Measuring health equity in the ASEAN region: conceptual framework and assessment of data availability
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1
Yale-NUS College, National University of Singapore, Singapore
2
Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A761
ABSTRACT
Background: Existing research on health equity falls short of identifying a comprehensive set of indicators for measurement across health systems. Health systems in the ASEAN region, in particular, lack a standardized framework to assess health equity. This paper proposes a comprehensive framework to measure health equity in the ASEAN region and highlights current gaps in data availability according to its indicator components. Methods: A comprehensive literature review was undertaken to map out a core set of indicators to evaluate health equity at the health system level. Secondary data collection was subsequently conducted to assess current data availability for ASEAN states in key global health databases, national health accounts, and policy documents. Results: A robust framework to measure health equity was developed comprising 143 indicators across Health System Inputs, Outputs, and Outcomes. Across the ASEAN region, the Inputs sub-component of Health Financing had data available for all indicators (160/160, 100%), while Access to Essential Medicine had the least data available (6/30, 20%). Under Outputs and Outcomes, Coverage of Selected Interventions (161/270, 59.63%) and Population Health (350/350, 100%) had the most data available, while other indicator sub-components had little to none (≤ 38%). Cambodia had the most complete data overall (79.72%) while Vietnam had the least (66.43%). Figure 1. Proposed conceptual framework for measuring health equity Conclusions: The data availability gaps highlighted in this study underscore the need for a standardised framework to guide data collection and benchmarking of health equity in ASEAN. There is a need to prioritise regular data collection for overlooked indicator areas and in countries with low levels of data availability. The application of this indicator framework and resulting data availability analysis could be conducted beyond ASEAN to enable cross-regional benchmarking of health equity.