Evaluation of Coverage

Coverage refers to the proportion of the target population in need of a specific, efficacious intervention and who could potentially have access to it. It describes whether or not an individual in need of a specific health intervention makes contact with the health professional. Because coverage estimates do not represent the proportion of all patients in need who are effectively treated, they do not take into account the other components of community effectiveness.

Coverage evaluation requires that the use of health services be related to the need for them in a defined population during a specific time period. It should be differentiated from utilization of services, which describes the form of activity-to-population ratios. Since utilization of services fails to incorporate information about need, it is not as accurate as a measure of availability.

Availability and Acceptability of Effective Health Services

Availability concerns whether efficacious health services are accessible to those in need and whether the population is aware of services being available. Accessibility can be measured by estimating the supply of services and by taking into account the distribution. Awareness of the availability of these services by those in need is also relevant. This component is important in screening studies to ensure that there is appropriate linkage of identified patients with the condition of interest to the health provider, so that they get treated rather than just 'labeled'. For example, a promotional campaign on the use of oral rehydration salts (ORS) is required to enhance awareness and the level of coverage.

Quantification of acceptability can be best obtained from surveys and should not be confined to users of health services. Measurement of acceptability can be divided into the patients' perceptions of (1) the resources or facilities, (2) the behavior of health professionals and their staff, and (3) the benefits expected from the health service.

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