Document Type : Original Article

Authors

• Efat Mohamadi ¹
• Zhila Najafpour ²
• Mohammad Mehdi Kiani ^{1, 3}
• Morteza Mohammadzadeh ⁴
• Amirhossein Takian ^{1, 3, 5}
• Alireza Olyaeemanesh ^{1, 6}

¹ Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran

² Department of Health Care Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

³ Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

⁴ Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

⁵ Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

⁶ National Institute of Health Research, TehranUniversity of Medical Sciences, Tehran, Iran

Abstract

Background: There are substantial differences in the health outcomes across countries. Then, assessment of the status of health indicators can give us a valuable information to adjust policies to improve the health status in the world. This paper examines differences and relationships of health status and contextual factors.
Methods: This is a multi-country cross-sectional study performed using secondary data of different sources in 2019. We identified indicators that revealed the relationships of health status and health coverage and also contextual factors by expert panel which consist of two categories of indicators: (1) producing health indicators as dependent variables (Life expectancy, Healthy life expectancy, Maternal mortality ratio, Under-five mortality rate and Universal Health Coverage (UHC) service coverage indicator); (2) contextual indicators as independent variables (Current Health Expenditure, Skilled health professionals density, Population density and Government Type). Also, countries were categorized based on the income level and six regions of World Health Organization (WHO). We used SPSS 20 software for a descriptive analysis and R 2018 software for statistical analysis and also drawing of scatter charts.
Results: Results showed a considerable gap between the average of life expectancy (84.2 vs. 53 years) and healthy life expectancy rate (72-63.3 years). This disparity was observed in the Maternal mortality and Under-5 mortality rate (from 882 to 3 per 100000 live births), (5 is 2.1 and the highest is 127.3). Although there was a marginal correlation between population density indicator and life expectancy, healthy life expectancy, and under-5 mortality rate indicators (±0.2), there was no correlation between population density and maternal mortality rate with UHC (P>0.05).
Conclusion: There is a considerable difference between countries in producing health indicators based on contextual indicators; a comprehensive health system approach that can result in improvement in the health outcome.

Highlights

Keywords

• Produce health
• Sustainable development goals (SDGs)
• Health
• Policy
• Contextual factors