Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

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Zastrozhin M.S. Zhang Z.-J. Zhong C. Zuniga Y.M.H. Lim S.S. Murray C.J.L. Lozano R.
December 2022 Elsevier Ltd

The Lancet Global Health
2022 #10 Issue 12 e1715 - e1743 pp.

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation.

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Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States
Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States
Department of Global Health and Population, Harvard University, Boston, MA, United States
Brigham and Womens Hospital, Harvard University, Boston, MA, United States
T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
Center for Primary Care, Harvard University, Boston, MA, United States
Department of Global Health and Social Medicine, Harvard University, Boston, MA, United States
Division of Cardiology, Harvard University, Boston, MA, United States
Division of General Internal Medicine, Harvard University, Boston, MA, United States
Department of Nutrition, Gates Ventures, Seattle, WA, United States
Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy
Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
Postgraduate Department, University of Sierra Sur, Miahuatlan de Porfirio Diaz, Mexico
National Research Council of Mexico, Mexico City, Mexico
Department of Sociology, Olabisi Onabanjo University, Ago-Iwoye, Nigeria
Department of Obstetrics & Gynecology, University of Texas, Galveston, TX, United States
The Office of Health Policy & Legislative Affairs, University of Texas, Galveston, TX, United States
DSI-NRF Centre of Excellence for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
Division of Epidemiology & Biostatistics, Stellenbosch University, Cape Town, South Africa
Department of Life Sciences, University of Management and Technology, Lahore, Pakistan
Department of Community Medicine, King Edward Memorial Hospital, Lahore, Pakistan
Department of Public Health, Public Health Institute, Lahore, Pakistan
Center for Policy, Population & Health Research, National Autonomous University of Mexico, Mexico City, Mexico
Health Policy and Population Research Center (CIPPS), National Autonomous University of Mexico, Mexico City, Mexico
The Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, NSW, Australia
School of Computing Sciences, University of Technology Sydney, Sydney, NSW, Australia
Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Virtual School of Medical Education & Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
School of Pharmacy, Monash University, Bandar Sunway, Malaysia
Department of Pharmacy, Quaid i Azam University Islamabad, Islamabad, Pakistan
Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
Faculty of Medicine and Public Health, Jenderal Soedirman University, Purwokerto, Indonesia
Department of Clinical Pharmacy and Pharmacy Administration, University of Ibadan, Ibadan, Nigeria
Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
Department of Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
Murdoch Business School, Murdoch University, Perth, WA, Australia
Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Multidisciplinary Department, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
Department of Health Policy and Management, Kuwait University, Kuwait, Kuwait
International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
School of Graduate Studies, Lingnan University, Hong Kong
Public Heath Department, Cairo University, Cairo, Egypt
Maternal and Child Wellbeing, African Population and Health Research Center, Nairobi, Kenya
Department of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Universal Health Coverage Health System Strengthening Cluster, WHO Country Office São Tomé and Príencipe, São Tomé, Sao Tome and Principe
Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Netherlands
Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
Department of Maternal and Child Health, Sultan Qaboos University, Muscat, Oman
University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
University Institute of Public Health, The University of Lahore, Lahore, Pakistan
Department of Health System and Health Economics, Bahir Dar University, Bahir Dar, Ethiopia
Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal
School of Business, University of Leicester, Leicester, United Kingdom
Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
School of Public Health, Curtin University, Perth, WA, Australia
Department of Health Economics, Centre for Health Policy Advocacy Innovation & Research in Africa (CHPAIR-Africa), Accra, Ghana
Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
Unit of Biochemistry, Universiti Sultan Zainal Abidin (Sultan Zainal Abidin University), Kuala Terengganu, Malaysia
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India
Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, India
Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
Department of Health Information Management, Manipal Academy of Higher Education, Manipal, India
Department of Microbiology, Manipal Academy of Higher Education, Mangalore, India
Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
Department of Obstetrics and Gynaecology, Manipal Academy of Higher Education, Mangalore, India
Department of Non-communicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
Academic Unit of Obstetrics and Gynecology, University of Genoa, Genoa, Italy
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
University Eye Clinic, University of Genoa, Genoa, Italy
Department of Public & Environmental Health, University of the Gambia, Brikama, Gambia
Epidemiology and Disease Control Unit, Ministry of Health, Kotu, Gambia
School of Public Health, Imperial College London, London, United Kingdom
Imperial College Business School, Imperial College London, London, United Kingdom
Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
The George Institute for Global Health, Imperial College London, London, United Kingdom
Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Non-communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Medical Laboratory Sciences, Haramaya University, Harar, Ethiopia
Department of Social Services, Tufts Medical Center, Boston, MA, United States
Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
Department of Health, University of Arkansas, Fayetteville, AR, United States
Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
Neurovascular Imaging Laboratory, NSW Brain Clot Bank, Sydney, NSW, Australia
Department of Neurology and Neurophysiology, South West Sydney Local Heath District and Liverpool Hospital, Sydney, NSW, Australia
Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
Department of Statistics, University of Calcutta, Kolkata, India
Centre for Global Child Health, University of Toronto, Toronto, ON, Canada
Centre of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
Mario Negri Institute for Pharmacological Research, Ranica, Italy
Department of General Surgery and Medical- Surgical Specialties, University of Catania, Catania, Italy
Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
Department of Cardiology, Centre Hospitalier Montfermeil (Montfermeil Hospital Center), Montfermeil, France
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS (Fondazione Policlinico Universitario A. Gemelli IRCCS), Roma, Italy
Global Health Research Institute, Università Cattolica Del Sacro Cuore (Catholic University of Sacred Heart), Roma, Italy
Department of Health Care Management, Technical University of Berlin, Berlin, Germany
Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
Institute of Microengineering, Federal Polytechnic School of Lausanne, Lausanne, Switzerland
School of Public Health and Administration, Peruvian University Cayetano Heredia, Lima, Peru
Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Board of Directors, Buenos Aires, Argentina
Argentine Society of Medicine, Buenos Aires, Argentina
Department of Health Care, Metropolitan Autonomous University, Mexico City, Mexico
School of Sciences, University of Minho, Braga, Portugal
Directive Board, Linda-a-Velha, Portugal
Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal
National School of Public Health, Institute of Health Carlos III, Madrid, Spain
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States
Center of Excellence for Population Ageing Research (CEPAR), University of New South Wales, Sydney, NSW, Australia
School of Medicine, University of New South Wales, Sydney, NSW, Australia
School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Department of Human Centred Computing, Monash University, Melbourne, VIC, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
The School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
Centre for Noncommunicable Diseases and Nutrition, BRAC University, Dhaka, Bangladesh
Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, United States
Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia, SC, United States
Department of Public Health, University of Naples Federico II, Naples, Italy
Institute of Neuroscience, National Research Council, Pisa, Italy
Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Health Policy Research, Gurugram, India
Public Health Foundation of India, Gurugram, India
Indian Council of Medical Research, New Delhi, India
Department of Population and Development, Latin American Faculty of Social Sciences Mexico, Mexico City, Mexico
Health Research Institute, Al Farabi Kazakh National University, Almaty, Kazakhstan
National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal
Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
Research Department, Kathmandu, Nepal
Policy Research Institute, Kathmandu, Nepal
Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
Department of Health Policy and Management, Tabriz University of Medical Sciences, Tabriz, Iran
Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
Centre Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia
Biomedical Informatics and Medical Statistics Department, Alexandria University, Alexandria, Egypt
Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States
Faculty of Medicine, University of Tripoli, Tripoli, Libya
Centre for Applied Health Economics, Griffith University, Gold Coast, QLD, Australia
School of Medicine, Griffith University, Gold Coast, QLD, Australia
Department of Neurological Surgery, Northwestern University, Chicago, IL, United States
Institute of Public Health, Charité Medical University Berlin, Berlin, Germany
Institute of Gerontology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
Department of Dermatology, Kobe University, Kobe, Japan
Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
Institute of Applied Health Sciences (IAHS), University of Aberdeen, Coleraine, United Kingdom
Department of Radiology, King Edward Memorial Hospital, Mumbai, India
School of Psychology, Addis Ababa University, Addis Ababa, Ethiopia
School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
Research Group for Social Epidemiology, Lund University, Lund, Sweden
Afro-Asian Institute, Lahore, Pakistan
Warwick Medical School, University of Warwick, Coventry, United Kingdom
Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, Chicago, IL, United States
Department of Epidemiology, Binzhou Medical University, Yantai City, China
Department of Preventive Cardiology, Eternal Heart Care Centre & Research Institute, Jaipur, India
Department of Medicine, Mahatma Gandhi University Medical Sciences, Jaipur, India
School of Medicine, Deakin University, Geelong, VIC, Australia
Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
School of Engineering, Macquarie University, Sydney, NSW, Australia
Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
Research Unit, University of Barcelona, Barcelona, Spain
Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain
Department of Zoology and Entomology, Al Azhar University, Cairo, Egypt
Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, Australia
ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Indooroopilly, QLD, Australia
Department of Public Health, Jigjiga University, Jigjiga, Ethiopia
Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
Santa Clara, CA, United States
Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
School of Business, London South Bank University, London, United Kingdom
Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
University College London, London, United Kingdom
Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam
Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
Burn Research Center, Shahid Motahari Hospital, Tehran, Iran
Department of Health Services Administration, China Medical University, Taichung, Taiwan
Department of Epidemiology and Health Statistics, Central South University, Changsha, China
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
Independent Consultant, Tabriz, Iran
Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC, Australia
Sydney Medical School, University of Sydney, Sydney, NSW, Australia
Save Sight Institute, University of Sydney, Sydney, NSW, Australia
Department of Clinical Pharmacy, MAHSA University, Bandar Saujana Putra, Malaysia
Public Health Department of Social Medicine, Osaka University, Suita, Japan
Graduate School of Medicine, Osaka University, Suita, Japan
Department of Health Management, University of Hail, Hail, Saudi Arabia
Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
Research and Development Center for Health Services, University of Tsukuba, Tsukuba, Japan
Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, United Kingdom
Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
Non-communicable Disease Department, National Health Mission, Lucknow, India
Department of Medicine, Mahavir Sikshan Sansthan, Kanpur, India
Institute of Advanced Manufacturing Technologies, Peter the Great St. Petersburg Polytechnic University, St. Petersburg, Russian Federation
Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
Centre of Studies and Research, Ministry of Health, Muscat, Oman
Department of Biochemistry, Government Medical College, Mysuru, India
Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, Delhi, India
Department of Community Medicine, Banaras Hindu University, Varanasi, India
Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
Department of Ophthalmology, Heidelberg University, Mannheim, Germany
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland
Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia
The Hansjörg Wyss Department of Plastic and Reconstructive Surgery, Naba Al-Hayat Foundation for Medical Sciences and Health Care, New York City, NY, United States
Cleft Lip and Palate Surgery, Global Smile Foundation, Norwood, MA, United States
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
Department of Surface Engineering, The John Paul II Catholic University of Lublin, Lublin, Poland
Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
Department of Mental Health, University of Tokyo, Tokyo, Japan
International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, Netherlands
Department of Healthcare Services Management, School of Health, Alborz University of Medical Sciences, Karaj, Iran
Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
Amity Institute of Forensic Sciences, Amity University, Noida, India
Department of Biophysics and Biochemistry, Baku State University, Baku, Azerbaijan
Russian Institute for Advanced Study, Moscow State Pedagogical University, Moscow, Russian Federation
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
Epidemiology Department, Jazan University, Jazan, Saudi Arabia
Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
Primary Care Department, NHS North West London, London, United Kingdom
Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
Department of Genomics and Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, South Korea
Public Health Center, Ministry of Health and Welfare, Wando, South Korea
School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
School of Health Sciences, Kristiania University College, Oslo, Norway
Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, United States
Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
Community-based Services Development, Mental Health for Ukraine Project, Lviv, Ukraine
Laboratory of Social Psychology, Institute of Social and Political Psychology, Kyiv, Ukraine
Department of General Practice - Family Medicine, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
Jakarta, Indonesia
Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
Department of Demography, University of Montreal, Montreal, QC, Canada
Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada
Faculty of Public Health, University of Indonesia, Depok, Indonesia
Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Department of Clinical Chemistry and Pharmacology, Uppsala University Hospital, Uppsala, Sweden
Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
Department of Preventive Medicine, Korea University, Seoul, South Korea
School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal, India
Mass Communication Department, University of Sharjah, Sharjah, United Arab Emirates
Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
Department of Clinical Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
School of Medicine and Surgery, University of Milan Bicocca, Monza, Italy
Laboratory of Public Health, IRCCS Auxologico, Milan, Italy
Joint Learning Network for Universal Coverage, Arlington, VA, United States
Federal Institute of Education, Science and Technology of Ceará, Campus Caucaia, Caucaia, Brazil
Department of Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
Epidemiology Department, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
Research Division, The George Institute for Global Health, New Delhi, India
Research and Development Division, The George Institute for Global Health, New Delhi, India
Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
Center for Translation Research and Implementation Science, National Institutes of Health, Bethesda, MD, United States
Department of Medicine, University of Cape Town, Cape Town, South Africa
Neurology Unit, Helsinki University Hospital, Helsinki, Finland
Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia
Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
University of Helsinki, Helsinki, Finland
University Centre Varazdin, University North, Varazdin, Croatia
Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
Internal Medicine Programme, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
Department of Atherosclerosis and Coronary Heart Disease, National Center of Cardiology a

Institute for Health Metrics and Evaluation
Department of Health Metrics Sciences
Division of Allergy and Infectious Diseases
Department of Anesthesiology & Pain Medicine
Department of Global Health and Population
Brigham and Womens Hospital
T.H. Chan School of Public Health
Center for Primary Care
Department of Global Health and Social Medicine
Division of Cardiology
Division of General Internal Medicine
Department of Nutrition
Department of Juridical and Economic Studies
Noncommunicable Diseases Research Center
National Institute for Health Research
Multiple Sclerosis Research Center
Students Scientific Research Center (SSRC)
Digestive Diseases Research Institute
Department of Epidemiology and Biostatistics
Sina Trauma and Surgery Research Center
Zoonoses Research Center
Postgraduate Department
National Research Council of Mexico
Department of Sociology
Department of Obstetrics & Gynecology
The Office of Health Policy & Legislative Affairs
DSI-NRF Centre of Excellence for Epidemiological Modelling and Analysis (SACEMA)
Division of Epidemiology & Biostatistics
Department of Life Sciences
Department of Community Medicine
Department of Public Health
Center for Policy
Health Policy and Population Research Center (CIPPS)
The Australian Centre for Public and Population Health Research (ACPPHR)
School of Computing Sciences
Department of Health and Biological Sciences
Department of Epidemiology and Biostatistics
Community-Oriented Nursing Midwifery Research Center
Department of Epidemiology
School of Advanced Technologies in Medicine
Virtual School of Medical Education & Management
Prevention of Cardiovascular Disease Research Center
School of Pharmacy
Department of Pharmacy
Department of Computer Science and Engineering
Faculty of Medicine and Public Health
Department of Clinical Pharmacy and Pharmacy Administration
Department of Community Medicine
Department of Obstetrics and Gynecology
Geriatric and Long Term Care Department
Rumailah Hospital
Murdoch Business School
Institute of Health Research
Department of Population and Behavioural Sciences
Department of Health Policy Planning and Management
Department of Biological Sciences
Multidisciplinary Department
Health Management and Economics Research Center
Department of Health Economics
Hospital Management Research Center
Preventive Medicine and Public Health Research Center
Minimally Invasive Surgery Research Center
Department of Health Policy and Management
International Centre for Casemix and Clinical Coding
School of Graduate Studies
Public Heath Department
Maternal and Child Wellbeing
Department of Pharmacy
Department of Legal Medicine and Bioethics
Department of General Surgery
Universal Health Coverage Health System Strengthening Cluster
Erasmus School of Health Policy and Management
Department of Public Health and Informatics
Social Determinants of Health Research Center
Cardiovascular Diseases Research Center
Department of Paediatrics
University of Malaya Medical Centre
Department of Maternal and Child Health
University Institute of Radiological Sciences and Medical Imaging Technology
Faculty of Allied Health Sciences
University Institute of Public Health
Department of Health System and Health Economics
Department of Forensic Medicine
School of Business
Department of Statistics and Econometrics
Center for Health Systems Research
School of Indigenous Studies
School of Public Health
Department of Health Economics
Department of Forensic Science
Unit of Biochemistry
Centre for Community Medicine
Department of Forensic Medicine and Toxicology
Manipal College of Pharmaceutical Sciences
Manipal College of Dental Sciences
Department of Community Medicine
Department of Health Information Management
Department of Microbiology
Kasturba Medical College
Department of Community Medicine
Department of Obstetrics and Gynaecology
Department of Non-communicable Diseases
Heidelberg Institute of Global Health (HIGH)
Academic Unit of Obstetrics and Gynecology
Department of Neurosciences
University Eye Clinic
Department of Public & Environmental Health
Epidemiology and Disease Control Unit
School of Public Health
Imperial College Business School
Department of Primary Care and Public Health
WHO Collaborating Centre for Public Health Education and Training
The George Institute for Global Health
Health Human Resources Research Center
Non-communicable Disease Research Center
Department of Medical Laboratory Sciences
Department of Social Services
Department of Forensic Chemistry
Department of Health
Department of Anatomy
Department of Community Medicine and Family Medicine
School of Public Health
Department of Pharmacology
Department of Surgical Oncology
Neurovascular Imaging Laboratory
Department of Neurology and Neurophysiology
Department of Statistical and Computational Genomics
Department of Statistics
Centre for Global Child Health
Centre of Excellence in Women & Child Health
Institute of Soil and Environmental Sciences
Social Determinants of Health Research Center
Mario Negri Institute for Pharmacological Research
Department of General Surgery and Medical- Surgical Specialties
Department of Medical and Surgical Sciences and Advanced Technologies
Discipline of Public Health Medicine
Faculty of Medicine and Pharmaceutical Sciences
Department of Cardiology
Division of Clinical Epidemiology and Aging Research
Department of Woman and Child Health and Public Health
Global Health Research Institute
Department of Health Care Management
Department of Family and Community Medicine
Rabigh Faculty of Medicine
School of Public Health and Health Systems
Al Shifa School of Public Health
Institute of Microengineering
School of Public Health and Administration
Internal Medicine Department
Board of Directors
Argentine Society of Medicine
Department of Health Care
School of Sciences
Directive Board
Association of Licensed Optometry Professionals
National School of Public Health
Clinical Epidemiology Program
Institute of Applied Health Research
Department of Epidemiology and Environmental Health
Center of Excellence for Population Ageing Research (CEPAR)
School of Medicine
School of Optometry and Vision Science
Department of Community Medicine
Department of Epidemiology and Preventative Medicine
Department of Epidemiology and Preventive Medicine
Department of Human Centred Computing
School of Public Health and Preventive Medicine
The School of Clinical Sciences at Monash Health
James P Grant School of Public Health
Centre for Noncommunicable Diseases and Nutrition
Department of Epidemiology and Biostatistics
Department of Clinical Pharmacy and Outcomes Sciences
Department of Public Health
Institute of Neuroscience
Section Global Health and Rehabilitation
Department of Global Public Health and Primary Care
Environmental Health Department
Forensic Medicine Division
Health Policy Research
Public Health Foundation of India
Indian Council of Medical Research
Department of Population and Development
Health Research Institute
National Centre for AIDS and STD Control
Department of Global Public Health
Research Department
Policy Research Institute
Global Institute for Interdisciplinary Studies
Health Research Section
Development of Research and Technology Center
Center of Excellence in Behavioral Medicine
Department of Health Policy and Management
Department of Medical Surgical Nursing
School of Management and Medical Informatics
Postgraduate Program in Epidemiology
Centre Clinical Epidemiology and Biostatistics
Biomedical Informatics and Medical Statistics Department
Pediatric Dentistry and Dental Public Health Department
Division of Cardiology
Faculty of Medicine
Centre for Applied Health Economics
School of Medicine
Department of Neurological Surgery
Institute of Public Health
Institute of Gerontology
Department of Medical Parasitology
Faculty of Medicine
Department of Dermatology
Health Services Management Training Centre
Faculty of Health and Public Administration
Department of Applied Social Sciences
Institute of Applied Health Sciences (IAHS)
Department of Radiology
School of Psychology
School of Public Health
Institute for Prevention of Non-communicable Diseases
Health Services Management Department
Research Group for Social Epidemiology
Afro-Asian Institute
Warwick Medical School
Health Systems and Policy Research
Department of Pharmacy Systems
Department of Epidemiology
Department of Preventive Cardiology
Department of Medicine
School of Medicine
Department of Clinical Medicine
School of Engineering
Faculty of Health
Research Unit
Biomedical Research Networking Center for Mental Health Network (CiberSAM)
Department of Zoology and Entomology
Institute for Social Science Research
ARC Centre of Excellence for Children and Families over the Life Course
Department of Public Health
Institute of Pharmaceutical Sciences
Department of Pharmacy Administration and Clinical Pharmacy
Santa Clara
Nuffield Department of Clinical Medicine
Nuffield Department of Medicine
School of Business
Department of Population Sciences
University College London
Maternal and Child Health Division
Health System and Population Studies Divisions
Institute of Research and Development
Department of Computer Science
Diplomacy and Public Relations Department
Clinical Legal Medicine Department
Burn Research Center
Department of Health Services Administration
Department of Epidemiology and Health Statistics
Jockey Club School of Public Health and Primary Care
Institute for Social Science Research
Faculty of Health and Behavioural Sciences
Department of Public Health and Primary Care
Department of Community Medicine
Independent Consultant
Institute for Physical Activity and Nutrition
Sydney Medical School
Save Sight Institute
Department of Clinical Pharmacy
Public Health Department of Social Medicine
Graduate School of Medicine
Department of Health Management
Department of Health Services Research
Research and Development Center for Health Services
Department of Non-communicable Disease Epidemiology
European Observatory on Health Systems and Policies
Department of Health Services Research and Policy
Center for Global Mental Health
Non-communicable Disease Department
Department of Medicine
Institute of Advanced Manufacturing Technologies
Institute of Comparative Economic Studies
Centre of Studies and Research
Department of Biochemistry
Department of Community Medicine
Department of Community Medicine
Institute of Molecular and Clinical Ophthalmology Basel
Department of Ophthalmology
Institute of Family Medicine and Public Health
Department of Noncommunicable Diseases
Sydney Eye Hospital
The Hansjörg Wyss Department of Plastic and Reconstructive Surgery
Cleft Lip and Palate Surgery
MRC/CSO Social and Public Health Sciences Unit
Department of Surface Engineering
Drohobych Ivan Franko State Pedagogical University
Department of Mental Health
International Research Center of Excellence
Julius Centre for Health Sciences and Primary Care
Department of Healthcare Services Management
Department of Public Health
Amity Institute of Forensic Sciences
Department of Biophysics and Biochemistry
Russian Institute for Advanced Study
Health Promotion Research Center
Epidemiology Department
Department of Population Science
Family Medicine Department
Primary Care Department
Social Development and Health Promotion Research Center
Department of Genomics and Digital Health
Public Health Center
School of Traditional Chinese Medicine
School of Health Sciences
Department of Global Community Health and Behavioral Sciences
Department of Nursing and Health Promotion
Community-based Services Development
Laboratory of Social Psychology
Department of General Practice - Family Medicine
Jakarta
Department of Internal and Pulmonary Medicine
Department of Demography
Department of Social and Preventive Medicine
Faculty of Public Health
Department of Medical Sciences
Department of Clinical Chemistry and Pharmacology
Department of Otorhinolaryngology
Department of Preventive Medicine
School of Medicine
Department of Community Medicine
Mass Communication Department
Department of Maternal and Child Nursing and Public Health
Department of Clinical Medicine
Clinical Hospital
School of Medicine and Surgery
Laboratory of Public Health
Joint Learning Network for Universal Coverage
Federal Institute of Education
Department of Midwifery
Institute of Population Health Sciences
Epidemiology Department
Research Division
Research and Development Division
Peru Country Office
Center for Translation Research and Implementation Science
Department of Medicine
Neurology Unit
Breast Surgery Unit
School of Health Sciences
Department of Pediatrics
University of Helsinki
University Centre Varazdin
Woman-Mother-Child Department
Internal Medicine Programme
Department of Atherosclerosis and Coronary Heart Disease

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