Disaggregating the Universal Coverage Cube: Putting Equity in the Picture.

Area of Science:

• Health Policy and Systems Research
• Global Health Equity
• Health Economics

Background:

• The World Health Organization's Cube Diagram is a standard tool for visualizing progress toward Universal Health Coverage.
• The Cube Diagram illustrates policy options based on services, population, and cost coverage.
• A limitation of the Cube Diagram is its reliance on national averages, masking significant coverage disparities within countries.

Purpose of the Study:

• To introduce a new visualization tool, the Step Pyramid diagram, to address the limitations of the Cube Diagram.
• To enable policymakers to visualize and address coverage gaps across different population groups.
• To emphasize equity concerns in the pursuit of Universal Health Coverage.

Main Methods:

• Conceptual development of the Step Pyramid diagram.
• Explanation of the construction methodology for the Step Pyramid.
• Application of the Step Pyramid using hypothetical data and real-world data from Mexico.

Main Results:

• The Step Pyramid diagram effectively disaggregates coverage data, highlighting disparities missed by the Cube Diagram.
• The visualization allows for a clearer understanding of specific policy choices for expanding coverage to diverse population segments.
• The Mexican case study demonstrates the practical utility of the Step Pyramid in identifying equity-focused policy priorities.

Conclusions:

• The Step Pyramid diagram offers a valuable complementary tool to the Cube Diagram for health policy analysis.
• This new visualization aids policymakers in focusing on equity and addressing disparities in Universal Health Coverage.
• Further exploration of the strengths, limitations, and implications of both diagrams is warranted for effective health system reform.