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J Clin Epidemiol. 2008 Feb;61(2):142-50. doi: 10.1016/j.jclinepi.2007.05.001. Epub 2007 Sep 24.

A new Inequity-in-Health Index based on Millennium Development Goals: methodology and validation.

Author information

  • 1School of Medicine, National University of Colombia, Bogotá, Colombia. jheslavas@unal.edu.co

Abstract

OBJECTIVES:

Developing a new Inequity-in-Health Index (IHI) assuming inequity as "inequality of health outcomes," based on Millennium Development Goals (MDG).

STUDY DESIGN AND SETTING:

Ecological study. Countries from around the world were included from United Nations, the World Bank, and a nonprofit organization's databases. The reliability and validity of this bidimensional IHI was tested. Main factor analysis (promax rotation) and main component analysis were used.

RESULTS:

Six variables were used for constructing the IHI was constructed with six variables: underweight children, child mortality, death from malaria in children aged 0-4, death from malaria at all ages, births attended by skilled health personnel, and immunization against measles. The IHI had high internal consistency (Cronbach's alpha=0.8504), was reliable (Spearman>0.9, P=0.0000), and had 0.3033pi around the world (range: 0pi-0.5984pi). IHI had high correlation with the human development and poverty indexes, health gap indicator, life expectancy at birth, probability of dying before 40 years of age, and Gini coefficients (Spearman>0.7, P=0.0000). IHI discriminated countries by income, region, indebtedness, and corruption level (Kruskal Wallis, P<0.01). IHI had sensitivity to change (P=0.0000).

CONCLUSION:

IHI is a bidimensional, valid and reliable index to monitor MDG. A new reliable methodology for developing bidimensional indicators is shown, which could be used for constructing other ones with their corresponding scores and graphs.

PMID:
18177787
[PubMed - indexed for MEDLINE]
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