Healthcare Effective Coverage (PI7191)

This metric is intended to capture the proportion of patients that are eligible for an intervention that receive that intervention and then go on to benefit from it. For a detailed explanation of this measure, see “Effective Coverage: A Metric for Monitoring Universal Health Coverage” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171091/#:~:text=Effective%20coverage%2C%20which%20unites%20individual,tracking%20progress%20towards%20achieving%20UHC).

Healthcare Crude Coverage (PI3902) is an input into Healthcare Effective Coverage (PI7191) – crude coverage is a simple measure of percent of patients needing treatment who received it during the reporting period, while effective coverage includes a measure of quality. Both can be applied at a national, individual, or organizational level; investors are encouraged to apply them at the level of the investee company. While crude coverage is more widely used, experts are increasingly encouraging use of the quality-inclusive effective coverage measure. However, there are not, as of yet, broadly standardized ratios for the “quality of the intervention” element of the calculation. IRIS users are encouraged to document all assumptions used in calculating this measure as well as to use existing publications such as the following to inform their approaches:

• IADB’s "The Use of Effective Coverage in the Evaluation of Maternal and Child Health Programs: A Technical Note for the IDB’s Social Protection and Health” (https://publications.iadb.org/publications/english/document/The-Use-of-Effective-Coverage-in-the-Evaluation-of-Maternal-and-Child-Health-Programs-A-Technical-Note-for-the-IDB-Social-Protection-and-Health-Division.pdf)
• “Effective coverage as a new approach to health system performance assessment: a scoping review” (https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3692-7#:~:text=In%20their%20work%2C%20effective%20coverage%20combines%20three%20widely,which%20is%20actually%20delivered%20%5B%201%2C%2010%20%5D).
• “Access, utilization, quality, and effective coverage: an integrated conceptual framework and measurement strategy” (https://www.sciencedirect.com/science/article/abs/pii/S0277953604006070?via%3Dihub).

In specific contexts, and based on evidence, this metric may serve as a proxy indicator of whether the outcome being sought by an investor or organization is occurring (the WHAT dimension of impact). For more on the alignment of IRIS metrics to the five dimensions of impact, see IRIS+ and the Five Dimensions of Impact (https://iris.thegiin.org/document/iris-and-the-five-dimensions/). No single metric is sufficient to understand an impact; rather, metrics are selected as a set across all dimensions of impact. When possible, the selection of metrics to measure and describe the five dimensions should be based on best practice and evidence.