Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016
Authors: Nancy Fullman, Jamal Yearwood, Solomon M Abay, Cristiana Abbafati, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Zegeye Abebe, Teshome Abuka Abebo, Victor Aboyans, Haftom Niguse Abraha, Daisy M X Abreu, Laith J Abu-Raddad, Akilew Awoke Adane, Rufus Adesoji Adedoyin, Olatunji Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Ashkan Afshin, Gina Agarwal, Dominic Agius, Anurag Agrawal, Sutapa Agrawal, Aliasghar Ahmad Kiadaliri, Miloud Taki Eddine Aichour, Mohammed Akibu, Rufus Olusola Akinyemi, Tomi F Akinyemiju, Nadia Akseer, Faris Hasan Al Lami, Fares Alahdab, Ziyad Al-Aly, Khurshid Alam, Tahiya Alam, Deena Alasfoor, Mohammed I Albittar, Kefyalew Addis Alene, Ayman Al-Eyadhy, Syed Danish Ali, Mehran Alijanzadeh, Syed M Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Christine Allen, Mahmoud A Alomari, Rajaa Al-Raddadi, Ubai Alsharif, Khalid A Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Kebede Amenu, Walid Ammar, Yaw Ampem Amoako, Nahla Anber, Catalina Liliana Andrei, Sofia Androudi, Carl Abelardo T Antonio, Valdelaine E M Araújo, Olatunde Aremu, Johan Ärnlöv, Al Artaman, Krishna Kumar Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Solomon Weldegebreal Asgedom, Rana Jawad Asghar, Mengistu Mitiku Ashebir, Netsanet Abera Asseffa, Tesfay Mehari Atey, Sachin R Atre, Madhu S Atteraya, Leticia Avila-Burgos, Euripide Frinel G Arthur Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Animut Alebel Ayalew, Henok Tadesse Ayele, Rakesh Ayer, Tambe Betrand Ayuk, Peter Azzopardi, Natasha Azzopardi-Muscat, Tesleem Kayode Babalola, Hamid Badali, Alaa Badawi, Maciej Banach, Amitava Banerjee, Amrit Banstola, Ryan M Barber, Miguel A Barboza, Suzanne L Barker-Collo, Till Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Abate Bekele Belachew, Saba Abraham Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, James R Bennett, Isabela M Bensenor, Derbew Fikadu Berhe, Eduardo Bernabé, Robert Steven Bernstein, Mircea Beuran, Ashish Bhalla, Paurvi Bhatt, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Ali Bijani, Boris Bikbov, Charles Birungi, Stan Biryukov, Hailemichael Bizuneh, Ian W Bolliger, Kaylin Bolt, Ibrahim R Bou-Orm, Kayvan Bozorgmehr, Oliver Jerome Brady, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Gabrielle Britton, Traolach S Brugha, Zahid A Butt, Lucero Cahuana-Hurtado, Ismael Ricardo Campos-Nonato, Julio Cesar Campuzano, Josip Car, Mate Car, Rosario Cárdenas, Juan Jesus Carrero, Felix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Ferrán Catalá-López, Kelly Cercy, Julian Chalek, Hsing-Yi Chang, Jung-Chen Chang, Aparajita Chattopadhyay, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Vesper Hichilombwe Chisumpa, Jee-Young J Choi, Hanne Christensen, Devasahayam Jesudas Christopher, Sheng-Chia Chung, Liliana G Ciobanu, Massimo Cirillo, Danny Colombara, Sara Conti, Cyrus Cooper, Leslie Cornaby, Paolo Angelo Cortesi, Monica Cortinovis, Alexandre Costa Pereira, Ewerton Cousin, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Alemneh Kabeta Daba, Berihun Assefa Dachew, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Paul I Dargan, Ahmad Daryani, Maryam Daryani, Jai Das, Siddharth Kumar Das, José das Neves, Nicole Davis Weaver, Kairat Davletov, Barbora de Courten, Diego De Leo, Jan-Walter De Neve, Robert P Dellavalle, Gebre Demoz, Kebede Deribe, Don C Des Jarlais, Subhojit Dey, Samath D Dharmaratne, Meghnath Dhimal, Shirin Djalalinia, David Teye Doku, Kate Dolan, E Ray Dorsey, Kadine Priscila Bender dos Santos, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Bruce Bartholow Duncan, Michelle Echko, Dumessa Edessa, David Edvardsson, Joshua R Ehrlich, Erika Eldrenkamp, Ziad Ziad El-Khatib, Matthias Endres, Aman Yesuf Endries, Babak Eshrati, Sharareh Eskandarieh, Alireza Esteghamati, Mahdi Fakhar, Tamer Farag, Mahbobeh Faramarzi, Emerito Jose Aquino Faraon, André Faro, Farshad Farzadfar, Adesegun Fatusi, Mir Sohail Fazeli, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, João C Fernandes, Daniel Obadare Fijabi, Irina Filip, Florian Fischer, Christina Fitzmaurice, Abraham D Flaxman, Luisa Sorio Flor, Nataliya Foigt, Kyle J Foreman, Joseph J Frostad, Thomas Fürst, Neal D Futran, Emmanuela Gakidou, Silvano Gallus, Ketevan Gambashidze, Amiran Gamkrelidze, Morsaleh Ganji, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Yalemzewod Assefa Gelaw, Johanna M Geleijnse, Demeke Geremew, Peter W Gething, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Paramjit Singh Gill, Ababi Zergaw Giref, Maurice Giroud, Melkamu Dedefo Gishu, Giorgia Giussani, William W Godwin, Srinivas Goli, Hector Gomez-Dantes, Philimon N Gona, Amador Goodridge, Sameer Vali Gopalani, Yevgeniy Goryakin, Alessandra Carvalho Goulart, Ayman Grada, Max Griswold, Giuseppe Grosso, Harish Chander Gugnani, Yuming Guo, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Tarun Gupta, Vipin Gupta, Juanita A Haagsma, Vladimir Hachinski, Nima Hafezi-Nejad, Gessessew Bugssa Hailu, Randah Ribhi Hamadeh, Samer Hamidi, Graeme J Hankey, Hilda L Harb, Heather C Harewood, Sivadasanpillai Harikrishnan, Josep Maria Haro, Hamid Yimam Hassen, Rasmus Havmoeller, Caitlin Hawley, Simon I Hay, Jiawei He, Stephen J C Hearps, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Nathaniel J Henry, Victor Hugo Herrera Ballesteros, Claudiu Herteliu, Desalegn Tsegaw Hibstu, Molla Kahssay Hiluf, Hans W Hoek, Enayatollah Homaie Rad, Nobuyuki Horita, H Dean Hosgood, Mostafa Hosseini, Seyed Reza Hosseini, Mihaela Hostiuc, Sorin Hostiuc, Damian G Hoy, Mohamed Hsairi, Aung Soe Htet, Guoqing Hu, John J Huang, Kim Moesgaard Iburg, Fachmi Idris, Ehimario Uche Igumbor, Chad Ikeda, Bogdan Vasile Ileanu, Olayinka S Ilesanmi, Kaire Innos, Seyed Sina Naghibi Irvani, Caleb M S Irvine, Farhad Islami, Troy A Jacobs, Kathryn H Jacobsen, Nader Jahanmehr, Rajesh Jain, Sudhir Kumar Jain, Mihajlo B Jakovljevic, Moti Tolera Jalu, Amr A Jamal, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Ravi Prakash Jha, Vivekanand Jha, Jacek Jóúwiak, Oommen John, Sarah Charlotte Johnson, Jost B Jonas, Vasna Joshua, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Chittaranjan Kar, Marina Karanikolos, André Karch, Corine Kakizi Karema, Seyed M Karimi, Amir Kasaeian, Dessalegn Haile Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Norito Kawakami, Konstantin Kazanjan, Seifu Kebede, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Maia Kereselidze, Ezra Belay Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Alireza Khajavi, Ibrahim A Khalil, Ejaz Ahmad Khan, Gulfaraz Khan, Md Nuruzzaman Khan, Muhammad Ali Khan, Mukti Nath Khanal, Young-Ho Khang, Mona M Khater, Abdullah Tawfih Abdullah Khoja, Ardeshir Khosravi, Jagdish Khubchandani, Getiye Dejenu Kibret, Daniel Ngari Kiirithio, Daniel Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Sanjay Kinra, Adnan Kisa, Niranjan Kissoon, Sonali Kochhar, Yoshihiro Kokubo, Jacek A Kopec, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Michael Kravchenko, Kewal Krishan, Kristopher J Krohn, Barthelemy Kuate Defo, G Anil Kumar, Pushpendra Kumar, Michael Kutz, Igor Kuzin, Hmwe H Kyu, Deepesh Pravinkumar Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Hilton Lam, Qing Lan, Justin J Lang, Van C Lansingh, Sonia Lansky, Anders Larsson, Arman Latifi, Jeffrey Victor Lazarus, Janet L Leasher, Paul H Lee, Yirga Legesse, James Leigh, Cheru Tesema Leshargie, Samson Leta, Janni Leung, Ricky Leung, Miriam Levi, Yongmei Li, Juan Liang, Misgan Legesse Liben, Lee-Ling Lim, Stephen S Lim, Margaret Lind, Shai Linn, Stefan Listl, Patrick Liu, Shiwei Liu, Rakesh Lodha, Alan D Lopez, Scott A Lorch, Stefan Lorkowski, Paulo A Lotufo, Timothy C D Lucas, Raimundas Lunevicius, Grégoire Lurton, Ronan A Lyons, Fadi Maalouf, Erlyn Rachelle King Macarayan, Mark T Mackay, Emilie R Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Mohammed Magdy Abd El Razek, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Rajesh Malhotra, Deborah Carvalho Malta, Abdullah A Mamun, Trey Manhertz, Helena Manguerra, Mohammad Ali Mansournia, Lorenzo G Mantovani, Tsegahun Manyazewal, Chabila C Mapoma, Christopher Margono, Jose Martinez-Raga, Sheila Cristina Ouriques Martins, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Benjamin Ballard Massenburg, Manu Raj Mathur, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Suresh Mehata, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Toni Meier, Fabiola Mejia-Rodriguez, Kidanu Gebremariam Meles, Mulugeta Melku, Peter Memiah, Ziad A Memish, Walter Mendoza, Degu Abate Mengiste, Desalegn Tadese Mengistu, Bereket Gebremichael Menota, George A Mensah, Atte Meretoja, Tuomo J Meretoja, Haftay Berhane Mezgebe, Tomasz Miazgowski, Renata Micha, Robert Milam, Anoushka Millear, Ted R Miller, GK Mini, Shawn Minnig, Andreea Mirica, Erkin M Mirrakhimov, Awoke Misganaw, Philip B Mitchell, Fitsum Weldegebreal Mlashu, Babak Moazen, Karzan Abdulmuhsin Mohammad, Roghayeh Mohammadibakhsh, Ebrahim Mohammed, Mohammed A Mohammed, Shafiu Mohammed, Ali H Mokdad, Glen Liddell Mola, Mariam Molokhia, Fatemeh Momeniha, Lorenzo Monasta, Julio Cesar Montañez Hernandez, Mahmood Moosazadeh, Maziar Moradi-Lakeh, Paula Moraga, Lidia Morawska, Ilais Moreno Velasquez, Rintaro Mori, Shane D Morrison, Mark Moses, Seyyed Meysam Mousavi, Ulrich O Mueller, Manoj Murhekar, Gudlavalleti Venkata Satyanarayana Murthy, Srinivas Murthy, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Chie Nagata, Gabriele Nagel, Mohsen Naghavi, Aliya Naheed, Gurudatta A Naik, Nitish Naik, Farid Najafi, Luigi Naldi, Vinay Nangia, Jobert Richie Njingang Nansseu, KM Venkat Narayan, Bruno Ramos Nascimento, Ionut Negoi, Ruxandra Irina Negoi, Charles R Newton, Josephine Wanjiku Ngunjiri, Grant Nguyen, Long Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Ellen Nolte, Vuong Minh Nong, Ole F Norheim, Bo Norrving, Jean Jacques N Noubiap, Alypio Nyandwi, Carla Makhlouf Obermeyer, Richard Ofori-Asenso, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Andrew Toyin Olagunju, Tinuke Oluwasefunmi Olagunju, Pedro R Olivares, Patricia Pereira Vasconcelos de Oliveira, Helen E Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin Ong, John Nelson Opio, Eyal Oren, Doris V Ortega-Altamirano, Alberto Ortiz, Raziye Ozdemir, Mahesh PA, Amanda W Pain, Marcos Roberto Tovani Palone, Adrian Pana, Songhomitra Panda-Jonas, Jeyaraj D Pandian, Eun-Kee Park, Hadi Parsian, Tejas Patel, Sanghamitra Pati, Snehal T Patil, Ajay Patle, George C Patton, Vishnupriya Rao Paturi, Deepak Paudel, Marcel de Moares Pedroso, Sandra P Pedroza, David M Pereira, Norberto Perico, Hannah Peterson, Max Petzold, Niloofar Peykari, Michael Robert Phillips, Frédéric B Piel, David M Pigott, Julian David Pillay, Michael A Piradov, Suzanne Polinder, Constance D Pond, Maarten J Postma, Farshad Pourmalek, Swayam Prakash, V Prakash, Narayan Prasad, Noela Marie Prasad, Caroline Purcell, Mostafa Qorbani, Hedley Knewjen Quintana, Amir Radfar, Anwar Rafay, Alireza Rafiei, Kazem Rahimi, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Muhammad Aziz Rahman, Sajjad Ur Rahman, Rajesh Kumar Rai, Sree Bhushan Raju, Usha Ram, Saleem M Rana, Zane Rankin, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sarah E Ray, Christian Aspacia Razo-García, Priscilla Reddy, Robert C Reiner, Cesar Reis, Marissa B Reitsma, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Mohammad Sadegh Rezai, Antonio L Ribeiro, Maria Jesus Rios Blancas, Juan A Rivera, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Gregory A Roth, Dietrich Rothenbacher, Ambuj Roy, Nobhojit Roy, George Mugambage Ruhago, Yogesh Damodar Sabde, Perminder S Sachdev, Nafis Sadat, Mahdi Safdarian, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Haniye Sadat Sajadi, Joseph Salama, Payman Salamati, Raphael de Freitas Saldanha, Hamideh Salimzadeh, Joshua A Salomon, Abdallah M Samy, Juan Ramon Sanabria, Parag K Sancheti, Maria Dolores Sanchez-Niño, Damian Santomauro, Itamar S Santos, Milena M Santric Milicevic, Abdur Razzaque Sarker, Nizal Sarrafzadegan, Benn Sartorius, Maheswar Satpathy, Miloje Savic, Monika Sawhney, Sonia Saxena, Mete I Saylan, Elke Schaeffner, Josef Schmidhuber, Maria Inês Schmidt, Ione J C Schneider, Austin E Schumacher, Aletta E Schutte, David C Schwebel, Falk Schwendicke, Mario Sekerija, Sadaf G Sepanlou, Edson E Servan-Mori, Azadeh Shafieesabet, Masood Ali Shaikh, Marina Shakh-Nazarova, Mehran Shams-Beyranvand, Heidar Sharafi, Mahdi Sharif-Alhoseini, Sheikh Mohammed Shariful Islam, Meenakshi Sharma, Rajesh Sharma, Jun She, Aziz Sheikh, Mebrahtu Teweldemedhin Shfare, Peilin Shi, Chloe Shields, Mika Shigematsu, Yukito Shinohara, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Mark G Shrime, Sharvari Rahul Shukla, Soraya Siabani, Inga Dora Sigfusdottir, Donald H Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Dayane Gabriele Alves Silveira, Jasvinder A Singh, Lavanya Singh, Narinder Pal Singh, Virendra Singh, Dhirendra Narain Sinha, Abiy Hiruye Sinke, Mekonnen Sisay, Vegard Skirbekk, Karen Sliwa, Alison Smith, Adauto Martins Soares Filho, Badr H A Sobaih, Melek Somai, Samir Soneji, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vasiliki Stathopoulou, Nicholas Steel, Dan J Stein, Mark Andrew Stokes, Lela Sturua, Muawiyyah Babale Sufiyan, Rizwan Abdulkader Suliankatchi, Bruno F Sunguya, Patrick J Sur, Bryan L Sykes, PN Sylaja, Rafael Tabarés-Seisdedos, Santosh Kumar Tadakamadla, Andualem Henok Tadesse, Getachew Redae Taffere, Nikhil Tandon, Amare Tariku Tariku, Nuno Taveira, Arash Tehrani-Banihashemi, Girma Temam Shifa, Mohamad-Hani Temsah, Abdullah Sulieman Terkawi, Azeb Gebresilassie Tesema, Dawit Jember Tesfaye, Belay Tessema, JS Thakur, Nihal Thomas, Matthew J Thompson, Taavi Tillmann, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Fotis Topouzis, Anna Torre, Miguel Tortajada, Bach Xuan Tran, Khanh Bao Tran, Avnish Tripathi, Srikanth Prasad Tripathy, Christopher Troeger, Thomas Truelsen, Derrick Tsoi, Lorainne Tudor Car, Kald Beshir Tuem, Stefanos Tyrovolas, Uche S Uchendu, Kingsley N Ukwaja, Irfan Ullah, Rachel Updike, Olalekan A Uthman, Benjamin S Chudi Uzochukwu, Pascual Rubén Valdez, Job F M van Boven, Santosh Varughese, Tommi Vasankari, Francesco S Violante, Sergey K Vladimirov, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Theo Vos, Fasil Wagnew, Yasir Waheed, Mitchell T Wallin, Judd L Walson, Yafeng Wang, Yuan-Pang Wang, Molla Mesele Wassie, Marcia R Weaver, Elisabete Weiderpass, Robert G Weintraub, Jordan Weiss, Kidu Gidey Weldegwergs, Andrea Werdecker, T Eoin West, Ronny Westerman, Richard G White, Harvey A Whiteford, Justyna Widecka, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles DA Wolfe, Yohanes Ayele Wondimkun, Abdulhalik Workicho, Grant M A Wyper, Denis Xavier, Gelin Xu, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Nigus Bililign Yimer, Peng Yin, Paul Yip, Biruck Desalegn Yirsaw, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Maysaa El Sayed Zaki, Sojib Bin Zaman, Mohammad Zamani, Zerihun Menlkalew Zenebe, Maigeng Zhou, Jun Zhu, Stephanie R M Zimsen, Ben Zipkin, Sanjay Zodpey, Liesl Joanna Zuhlke, Christopher J L Murray, Rafael Lozano
Journal: The Lancet (2018)

A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.