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Effective coverage practice in Ethiopia
Seblewengel Lemma1,2, Anene Tesfa Berhanu3,4, Ashenif Tadele3
1Department of Disease Control, London School of Hygiene and Tropical Medicine, London, England, UK s.abreham@ucl.ac.uk.
BMJ Global Health
|February 25, 2026
Summary
Effective coverage measurement, using antenatal care in Ethiopia, faces challenges in data sources, cascade steps, and methods. Increased transparency and a reporting checklist are needed for better health system decision-making.
Area of Science:
- Health Services Research
- Public Health
- Health Systems Analysis
Background:
- Effective coverage measurement is crucial for assessing health system performance and identifying gaps in care delivery.
- A cascade approach, integrating demand- and supply-side data, helps pinpoint areas for improvement to maximize health service benefits.
Purpose of the Study:
- To analyze challenges in calculating effective coverage in Ethiopia, using antenatal care as a case study.
- To propose solutions for enhancing the usability of effective coverage measures for health system decision-making.
Main Methods:
- Analysis of effective coverage calculation methods for antenatal care in Ethiopia.
- Identification of key challenges through a technical working group with expertise in effective coverage analysis.
Main Results:
- Four primary challenges were identified: data source characteristics, the number of cascade steps, data elements within steps, and composite indicator generation methods.
- Discrepancies in these factors were found to impact the utility of effective coverage measures for informed decision-making.
Conclusions:
- Greater transparency in reporting effective coverage measures is urgently required.
- A standardized reporting checklist was proposed and discussed as a potential solution to improve data usability and comparability.
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