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1. 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.

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Shetty B.S.K., Stein C., Stokes M.A., Sufiyan M.B., Suleria H.A.R., Sultan I., Szumowski L., Tabares-Seisdedos R., Tabuchi T., Tadakamadla S.K., Taddele B.W., Tadesse D.B., Taherkhani A., Tamiru A.T., Tanser F.C., Tareque M.I., Tarigan I.U., Teagle W.L., Tediosi F., Tefera Y.G.G., Tela F.G., Tessema Z.T., Thakur B., Titova M.V., Tonelli M., Topor-Madry R., Topouzis F., Tovani-Palone M.R.R., Tran B.X., Travillian R., Troeger C.E., Tudor Car L., Uddin R., Ullah I., Umeokonkwo C.D., Unnikrishnan B., Upadhyay E., Uthman O.A., Vacante M., Valdez P.R., Varughese S., Vasankari T.J., Vasseghian Y., Venketasubramanian N., Violante F.S., Vlassov V., Vollset S.E., Vongpradith A., Vos T., Waheed Y., Walters M.K., Wamai R.G., Wang H., Wang Y.-P., Weintraub R.G., Weiss J., Werdecker A., Westerman R., Wilner L.B., Woldu G., Wolfe C.D.A., Wu A.-M., Wulf Hanson S., Xie Y., Yahyazadeh Jabbari S.H., Yamagishi K., Yano Y., Yaya S., Yazdi-Feyzabadi V., Yearwood J.A., Yeshitila Y.G., Yip P., Yonemoto N., Younis M.Z., Yousefi Z., Yousefinezhadi T., Yusefzadeh H., Zadey S., Zahirian Moghadam T., Zaidi S.S., Zaki L., Zaman S.B., Zamanian M., Zandian H., Zastrozhin M.S., Zewdie K.A., Zhang Y., Zhao X.-J.G., Zhao Y., Zheng P., Zhu C., Ziapour A., Zlavog B.S., Zodpey S., Murray C.J.L., Lozano R., Fullman N., Mumford J.E., Knight M., Barthelemy C.M., Abbafati C., Abbastabar H., Abd-Allah F., Abdollahi M., Abedi A., Abolhassani H., Abosetugn A.E., Abreu L.G., Abrigo M.R.M., Abu Haimed A.K., Abushouk A.I., Adabi M., Adebayo O.M., Adekanmbi V., Adelson J., Adetokunboh O.O., Adham D., Advani S.M., Afshin A., Agarwal G., Agasthi P., Aghamir S.M.K., Agrawal A., Ahmad T., Akinyemi R.O., Alahdab F., Al-Aly Z., Alam K., Albertson S.B., Alemu Y.M., Alhassan R.K., Ali M., Ali S., Alipour V., Aljunid S.M., Alla F., Almadi M.A.H., Almasi A., Almasi-Hashiani A., Almasri N.A., Al-Mekhlafi H.M., Almulhim A.M., Alonso J., Al-Raddadi R.M., Altirkawi K.A., Alvis-Guzman N., Alvis-Zakzuk N.J., Amini S., Amini-Rarani M., Amiri F., Amit A.M.L., Amugsi D.A., Ancuceanu R., Anderlini D., Andrei C.L., Androudi S., Ansari F., Ansari-Moghaddam A., Antonio C.A.T., Antony C.M., Antriyandarti E., Anvari D., Anwer R., Arabloo J., Arab-Zozani M., Aravkin A.Y., Aremu O., Arnlov J., Asaad M., Asadi-Aliabadi M., Asadi-Pooya A.A., Athari S.S., Atout M.M.W., Ausloos M., Avila-Burgos L., Ayala Quintanilla B.P., Ayano G., Ayanore M.A., Aynalem Y.A., Aynalem G.L., Ayza M.A., Azari S., Azzopardi P.S., B D.B., Babaee E., Badiye A.D., Bahrami M.A., Baig A.A., Bakhshaei M.H., Bakhtiari A., Bakkannavar S.M., Balachandran A., Banach M., Banerjee S.K., Banik P.C., Bante A.B., Bante S.A., Barker-Collo S.L., Barnighausen T.W., Barrero L.H., Bassat Q., Basu S., Baune B.T., Bayati M., Baye B.A., Bedi N., Beghi E., Behzadifar M., Bekuma T.T.T., Bell M.L., Bensenor I.M., Berman A.E., Bernabe E., Bernstein R.S., Bhagavathula A.S., Bhandari D., Bhardwaj P., Bhat A.G., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Bilano V., Biondi A., Birihane B.M., Bockarie M.J., Bohlouli S., Bojia H.A., Bolla S.R.R., Boloor A., Brady O.J., Braithwaite D., Briggs A.M., Briko N.I., Burugina Nagaraja S., Busse R., Butt Z.A., Caetano dos Santos F.L., Cahuana-Hurtado L., Camera L.A., Cardenas R., Carreras G., Carrero J.J., Carvalho F., Castaldelli-Maia J.M., Castaneda-Orjuela C.A., Castelpietra G., Castro F., Catala-Lopez F., Cederroth C.R., Cerin E., Chandan J.S., Chang A.Y., Charan J., Chattu V.K., Chaturvedi S., Chin K.L., Cho D.Y., Choi J.-Y.J., Christensen H., Chu D.-T., Chung M.T., Ciobanu L.G., Cirillo M., Compton K., Cortesi P.A., Costa V.M., Cousin E., Dahlawi S.M.A., Damiani G., Dandona L., Dandona R., Darega Gela J., Darwesh A.M., Daryani A., Dash A.P., Davey G., Davila-Cervantes C.A., Davletov K., De Neve J.-W., Denova-Gutierrez E., Deribe K., Dervenis N., Desai R., Dharmaratne S.D., Dhungana G.P., Dianatinasab M., Dias da Silva D., Diaz D., Dippenaar I.N., Do H.T., Dorostkar F., Doshmangir L., Duncan B.B., Duraes A.R., Eagan A.W., Edvardsson D., El Sayed I., El Tantawi M., Elgendy I.Y., Elyazar I.R., Eskandari K., Eskandarieh S., Esmaeilnejad S., Esteghamati A., Ezekannagha O., Farag T., Farahmand M., Faraon E.J.A., Farinha C.S.E.S., Farioli A., Faris P.S., Faro A., Fazlzadeh M., Feigin V.L., Fernandes E., Ferrara P., Feyissa G.T., Filip I., Fischer F., Fisher J.L., Flor L.S., Foigt N.A., Folayan M.O., Fomenkov A.A., Foroutan M., Francis J.M., Fu W., Fukumoto T., Furtado J.M., Gad M.M., Gaidhane A.M., Gakidou E., Galles N.C., Gallus S., Gardner W.M., Geberemariyam B.S., Gebrehiwot A.M., Gebremeskel L.G., Gebremeskel G.G., Gesesew H.A., Ghadiri K., Ghafourifard M., Ghashghaee A., Ghith N., Gholamian A., Gilani S.A., Gill P.S., Gill T.K., Ginindza T.G., Gitimoghaddam M., Giussani G., Glagn M., Gnedovskaya E.V., Godinho M.A., Goharinezhad S., Gopalani S.V., Goudarzian A.H., Goulart B.N.G., Gubari M.I.M., Guimaraes R.A., Guled R.A., Gultie T., Guo Y., Gupta R., Hafezi-Nejad N., Hafiz A., Haile T.G., Hamadeh R.R., Hameed S., Hamidi S., Han C., Han H., Handiso D.W., Hanif A., Hankey G.J., Haro J.M., Hasaballah A.I., Hasan M.M., Hashi A., Hassan S., Hassan A., Hassanipour S., Hassankhani H., Havmoeller R.J., Hay S.I., Hayat K., Heidari G., Heidari-Soureshjani R., Hendrie D., Herteliu C., Hird T.R., Ho H.C., Hole M.K., Holla R., Hoogar P., Hopf K.P., Horita N., Hossain N., Hosseini M., Hosseinzadeh M., Hostiuc M., Hostiuc S., Househ M., Hsieh V.C.-R., Hu G., Huda T.M., Humayun A., Hwang B.-F., Iavicoli I., Ibitoye S.E., Ikeda N., Ilesanmi O.S., Ilic M.D., Inbaraj L.R., Iqbal U., Irvani S.S.N., Irvine C.M.S., Islam M.M., Islam S.M.S., Islami F., Iso H., Iwu C.J., Jaafari J., Jadidi-Niaragh F., Jafarinia M., Jahagirdar D., Jahani M.A., Jahanmehr N., Jakovljevic M., Janjani H., Javaheri T., Jayatilleke A.U., Jenabi E., Jha R.P., Jha V., Ji J.S., Jia P., John-Akinola Y.O., Jonas J.B., Joukar F., Jozwiak J.J., Jurisson M., Kabir Z., Kalankesh L.R., Kalhor R., Kamath A.M., Kanchan T., Kapoor N., Karami Matin B., Karanikolos M., Karimi S.M., Kassebaum N.J., Katikireddi S.V., Kayode G.A., Keiyoro P.N., Khader Y.S., Khammarnia M., Khan M., Khan E.A., Khang Y.-H., Khatab K., Khater A.M., Khater M.M., Khatib M.N., Khayamzadeh M., Khubchandani J., Kianipour N., Kim Y.J., Kimokoti R.W., Kinfu Y., Kisa A., Kissimova-Skarbek K., Kivimaki M., Kneib C.J., Kocarnik J.M., Kochhar S., Kohler S., Kopec J.A., Korotkova A.V., Korshunov V.A., Kosen S., Kotlo A., Koul P.A., Koyanagi A., Krishan K., Krohn K.J., Kugbey N., Kulkarni V., Kumar G.A., Kumar N., Kumar M., Kurmi O.P., Kusuma D., Kyu H.H., La Vecchia C., Lacey B., Lal D.K., Lalloo R., Landires I., Lansingh V.C., Larsson A.O., Lasrado S., Lau K.M.-M., Lauriola P., Lazarus J.V., Ledesma J.R., Lee P.H., Lee S.W.H., Leever A.T., LeGrand K.E., Leigh J., Leonardi M., Li S., Lim S.S., Lim L.-L., Liu X., Logroscino G., Lopez A.D., Lopukhov P.D., Lotufo P.A., Lu A., Ma J., Madadin M., Mahasha P.W., Mahmoudi M., Majeed A., Malagon-Rojas J.N., Maleki S., Malta D.C., Mansouri B., Mansournia M.A., Martini S., Martins-Melo F.R., Martopullo I., Massenburg B.B., Mastrogiacomo C.I., Mathur M.R., McAlinden C., McKee M., Medina-Solis C.E., Meharie B.G., Mehndiratta M.M., Mehrabi Nasab E., Mehri F., Mehrotra R., Mekonnen T., Melese A., Memiah P.T.N., Mendoza W., Menezes R.G., Mensah G.A., Meretoja T.J., Meretoja A., Mestrovic T., Miazgowski B., Michalek I.M., Mirrakhimov E.M., Mirzaei M., Mirzaei-Alavijeh M., Mitchell P.B., Moazen B., Moghadaszadeh M., Mohamadi E., Mohammad Y., Mohammad D.K., Mohammad Gholi Mezerji N., Mohammadian-Hafshejani A., Mohammed S., Mohammed J.A., Mokdad A.H., Monasta L., Mondello S., Moradi M., Moradi-Lakeh M., Moradzadeh R., Moraga P., Morgado-da-Costa J., Morrison S.D., Mosapour A., Mosser J.F., Mousavi Khaneghah A., Muriithi M.K., Mustafa G., Nabhan A.F., Naderi M., Nagarajan A.J., Naghavi M., Naghshtabrizi B., Naimzada M.D., Nangia V., Nansseu J.R., Nayak V.C., Nazari J., Ndejjo R., Negoi I., Negoi R.I., Neupane S., Ngari K.N., Nguefack-Tsague G., Ngunjiri J.W., Nguyen C.T., Nguyen D.N., Nguyen H.L.T., Nnaji C.A., Nomura S., Norheim O.F., Noubiap J.J., Nowak C., Nunez-Samudio V., Otoiu A., Ogbo F.A., Oghenetega O.B., Oh I.-H., Okunga E.W., Oladnabi M., Olagunju A.T., Olusanya J.O., Olusanya B.O., Oluwasanu M.M., Omar Bali A., Omer M.O., Ong K.L., Onwujekwe O.E., Ortega-Altamirano D.V.V., Ortiz A., Ostojic S.M., Otstavnov N., Otstavnov S.S., Overland S., Owolabi M.O., Padubidri J.R., Pakhale S., Palladino R., Pana A., Panda-Jonas S., Pangaribuan H.U., Pathak M., Patton G.C., Paudel S., Pazoki Toroudi H., Pease S.A., Peden A.E., Pennini A., Peprah E.K., Pereira J., Pigott D.M., Pilgrim T., Pilz T.M., Pinheiro M., Piradov M.A., Pirsaheb M., Pokhrel K.N., Postma M.J., Pourjafar H., Pourmalek F., Pourmirza Kalhori R., Pourshams A., Prada S.I., Pribadi D.R.A., Pupillo E., Quazi Syed Z., Radfar A., Rafiee A., Rafiei A., Raggi A., Rahim F., Rahman M.A., Rajabpour-Sanati A., Rana S.M., Ranabhat C.L., Rao S.J., Rasella D., Rashedi V., Rath G.K., Rathi P., Rawaf S., Rawaf D.L., Rawal L., Rawassizadeh R., Razo C., Renjith V., Renzaho A.M.N., Reshmi B., Rezaei N., Riahi S.M., Ribeiro D.C., Rickard J., Roberts N.L.S., Roever L., Romoli M., Ronfani L., Roshandel G., Rubagotti E., Rwegerera G.M., Sabour S., Sachdev P.S., Saddik B., Sadeghi M., Sadeghi E., Safari Y., Sagar R., Sahebkar A., Sahraian M.A., Sajadi S.M., Salahshoor M.R., Salem M.R.R., Salem H., Salomon J., Samadi Kafil H., Samy A.M., Sanabria J., Santric-Milicevic M.M., Saraswathy S.Y.I., Sarmiento-Suarez R., Sartorius B., Sarveazad A., Sathian B., Sathish T., Sattin D., Savic M., Sawyer S.M., Saxena D., Sbarra A.N., Schaeffer L.E., Schiavolin S., Schmidt M.I., Schutte A.E., Schwebel D.C., Schwendicke F., Seedat S., Sha F., Shahabi S., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Shannawaz M., Sharafi K., Sharara F., Sharifi H., Shaw D.H., Sheikh A., Sheikhtaheri A., Shibuya K., Shiferaw W.S., Shigematsu M., Shin J.I., Shiri R., Shirkoohi R., Shivakumar K.M., Shrime M.G., Shuval K., Siabani S., Sierpinski R., Sigfusdottir I.D., Sigurvinsdottir R., Silva D.A.S., Silva J.P., Simonetti B., Simpson K.E., Singh J.A., Singh P., Sinha D.N., Skryabin V.Y., Smith E.U.R., Soheili A., Soltani S., Soofi M., Sorensen R.J.D., Soriano J.B., Sorrie M.B., Soyiri I.N., Spurlock E.E., Sreeramareddy C.T., Stanaway J.D., Steel N., Shetty B.S.K., Stein C., Stokes M.A., Sufiyan M.B., Suleria H.A.R., Sultan I., Szumowski L., Tabares-Seisdedos R., Tabuchi T., Tadakamadla S.K., Taddele B.W., Tadesse D.B., Taherkhani A., Tamiru A.T., Tanser F.C., Tareque M.I., Tarigan I.U., Teagle W.L., Tediosi F., Tefera Y.G.G., Tela F.G., Tessema Z.T., Thakur B., Titova M.V., Tonelli M., Topor-Madry R., Topouzis F., Tovani-Palone M.R.R., Tran B.X., Travillian R., Troeger C.E., Tudor Car L., Uddin R., Ullah I., Umeokonkwo C.D., Unnikrishnan B., Upadhyay E., Uthman O.A., Vacante M., Valdez P.R., Varughese S., Vasankari T.J., Vasseghian Y., Venketasubramanian N., Violante F.S., Vlassov V., Vollset S.E., Vongpradith A., Vos T., Waheed Y., Walters M.K., Wamai R.G., Wang H., Wang Y.-P., Weintraub R.G., Weiss J., Werdecker A., Westerman R., Wilner L.B., Woldu G., Wolfe C.D.A., Wu A.-M., Wulf Hanson S., Xie Y., Yahyazadeh Jabbari S.H., Yamagishi K., Yano Y., Yaya S., Yazdi-Feyzabadi V., Yearwood J.A., Yeshitila Y.G., Yip P., Yonemoto N., Younis M.Z., Yousefi Z., Yousefinezhadi T., Yusefzadeh H., Zadey S., Zahirian Moghadam T., Zaidi S.S., Zaki L., Zaman S.B., Zamanian M., Zandian H., Zastrozhin M.S., Zewdie K.A., Zhang Y., Zhao X.-J.G., Zhao Y., Zheng P., Zhu C., Ziapour A., Zlavog B.S., Zodpey S., Murray C.J.L., Lozano R., Fullman N., Mumford J.E., Knight M., Barthelemy C.M., Abbafati C., Abbastabar H., Abd-Allah F., Abdollahi M., Abedi A., Abolhassani H., Abosetugn A.E., Abreu L.G., Abrigo M.R.M., Abu Haimed A.K., Abushouk A.I., Adabi M., Adebayo O.M., Adekanmbi V., Adelson J., Adetokunboh O.O., Adham D., Advani S.M., Afshin A., Agarwal G., Agasthi P., Aghamir S.M.K., Agrawal A., Ahmad T., Akinyemi R.O., Alahdab F., Al-Aly Z., Alam K., Albertson S.B., Alemu Y.M., Alhassan R.K., Ali M., Ali S., Alipour V., Aljunid S.M., Alla F., Almadi M.A.H., Almasi A., Almasi-Hashiani A., Almasri N.A., Al-Mekhlafi H.M., Almulhim A.M., Alonso J., Al-Raddadi R.M., Altirkawi K.A., Alvis-Guzman N., Alvis-Zakzuk N.J., Amini S., Amini-Rarani M., Amiri F., Amit A.M.L., Amugsi D.A., Ancuceanu R., Anderlini D., Andrei C.L., Androudi S., Ansari F., Ansari-Moghaddam A., Antonio C.A.T., Antony C.M., Antriyandarti E., Anvari D., Anwer R., Arabloo J., Arab-Zozani M., Aravkin A.Y., Aremu O., Arnlov J., Asaad M., Asadi-Aliabadi M., Asadi-Pooya A.A., Athari S.S., Atout M.M.W., Ausloos M., Avila-Burgos L., Ayala Quintanilla B.P., Ayano G., Ayanore M.A., Aynalem Y.A., Aynalem G.L., Ayza M.A., Azari S., Azzopardi P.S., B D.B., Babaee E., Badiye A.D., Bahrami M.A., Baig A.A., Bakhshaei M.H., Bakhtiari A., Bakkannavar S.M., Balachandran A., Banach M., Banerjee S.K., Banik P.C., Bante A.B., Bante S.A., Barker-Collo S.L., Barnighausen T.W., Barrero L.H., Bassat Q., Basu S., Baune B.T., Bayati M., Baye B.A., Bedi N., Beghi E., Behzadifar M., Bekuma T.T.T., Bell M.L., Bensenor I.M., Berman A.E., Bernabe E., Bernstein R.S., Bhagavathula A.S., Bhandari D., Bhardwaj P., Bhat A.G., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Bilano V., Biondi A., Birihane B.M., Bockarie M.J., Bohlouli S., Bojia H.A., Bolla S.R.R., Boloor A., Brady O.J., Braithwaite D., Briggs A.M., Briko N.I., Burugina Nagaraja S., Busse R., Butt Z.A., Caetano dos Santos F.L., Cahuana-Hurtado L., Camera L.A., Cardenas R., Carreras G., Carrero J.J., Carvalho F., Castaldelli-Maia J.M., Castaneda-Orjuela C.A., Castelpietra G., Castro F., Catala-Lopez F., Cederroth C.R., Cerin E., Chandan J.S., Chang A.Y., Charan J., Chattu V.K., Chaturvedi S., Chin K.L., Cho D.Y., Choi J.-Y.J., Christensen H., Chu D.-T., Chung M.T., Ciobanu L.G., Cirillo M., Compton K., Cortesi P.A., Costa V.M., Cousin E., Dahlawi S.M.A., Damiani G., Dandona L., Dandona R., Darega Gela J., Darwesh A.M., Daryani A., Dash A.P., Davey G., Davila-Cervantes C.A., Davletov K., De Neve J.-W., Denova-Gutierrez E., Deribe K., Dervenis N., Desai R., Dharmaratne S.D., Dhungana G.P., Dianatinasab M., Dias da Silva D., Diaz D., Dippenaar I.N., Do H.T., Dorostkar F., Doshmangir L., Duncan B.B., Duraes A.R., Eagan A.W., Edvardsson D., El Sayed I., El Tantawi M., Elgendy I.Y., Elyazar I.R., Eskandari K., Eskandarieh S., Esmaeilnejad S., Esteghamati A., Ezekannagha O., Farag T., Farahmand M., Faraon E.J.A., Farinha C.S.E.S., Farioli A., Faris P.S., Faro A., Fazlzadeh M., Feigin V.L., Fernandes E., Ferrara P., Feyissa G.T., Filip I., Fischer F., Fisher J.L., Flor L.S., Foigt N.A., Folayan M.O., Fomenkov A.A., Foroutan M., Francis J.M., Fu W., Fukumoto T., Furtado J.M., Gad M.M., Gaidhane A.M., Gakidou E., Galles N.C., Gallus S., Gardner W.M., Geberemariyam B.S., Gebrehiwot A.M., Gebremeskel L.G., Gebremeskel G.G., Gesesew H.A., Ghadiri K., Ghafourifard M., Ghashghaee A., Ghith N., Gholamian A., Gilani S.A., Gill P.S., Gill T.K., Ginindza T.G., Gitimoghaddam M., Giussani G., Glagn M., Gnedovskaya E.V., Godinho M.A., Goharinezhad S., Gopalani S.V., Goudarzian A.H., Goulart B.N.G., Gubari M.I.M., Guimaraes R.A., Guled R.A., Gultie T., Guo Y., Gupta R., Hafezi-Nejad N., Hafiz A., Haile T.G., Hamadeh R.R., Hameed S., Hamidi S., Han C., Han H., Handiso D.W., Hanif A., Hankey G.J., Haro J.M., Hasaballah A.I., Hasan M.M., Hashi A., Hassan S., Hassan A., Hassanipour S., Hassankhani H., Havmoeller R.J., Hay S.I., Hayat K., Heidari G., Heidari-Soureshjani R., Hendrie D., Herteliu C., Hird T.R., Ho H.C., Hole M.K., Holla R., Hoogar P., Hopf K.P., Horita N., Hossain N., Hosseini M., Hosseinzadeh M., Hostiuc M., Hostiuc S., Househ M., Hsieh V.C.-R., Hu G., Huda T.M., Humayun A., Hwang B.-F., Iavicoli I., Ibitoye S.E., Ikeda N., Ilesanmi O.S., Ilic M.D., Inbaraj L.R., Iqbal U., Irvani S.S.N., Irvine C.M.S., Islam M.M., Islam S.M.S., Islami F., Iso H., Iwu C.J., Jaafari J., Jadidi-Niaragh F., Jafarinia M., Jahagirdar D., Jahani M.A., Jahanmehr N., Jakovljevic M., Janjani H., Javaheri T., Jayatilleke A.U., Jenabi E., Jha R.P., Jha V., Ji J.S., Jia P., John-Akinola Y.O., Jonas J.B., Joukar F., Jozwiak J.J., Jurisson M., Kabir Z., Kalankesh L.R., Kalhor R., Kamath A.M., Kanchan T., Kapoor N., Karami Matin B., Karanikolos M., Karimi S.M., Kassebaum N.J., Katikireddi S.V., Kayode G.A., Keiyoro P.N., Khader Y.S., Khammarnia M., Khan M., Khan E.A., Khang Y.-H., Khatab K., Khater A.M., Khater M.M., Khatib M.N., Khayamzadeh M., Khubchandani J., Kianipour N., Kim Y.J., Kimokoti R.W., Kinfu Y., Kisa A., Kissimova-Skarbek K., Kivimaki M., Kneib C.J., Kocarnik J.M., Kochhar S., Kohler S., Kopec J.A., Korotkova A.V., Korshunov V.A., Kosen S., Kotlo A., Koul P.A., Koyanagi A., Krishan K., Krohn K.J., Kugbey N., Kulkarni V., Kumar G.A., Kumar N., Kumar M., Kurmi O.P., Kusuma D., Kyu H.H., La Vecchia C., Lacey B., Lal D.K., Lalloo R., Landires I., Lansingh V.C., Larsson A.O., Lasrado S., Lau K.M.-M., Lauriola P., Lazarus J.V., Ledesma J.R., Lee P.H., Lee S.W.H., Leever A.T., LeGrand K.E., Leigh J., Leonardi M., Li S., Lim S.S., Lim L.-L., Liu X., Logroscino G., Lopez A.D., Lopukhov P.D., Lotufo P.A., Lu A., Ma J., Madadin M., Mahasha P.W., Mahmoudi M., Majeed A., Malagon-Rojas J.N., Maleki S., Malta D.C., Mansouri B., Mansournia M.A., Martini S., Martins-Melo F.R., Martopullo I., Massenburg B.B., Mastrogiacomo C.I., Mathur M.R., McAlinden C., McKee M., Medina-Solis C.E., Meharie B.G., Mehndiratta M.M., Mehrabi Nasab E., Mehri F., Mehrotra R., Mekonnen T., Melese A., Memiah P.T.N., Mendoza W., Menezes R.G., Mensah G.A., Meretoja T.J., Meretoja A., Mestrovic T., Miazgowski B., Michalek I.M., Mirrakhimov E.M., Mirzaei M., Mirzaei-Alavijeh M., Mitchell P.B., Moazen B., Moghadaszadeh M., Mohamadi E., Mohammad Y., Mohammad D.K., Mohammad Gholi Mezerji N., Mohammadian-Hafshejani A., Mohammed S., Mohammed J.A., Mokdad A.H., Monasta L., Mondello S., Moradi M., Moradi-Lakeh M., Moradzadeh R., Moraga P., Morgado-da-Costa J., Morrison S.D., Mosapour A., Mosser J.F., Mousavi Khaneghah A., Muriithi M.K., Mustafa G., Nabhan A.F., Naderi M., Nagarajan A.J., Naghavi M., Naghshtabrizi B., Naimzada M.D., Nangia V., Nansseu J.R., Nayak V.C., Nazari J., Ndejjo R., Negoi I., Negoi R.I., Neupane S., Ngari K.N., Nguefack-Tsague G., Ngunjiri J.W., Nguyen C.T., Nguyen D.N., Nguyen H.L.T., Nnaji C.A., Nomura S., Norheim O.F., Noubiap J.J., Nowak C., Nunez-Samudio V., Otoiu A., Ogbo F.A., Oghenetega O.B., Oh I.-H., Okunga E.W., Oladnabi M., Olagunju A.T., Olusanya J.O., Olusanya B.O., Oluwasanu M.M., Omar Bali A., Omer M.O., Ong K.L., Onwujekwe O.E., Ortega-Altamirano D.V.V., Ortiz A., Ostojic S.M., Otstavnov N., Otstavnov S.S., Overland S., Owolabi M.O., Padubidri J.R., Pakhale S., Palladino R., Pana A., Panda-Jonas S., Pangaribuan H.U., Pathak M., Patton G.C., Paudel S., Pazoki Toroudi H., Pease S.A., Peden A.E., Pennini A., Peprah E.K., Pereira J., Pigott D.M., Pilgrim T., Pilz T.M., Pinheiro M., Piradov M.A., Pirsaheb M., Pokhrel K.N., Postma M.J., Pourjafar H., Pourmalek F., Pourmirza Kalhori R., Pourshams A., Prada S.I., Pribadi D.R.A., Pupillo E., Quazi Syed Z., Radfar A., Rafiee A., Rafiei A., Raggi A., Rahim F., Rahman M.A., Rajabpour-Sanati A., Rana S.M., Ranabhat C.L., Rao S.J., Rasella D., Rashedi V., Rath G.K., Rathi P., Rawaf S., Rawaf D.L., Rawal L., Rawassizadeh R., Razo C., Renjith V., Renzaho A.M.N., Reshmi B., Rezaei N., Riahi S.M., Ribeiro D.C., Rickard J., Roberts N.L.S., Roever L., Romoli M., Ronfani L., Roshandel G., Rubagotti E., Rwegerera G.M., Sabour S., Sachdev P.S., Saddik B., Sadeghi M., Sadeghi E., Safari Y., Sagar R., Sahebkar A., Sahraian M.A., Sajadi S.M., Salahshoor M.R., Salem M.R.R., Salem H., Salomon J., Samadi Kafil H., Samy A.M., Sanabria J., Santric-Milicevic M.M., Saraswathy S.Y.I., Sarmiento-Suarez R., Sartorius B., Sarveazad A., Sathian B., Sathish T., Sattin D., Savic M., Sawyer S.M., Saxena D., Sbarra A.N., Schaeffer L.E., Schiavolin S., Schmidt M.I., Schutte A.E., Schwebel D.C., Schwendicke F., Seedat S., Sha F., Shahabi S., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Shannawaz M., Sharafi K., Sharara F., Sharifi H., Shaw D.H., Sheikh A., Sheikhtaheri A., Shibuya K., Shiferaw W.S., Shigematsu M., Shin J.I., Shiri R., Shirkoohi R., Shivakumar K.M., Shrime M.G., Shuval K., Siabani S., Sierpinski R., Sigfusdottir I.D., Sigurvinsdottir R., Silva D.A.S., Silva J.P., Simonetti B., Simpson K.E., Singh J.A., Singh P., Sinha D.N., Skryabin V.Y., Smith E.U.R., Soheili A., Soltani S., Soofi M., Sorensen R.J.D., Soriano J.B., Sorrie M.B., Soyiri I.N., Spurlock E.E., Sreeramareddy C.T., Stanaway J.D., and Steel N.

Abstract

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. Method(s): 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 UH

Published
2020

2. Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Collaborators, GAM, Ward, JL, Azzopardi, PS, Francis, KL, Santelli, JS, Skirbekk, V, Sawyer, SM, Kassebaum, NJ, Mokdad, AH, Hay, SI, Abd-Allah, F, Abdoli, A, Abdollahi, M, Abedi, A, Abolhassani, H, Abreu, LG, Abrigo, MRM, Abu-Gharbieh, E, Abushouk, AI, Adebayo, OM, Adekanmbi, V, Adham, D, Advani, SM, Afshari, K, Agrawal, A, Ahmad, T, Ahmadi, K, Ahmed, AE, Aji, B, Akombi-Inyang, B, Alahdab, F, Al-Aly, Z, Alam, K, Alanezi, FM, Alanzi, TM, Alcalde-Rabanal, JE, Alemu, BW, Al-Hajj, S, Alhassan, RK, Ali, S, Alicandro, G, Alijanzadeh, M, Aljunid, SM, Almasi-Hashiani, A, Almasri, NA, Al-Mekhlafi, HM, Alonso, J, Al-Raddadi, RM, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, S, Aminorroaya, A, Amit, AML, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, CL, Androudi, S, Ansari, F, Ansari, I, Antonio, CAT, Anvari, D, Anwer, R, Appiah, SCY, Arabloo, J, Arab-Zozani, M, Ärnlöv, J, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, AA, Atout, MMW, Ausloos, M, Avenyo, EK, Avila-Burgos, L, Quintanilla, BPA, Ayano, G, Aynalem, YA, Azari, S, Azene, ZN, Bakhshaei, MH, Bakkannavar, SM, Banach, M, Banik, PC, Barboza, MA, Barker-Collo, SL, Bärnighausen, TW, Basu, S, Baune, BT, Bayati, M, Bedi, N, Beghi, E, Bekuma, TT, Bell, AW, Bell, ML, Benjet, C, Bensenor, IM, Berhe, AK, Berhe, K, Berman, AE, Bhagavathula, AS, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhattarai, S, Bhutta, ZA, Bijani, A, Bikbov, B, Biondi, A, Birhanu, TTM, Biswas, RK, Bohlouli, S, Bolla, SR, Boloor, A, Borschmann, R, Boufous, S, Bragazzi, NL, Braithwaite, D, Breitborde, NJK, Brenner, H, Britton, GB, Burns, RA, Nagaraja, SB, Butt, ZA, dos Santos, FLC, Cámera, LA, Campos-Nonato, IR, Rincon, JCC, Cárdenas, R, Carreras, G, Carrero, JJ, Carvalho, F, Castaldelli-Maia, JM, Castañeda-Orjuela, CA, Castelpietra, G, Catalá-López, F, Cerin, E, Chandan, JS, Chang, H-Y, Chang, J-C, Charan, J, Chattu, VK, Chaturvedi, S, Choi, J-YJ, Chowdhury, MAK, Christopher, DJ, Chu, D-T, Chung, MT, Chung, S-C, Cicuttini, FM, Constantin, TV, Costa, VM, 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Subjects
Male, Joves -- Mortalitat, ADOLESCENT HEALTH, CHILDREN, Socioeconomic Factor, Global Burden of Disease, RA0421, Cause of Death, Medicine, Young adult, Child, 11 Medical and Health Sciences, Cause of death, education.field_of_study, Adolescent, Age Distribution, Female, Humans, Mortality, Sex Distribution, Socioeconomic Factors, Young Adult, Mortality rate, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Articles, Hälsovetenskaper, MIDDLE-INCOME, MENTAL-HEALTH, Adolescent health, INTERVENTIONS, Human, SUICIDE, Total fertility rate, Population, Adolescent Health, Adolescents -- Mortalitat, General & Internal Medicine, Health Sciences, QUALITY, Medicine [Science], Social determinants of health, INCOME COUNTRIES, education, business.industry, TRENDS, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, INJURIES, business, Demography
Abstract

Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. Funding Bill & Melinda Gates Foundation.

Published
2021

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