Fitzpatrick C, et al. - Experts described the neglected tropical disease (NTD) service coverage index and compared it to the universal health coverage (UHC) service coverage index to demonstrate its usefulness in monitoring equity in progress toward UHC. Equity in progress towards UHC could be measured with the NTD index. At regional and country levels, a broader NTD index including services for other NTDs could be developed. Comparing the NTD and UHC service coverage indices reveals that still there is work to be done in prioritising services for their poorest and otherwise most marginalised communities by of the countries that are performing well by the measure of the UHC service coverage index. Hope that there is a probability to overcome the socioeconomic barriers to health service coverage is offered in the findings.

Methods

• Researchers developed an index focused on coverage of services for NTDs, comparable in methods to the UHC service coverage index.
• Based on the data availability, they focused on preventive chemotherapy, which was recently included in the highest-priority package of essential UHC interventions.
• They used data reported to WHO since 2008 for the five NTDs amenable to preventive chemotherapy (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases, and trachoma) to develop an NTD service coverage index based on the geometric mean of coverage rates for individual NTD services with regularly reported data.
• This NTD service coverage index was then compared with the UHC service coverage index.
• As suggested by high UHC index value and a low NTD index value, a country might not be adequately prioritising interventions for the poor.
• The Spearman rank-order correlation (ρ) of the NTD service coverage index was measured with income inequality, as measured by the Gini coefficient (range of 0–1), where values of the Gini coefficient close to 1 indicate higher income inequality, and a negative correlation was evidence of socioeconomic barriers to health service coverage for people who are least well off.

Results

• As per data, at least 123 countries can monitor NTD service coverage by use of a simple index.
• Results suggested the median national NTD index to be 32 in 2016, an increase from 3 in 2012, and from 0 in 2008.
• The NTD index, in 2015, was lower than the UHC index in 81 of the 113 countries for which both NTD and UHC indices are available, by up to 80 points.
• Findings demonstrated a negative bu weak association of the NTD index with income inequality; this correlation was strongest in the African Region (ρ=-0·46 in 2008, ρ=-0·32 in 2015), thereby, suggesting that high-income inequality, although associated with low coverage of services targeting the poor, does not preclude the extension of that coverage.