Healthcare Access and Quality Index 2019: Overview
“In 2019, the global mean HAQ [Healthcare Access and Quality] Index was 54·4 (95% UI 52·1–55·7), ranging from 15·2 to 93·1 across all countries and territories (table, figure 1A). The HAQ Index scores differed depending on levels of development and super-region. In high-SDI [Socio-Demographic Index] countries, the average HAQ Index score was 83·4 (82·4–84·3) in 2019, whereas low-SDI countries had an average HAQ Index score of 30·7 (28·6–33·0). Across GBD super-regions, the high-income region had the highest HAQ Index score (83·9, 82·6–85·0) and the sub-Saharan African region had the lowest average score (29·0, 26·7–31·7).
“Globally, the overall HAQ Index increased by 19·6 points between 1990 and 2019, with improvements in HAQ Index scores in 185 of 204 countries and territories. Zimbabwe was the only country that did not improve (for others, the UIs overlapped). In 1990, Zimbabwe ranked 133rd globally, but in 2019 it dropped to 194th, a decline driven primarily by lack of progress across four diseases: inguinal, femoral, and abdominal hernia; idiopathic epilepsy; lower respiratory infections; and tuberculosis— but nearly all conditions failed to improve. Lesotho also had a substantial drop in rank order over the same period, falling from 151st to 185th globally. Although HAQ Index scores improved minimally for Central African Republic and Somalia, the two countries saw no change in global rank order over the time period. The gap between the lowest and highest HAQ Index scores in 2019 (77·9, 95% UI 15·2–93·1) was larger than the gap in 1990 (69·9, 9·7–79·6). High-SDI-quintile countries increased by 15·1 points, as compared with 25·9 points in middle-SDI and 11·8 points in low-SDI countries (figure 2). Across regions, increases were highest in east Asia (32·4 point increase), Andean Latin America (22·7 point increase), and high-income Asia Pacific (19·6 point increase). The smallest regional improvements over the time period occurred in Oceania (3·9 point increase), southern sub-Saharan Africa (6·3 point increase), and central Asia (8·2 point increase).”
Source: GBD 2019 Healthcare Access and Quality Collaborators (2022). 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. The Lancet. Global health, 10(12), e1715–e1743. https://doi.org/10.1016/S2214-109X(22)00429-6
“Our analysis showed improvements in the overall and select age group HAQ [Healthcare Access and Quality] Indices in almost every country and territory between 1990 and 2019. However, disparities in HAQ Index scores across locations persisted into 2019. Between 1990 and 2019, the gap with the high-SDI quintile in the young group declined or was steady for all SDI [Socio-Demographic Index] levels. In the two other age groups, only the middle-SDI-quintile countries closed the average gap with high-SDI-quintile countries, and the gap for the low-SDI-quintile countries grew. While we find evidence of convergence in the young HAQ Index, social and economic development remains a crucial predictor of levels and trends in health-care access and quality.
“Countries with higher social and economic development had better performance in the HAQ Index—nearly 50 points separates the lowest and highest SDI quintiles for the overall and age-group scores. Social and economic development supports countries in raising more funds for health, pooling resources for health insurance, improving the health-care workforce, and other factors that enhance the ability of health systems to improve health-care access and quality.46,56,57 Greater resources also enable purchasing of more expensive technology, equipment, and pharmaceuticals to prevent and treat disease.”
Source: GBD 2019 Healthcare Access and Quality Collaborators (2022). 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. The Lancet. Global health, 10(12), e1715–e1743. https://doi.org/10.1016/S2214-109X(22)00429-6
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Page last updated March 24, 2023 by Doug McVay, Editor.
