanitation services, Density of health workers (as a proxy for access/capacity). | Fundamental elements of the health system environment and infrastructure. |
Relation to Global Reference List
The UHC Service Coverage Index (SDG 3.8.1) is one of the 100 core health indicators that make up the broader WHO Global Reference List. This comprehensive list, updated periodically (e.g., in 2018 to fully incorporate SDG indicators), is designed to be a normative guide for national health monitoring, covering four main domains:
Health Status
Risk Factors
Service Coverage
Health Systems
The list promotes a standardized approach to measuring key health outcomes, inputs, and outputs across the full spectrum of global health priorities.
.jpg "The WHO Reproductive, Maternal, Newborn and Child Health (RMNCH) Indicator")
The WHO Reproductive, Maternal, Newborn and Child Health (RMNCH) Indicator
The Reproductive, Maternal, Newborn, and Child Health (RMNCH) indicators form a cornerstone of global public health monitoring, representing the interventions essential for safeguarding the health and survival of women, newborns, and children. Managed and promoted by the World Health Organization (WHO) and partner agencies (like UNICEF and the World Bank), these indicators are crucial for tracking progress towards the Sustainable Development Goals (SDGs), particularly in reducing maternal and child mortality (SDG 3.1 and 3.2).
The Importance of RMNCH Indicators
RMNCH encompasses the essential health concerns and interventions across the continuum of care—from pre-pregnancy through adolescence. The indicators are designed to measure coverage and impact across this life-course framework.
The primary purpose is to:
Assess Progress: Track a country's success in delivering high-impact, evidence-based services to those in need.
Drive Accountability: Serve as a core part of global strategies, such as the Global Strategy for Women's, Children's and Adolescents' Health (2016–2030), holding governments and partners accountable for resource allocation and results.
Highlight Inequities: Reveal disparities in service access and utilization across different wealth, geographic, and educational groups within a country.
A major focus is to move beyond simply counting services to measuring effective coverage, which considers both access and quality.
RMNCH Indicators in Global Monitoring
While many individual indicators are tracked, two key ways RMNCH is monitored globally are:
Individual Tracer Indicators: Used to track specific intervention coverage at different stages of the life course. These often contribute to a summary index.
Composite Coverage Index (CCI): A summary index (sometimes included as a sub-index of the broader UHC Service Coverage Index) that combines several key RMNCH tracer indicators into a single measure to provide a general picture of overall RMNCH service coverage.
The following table presents a selection of core RMNCH indicators prioritized for global and national monitoring, often included in major household surveys like Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS).
Core WHO RMNCH Service Coverage Indicators (Selected)
These indicators track coverage of services across the four main stages of the RMNCH continuum.
| Domain/Life Stage | Indicator Name | Definition | Focus/Impact |
| Reproductive Health | Demand for family planning satisfied with modern methods (mDFPS) | Percentage of women of reproductive age (15–49) who are married or in union and who have their need for family planning satisfied with modern methods. | Prevents unwanted pregnancies, reduces high-risk births, and is a key component of universal access to sexual and reproductive health services (SDG 3.7.1). |
| Maternal Health (Antenatal) | Antenatal Care (ANC) Coverage (4+ visits) | Percentage of women aged 15–49 with a live birth who received at least four antenatal care visits during their last pregnancy. | Measures contact with the health system for preventative and diagnostic care during pregnancy. |
| Maternal & Newborn Health (Delivery) | Skilled Birth Attendance (SBA) | Percentage of live births attended by skilled health personnel (doctors, nurses, midwives). | Critical for managing delivery complications, which are the main cause of maternal and neonatal deaths. |
| Newborn Health | Early Postnatal Care (PNC) for Babies | Percentage of newborns who received postnatal care within two days of birth. | Monitors life-saving checks and care for the baby during the most vulnerable post-delivery period. |
| Child Health | DTP3 Immunization Coverage | Percentage of infants (e.g., aged 12–23 months) who received three doses of diphtheria-tetanus-pertussis vaccine. | A widely accepted measure of routine health service functioning and child survival interventions. |
| Child Health | Care-seeking for suspected pneumonia | Percentage of children under 5 years with suspected pneumonia who were taken to an appropriate health facility or provider. | Monitors access to treatment for a leading cause of child death. |
| Child Nutrition | Exclusive Breastfeeding (EBF) | Percentage of infants 0–5 months of age who are fed exclusively with breast milk. | A crucial nutritional intervention that significantly lowers the risk of childhood mortality from infectious diseases. |
The WHO's commitment to monitoring RMNCH through these specific indicators is a testament to the global focus on ending preventable deaths and promoting well-being for all ages. By focusing on coverage, quality, and equity—and continually refining the methods, such as the Composite Coverage Index (CCI)—the international community gains the essential data needed to hold health systems accountable and direct resources to close the gaps. Ultimately, the effective tracking and use of these RMNCH indicators are indispensable for realizing the promise of Universal Health Coverage (UHC) and securing a healthier future for women, children, and adolescents worldwide.
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The WHO Infectious Diseases Indicator
The World Health Organization (WHO) uses a standardized set of indicators to track global progress in combating infectious diseases, particularly in the context of achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs).
These indicators move beyond simple case counts to measure the coverage of essential health services for infectious disease prevention, diagnosis, and treatment. Effective monitoring is crucial for identifying gaps in health systems, directing resources, and ensuring vulnerable populations are not left behind.
Key WHO Infectious Disease Tracer Indicators
The World Health Organization's framework for monitoring UHC (SDG 3.8.1) includes a category specifically dedicated to infectious diseases. These "tracer indicators" are selected to be representative of the broader public health services offered for major communicable diseases.
The key infectious disease tracer indicators used for global UHC monitoring include the following:
| Infectious Disease Area | Tracer Indicator | Measurement Goal |
| Tuberculosis (TB) | Percentage of incident TB cases that are detected and treated. | Measures the effectiveness of the national TB program in identifying new cases and ensuring successful treatment coverage. |
| HIV/AIDS | Percentage of people living with HIV currently receiving Antiretroviral Therapy (ART). | Measures the coverage of life-saving treatment for a major global pandemic. |
| Malaria | Percentage of population in malaria-endemic areas who slept under an insecticide-treated net (ITN) the previous night. | Measures a key prevention intervention in areas with high malaria burden. |
| Water, Sanitation & Hygiene (WASH) | Percentage of population using at least basic sanitation services. | Measures access to a foundational service that prevents a wide array of water-borne and infectious diseases. |
| Child Immunization | Percentage of infants receiving three doses of diphtheria-tetanus-pertussis-containing vaccine (DTP3). | A core measure of a country's routine immunization program, which prevents many infectious diseases. |
Context within Global Health Monitoring
These indicators serve two critical functions:
Tracking Service Delivery: They provide a snapshot of the reach and effectiveness of health services. High coverage for these tracers suggests a robust primary healthcare system capable of delivering other essential services.
Part of the UHC Service Coverage Index: The values for these indicators are combined with tracers from other health domains (Reproductive, Maternal, Newborn, and Child Health, Non-Communicable Diseases, and Service Capacity) to calculate the Universal Health Coverage Service Coverage Index (UHC SCI). This index, measured on a scale of 0 to 100, is the official metric for tracking global progress toward SDG Target 3.8.1.
The Broader Spectrum of Infectious Disease Surveillance
While the UHC tracer indicators focus on service coverage, the WHO's work on infectious diseases involves a much broader array of surveillance and outcome metrics, which are also vital for public health.
Incidence and Mortality Rates: The WHO tracks the incidence (new cases) and mortality (deaths) for diseases like HIV, TB, and Malaria to measure the overall burden of disease.
Neglected Tropical Diseases (NTDs): Specific indicators measure the number of people requiring interventions against the 20 diseases categorized as NTDs, reflecting progress toward elimination and control targets.
International Health Regulations (IHR): The WHO monitors core capacities that countries need to prevent, detect, and respond to public health emergencies, which is essential for global health security and containing outbreaks of new and emerging infectious threats.
In conclusion, the WHO's Infectious Diseases Indicators—especially those designated as UHC tracers—are essential tools for moving beyond simple disease reporting. They provide the necessary data to assess the performance of national health systems, hold governments accountable for service delivery, and ensure the international community remains on track to end major epidemics and achieve the vision of Universal Health Coverage.
.jpg "The WHO Non-Communicable Diseases (NCDs) Indicator")
The WHO Non-Communicable Diseases (NCDs) Indicator
The World Health Organization (WHO) utilizes a set of Non-Communicable Diseases (NCDs) tracer indicators to monitor global progress, particularly toward achieving Universal Health Coverage (UHC) under Sustainable Development Goal (SDG) 3.8. These indicators are crucial because NCDs—primarily cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases—are the leading causes of death worldwide, posing a significant challenge to health systems.
Unlike risk factor indicators (like tobacco use or alcohol consumption), the NCD tracer indicators selected for UHC monitoring focus on the service coverage dimension—measuring a country's ability to provide essential diagnosis, treatment, and control services to its population.
Key NCD Service Coverage Tracer Indicators
The NCD component is one of the four main categories used to construct the overall UHC Service Coverage Index (UHC SCI). These indicators represent essential clinical interventions that a robust primary healthcare system should deliver for NCDs. They are standardized globally to allow for cross-country comparisons.
The following table details the three core NCD tracer indicators used in the WHO's UHC Service Coverage Index (SDG 3.8.1):
| Disease Area | WHO Tracer Indicator | Measurement Focus |
| Hypertension | Age-standardized prevalence of non-raised blood pressure ($\text{Systolic} < 140 \text{ mmHg}$ and $\text{Diastolic} < 90 \text{ mmHg}$) among adults aged 18 years and older. | This indicator acts as a proxy for effective coverage of detection and control services for hypertension. It measures the proportion of the population that is not experiencing elevated blood pressure, suggesting successful primary care and treatment. |
| Diabetes | Age-standardized mean fasting plasma glucose ($\text{mmol/L}$) for adults aged 18 years and older. | Similar to hypertension, this is a biochemical proxy for control. Lower mean fasting plasma glucose levels in the population reflect better detection, management, and control of diabetes cases through the health system. |
| Tobacco Control | Age-standardized prevalence of adults ($\ge 15$ years) not smoking tobacco in the last 30 days. | Measures a key population-level preventive intervention. High compliance with non-smoking is a direct result of effective health policy, public health campaigns, and health services promoting cessation. |
Context within Global Health Strategy
1. Focus on Coverage and Control
The selection of these indicators reflects a shift in global health monitoring from simply counting deaths and hospitalizations to evaluating the quality and reach of primary care. For chronic, manageable conditions like hypertension and diabetes, the key challenge is not just diagnosis but sustained control. Using population-level control markers (like non-raised blood pressure) provides a strong, albeit indirect, measure of a health system's ability to deliver continuous care.
2. The UHC Service Coverage Index (UHC SCI)
The three NCD tracer values are scaled from 0 (worst) to 100 (optimal) and combined with tracers from other domains—Reproductive, Maternal, Newborn and Child Health (RMNCH), Infectious Diseases, and Service Capacity and Access—to calculate a geometric mean. This final number is the UHC SCI, the official metric for reporting progress on SDG Target 3.8.1.
3. The NCD Global Monitoring Framework (GMF)
It is important to note that the WHO's overall monitoring of NCDs is broader than the three UHC tracers. The NCD Global Monitoring Framework tracks 26 indicators related to nine voluntary global targets. These targets cover:
Mortality: Reducing premature mortality from NCDs by one-third.
Risk Factors: Reducing tobacco use, harmful use of alcohol, physical inactivity, salt/sodium intake, and halting the rise of diabetes and obesity.
Health Systems: Covering drug therapy and counselling, and ensuring the availability of essential NCD medicines and technologies.
The UHC tracer indicators are a focused subset of the NCD-GMF indicators, specifically chosen to represent the core service delivery component of universal health coverage.
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The WHO Service Capacity and Access Indicators
The World Health Organization (WHO) monitors global progress towards Universal Health Coverage (UHC) (Sustainable Development Goal 3.8) using the UHC Service Coverage Index (UHC SCI). This index is a composite measure derived from 14 tracer indicators organized into four domains.
The final domain, Service Capacity and Access, is unique because its tracers do not measure the direct coverage of a specific clinical intervention (like vaccination or diabetes control). Instead, they quantify the structural pillars of the health system—the foundational resources and readiness required for a country to deliver any essential health service effectively. A system with high capacity and access is a prerequisite for achieving high coverage across all clinical areas.
Key Tracer Indicators for Service Capacity and Access
The Service Capacity and Access component of the UHC SCI is measured by three key tracer indicators that cover human resources, physical infrastructure, and the ability to respond to health security threats.
| Indicator Number | WHO Tracer Indicator | Measurement Focus | Rationale for UHC Monitoring |
| 12 | Hospital Beds per capita (Relative to a maximum threshold of 18 per 10,000 population). | Physical Infrastructure & Access. The indicator measures the availability of essential inpatient care resources, scaled against a practical target to gauge readiness. | Hospitals are crucial for severe illness, surgery, and referral. This metric proxies the availability of higher-level care access for the population. |
| 13 | Health Workforce density (Relative to a maximum threshold of 44.5 per 10,000 population for a composite of doctors, nurses, and midwives). | Human Resources. It measures the density of essential clinical staff, which determines the capacity to deliver quality care. | A sufficient workforce is the single most critical input for delivering any health service, from primary care to specialized treatment. |
| 14 | International Health Regulations (IHR) Core Capacity Index. | Health Security & Readiness. Measures the average percentage of 13 core capacities (e.g., surveillance, reporting, ports of entry) that have been attained. | A robust IHR capacity reflects a system's ability to prevent, detect, and respond to public health emergencies, which is foundational to protecting and sustaining routine service access. |
Context and Importance
Structural vs. Outcome Measures
The capacity and access indicators are deliberately structural inputs rather than health outcomes. They highlight areas of system weakness that directly restrict service delivery. For example:
A low Health Workforce density makes it impossible to achieve high rates of childhood immunization or hypertension screening, regardless of funding.
Low Hospital Bed access means a lack of essential life-saving services, undermining confidence in the entire system.
A poor IHR Core Capacity score indicates a country is vulnerable to outbreaks that can derail all progress on UHC, as demonstrated by the COVID-19 pandemic.
Role in the UHC Service Coverage Index
The UHC SCI combines 14 tracer indicators into a single score from 0 to 100, which reflects the average coverage of essential services.
The four components are:
Reproductive, Maternal, Newborn, and Child Health (RMNCH)
Infectious Diseases
Non-Communicable Diseases (NCDs)
Service Capacity and Access
Each of these four component scores is equally weighted and combined using a geometric mean to produce the final UHC SCI. By including Service Capacity and Access, the WHO acknowledges that UHC requires not just high coverage for specific conditions, but also the presence of the underlying infrastructure and personnel to ensure that all people can access the services they need, when and where they need them.
.jpg "The WHO UHC Service Coverage Index: Leading Countries")
The WHO UHC Service Coverage Index: Leading Countries
The Universal Health Coverage (UHC) Service Coverage Index (SCI), developed by the World Health Organization (WHO), is the primary tool for tracking global progress toward SDG Target 3.8. It measures the average level of access to essential health services—a crucial step toward ensuring people receive the care they need without facing financial hardship.
The index summarizes performance on a scale of 0 (no coverage) to 100 (full coverage) across 14 tracer indicators that span four core areas: reproductive, maternal, newborn, and child health (RMNCH); infectious diseases; non-communicable diseases (NCDs); and service capacity and access.
Leading Countries in WHO UHC Service Coverage Index (SCI)
| Rank | Country | UHC Service Coverage Index Score (0-100) | Data Year (Approx.) |
| 1 | Canada | 91 | 2021 |
| 2 | Iceland | 89 | 2021 |
| 2 | Republic of Korea | 89 | 2021 |
| 2 | Singapore | 89 | 2021 |
| 5 | Japan | $\sim$88 | 2021 |
| 5 | Germany | $\sim$88 | 2021 |
The Four Pillars of the UHC Service Coverage Index
Achieving a high UHC SCI score requires consistent, high performance across all dimensions of the health system, from basic prevention to complex care. The four categories of tracer indicators ensure that a country is being measured on a broad spectrum of services:
| UHC SCI Component | Focus Area | Example Tracer Indicators |
| I. RMNCH | Essential care for women and children. | Skilled birth attendance, Antenatal care (4+ visits), Child immunization (DTP3). |
| II. Infectious Diseases | Services to prevent and treat major infectious diseases. | HIV treatment coverage (ART), TB treatment success rate, Access to clean water and sanitation (WASH). |
| III. Non-Communicable Diseases | Screening, treatment, and control of chronic conditions. | Hypertension treatment coverage, Diabetes management, Tobacco (non-)use prevalence. |
| IV. Service Capacity and Access | Structural readiness and available resources. | Health workforce density (doctors, nurses, midwives), Hospital beds per capita, International Health Regulations (IHR) core capacity index. |
The final index score is calculated as the geometric mean of the four component scores. This mathematical method ensures that a country cannot compensate for poor performance in one pillar (like NCDs) with extremely high scores in another (like RMNCH), thereby rewarding systems that are balanced and comprehensive.
Global Trends and the Path to 2030
The UHC SCI serves as a vital report card on global health equity. Worldwide, the index has shown steady, though recently stalling, improvement, rising from a global average of 45 in 2000 to approximately 68 in 2021.
However, this global average masks vast inequalities. High-income regions, particularly Europe and the Americas, tend to have the highest regional averages (often in the 80s), while the African Region reports the lowest (often in the mid-40s).
The primary takeaway from the UHC SCI data is twofold:
Stagnation: Progress on service coverage has largely stalled since 2015, indicating that expanding services to the hardest-to-reach populations is becoming increasingly difficult.
The Double Burden: Many countries, including several middle-income nations, show improving service coverage (higher SCI scores) alongside worsening financial protection, meaning more households are forced into poverty or face catastrophic expenses to use the very services being measured.
Ultimately, the UHC SCI is a powerful advocacy tool, clearly showing that reaching the target of UHC by 2030 requires renewed political commitment, a focus on primary health care, and dedicated efforts to eliminate the financial barriers that still lock billions out of essential care.
.jpg "The WHO Service Coverage Indicator: Data Sources and Methodology")
The WHO Service Coverage Indicator: Data Sources and Methodology
The WHO Universal Health Coverage (UHC) Service Coverage Index (SCI) is a composite metric designed to track a country's progress toward providing essential health services. Its robustness depends on gathering reliable, globally comparable data from a variety of sources to calculate the score for its 14 tracer indicators.
The WHO UHC Service Coverage Index (SCI): Data Sources by Tracer Indicator
The Universal Health Coverage (UHC) Service Coverage Index (SCI) is computed from 14 tracer indicators grouped into four components. The data for these indicators are drawn from established global data collection systems, primarily national household surveys and administrative reporting systems compiled by UN agencies.
| Component | Tracer Indicator | Data Source Type (Primary) | Custodian Agency/Data Collection Mechanism (Examples) |
| I. Reproductive, Maternal, Newborn, & Child Health (RMNCH) | 1. Family Planning (Met need with modern methods) | Household Surveys | DHS, MICS, and other national surveys. |
| 2. Pregnancy Care (Antenatal care 4+ visits) | Household Surveys / Facility Data | WHO/UNICEF database, DHS, MICS, national facility reports. | |
| 3. Child Immunization (DTP3 coverage) | Administrative Data / Surveys | WHO/UNICEF Estimates of National Immunization Coverage (WUENIC), DHS, MICS. | |
| 4. Child Treatment (Care for presumed pneumonia) | Household Surveys | DHS, MICS, and other national surveys. | |
| II. Infectious Diseases (ID) | 5. Tuberculosis (TB) Effective Treatment | Administrative/Programmatic Data | WHO Global TB Programme (National TB programme data). |
| 6. HIV/AIDS (Antiretroviral therapy coverage) | Administrative/Programmatic Data | UNAIDS/WHO database (National AIDS programme data). | |
| 7. Malaria (Insecticide-treated net use) * | Household Surveys | DHS, MICS, Malaria Indicator Surveys (MIS) (Malaria programme data). | |
| 8. Water, Sanitation, & Hygiene (Basic sanitation) | Household Surveys / Census | WHO/UNICEF Joint Monitoring Programme (JMP) for WASH. | |
| III. Non-Communicable Diseases (NCD) | 9. Hypertension (Non-raised blood pressure prevalence) | Population-Based Surveys/Modeling | WHO NCD Global Monitoring Framework, STEPwise approach (STEPS). |
| 10. Diabetes (Mean fasting plasma glucose) | Population-Based Surveys/Modeling | WHO NCD Global Monitoring Framework, STEPS. | |
| 11. Tobacco (Non-smoking prevalence) | Population-Based Surveys/Modeling | WHO Global Tobacco Surveillance System (GTSS), STEPS. | |
| IV. Service Capacity & Access (SCA) | 12. Hospital Access (Hospital beds density) | Administrative/Facility Data | WHO Global Health Expenditure Database (GHED), national health accounts. |
| 13. Health Workforce (Health professionals density) | Administrative/Facility Data | WHO National Health Workforce Accounts (NHWA), national professional council registers. | |
| 14. Health Security (IHR core capacity index) | Administrative/Assessment Data | WHO International Health Regulations (IHR) Monitoring Framework. |
*Note: The Malaria tracer indicator (No. 7) is only included in the index calculation for countries with a significant malaria burden, ensuring the SCI remains relevant to the local disease profile.
Key Data Systems for the SCI:
DHS (Demographic and Health Surveys) & MICS (Multiple Indicator Cluster Surveys): Critical for population-level coverage of RMNCH, infectious diseases, and some NCD risk factors.
Programmatic Data: Routine data gathered by national disease-specific programs (TB, HIV) are used for treatment coverage indicators.
WHO Global Health Observatory (GHO): The central repository where the standardized, verified data for all 14 tracers, collected from the various custodian agencies, are ultimately compiled.
Primary Data Sources for the UHC SCI
The index relies on a multi-pronged data collection approach, drawing on established mechanisms used by the WHO and its partner agencies. The three main categories of preferred data sources are:
Household Surveys: These are the single most important source for indicators measuring service use by the general population, particularly in reproductive, maternal, newborn, and child health (RMNCH).
Examples: The Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), and other country-specific national health surveys.
Indicators Covered: Family planning (met need), Antenatal care, Childhood immunization, and treatment for childhood illnesses like diarrhea and pneumonia.
Administrative Data/Routine Health Information Systems (RHIS): These sources capture data generated during the regular delivery of health services.
Examples: National AIDS programs (for HIV treatment coverage), National Tuberculosis programs (for TB treatment success rates), and Civil Registration and Vital Statistics (CRVS) systems.
Indicators Covered: HIV/AIDS treatment, Tuberculosis (TB) treatment, and sometimes, service capacity indicators like health worker density.
Special Facility Surveys and Assessments: These are often used for structural and capacity indicators that cannot be easily measured through household surveys.
Examples: Surveys of health facilities, specialized disease surveillance systems, and the International Health Regulations (IHR) Core Capacity Index (used to measure health security).
Indicators Covered: Hospital bed density, Health workforce density, and compliance with the IHR (which includes capacity for public health emergencies).
The Role of International Agencies and Standardization
The data for the 14 tracer indicators are not collected directly by WHO for the SCI calculation. Instead, the WHO relies on data that has already been compiled, validated, and published by various specialized UN agencies and interagency groups.
Data Aggregation: For each of the 14 tracers, a specific custodian agency (e.g., UNICEF for child health, UNAIDS for HIV) is responsible for collecting, modeling, and quality-checking national-level data. The WHO then collates the most recent, officially reported values for each country.
Standardization: To calculate the final SCI, all 14 raw indicator values must be transformed onto the same 0 to 100 scale, where 0 is the lowest observed performance and 100 is the optimal or target value. This is necessary because the indicators have different natural units (e.g., percentage coverage vs. density of doctors).
Methodology: The final index is computed as the geometric mean of the four major component scores (RMNCH, Infectious Diseases, NCDs, and Capacity). This mathematical approach ensures that a country must perform relatively well across all service areas to achieve a high overall score.
This reliance on globally standardized, internationally published data ensures consistency and comparability, making the UHC SCI a trusted indicator for tracking progress towards the Sustainable Development Goals.