Preprint Article | https://doi.org/10.12688/verixiv.2006.1
Date of Publication | September 2025
Abstract
Composite indices provide an opportunity to measure the reach of multisector strategies as countries progress towards Sustainable Development Goals (SDGs) and the achievement of nutrition, health, and other sectoral targets. This scoping review aimed to identify composite coverage indices that capture nutrition and health interventions coverage or status, summarize their estimation methodologies and validation approaches, and evaluate their strengths and weaknesses. We searched five databases for articles published between 1980 and 18 May 2024 in English. We included studies of any design that described, utilized, or developed a composite measurement of health or nutrition intervention coverage or status. One reviewer screened the titles and abstracts and full text using Covidence and abstracted data from each article using Microsoft Excel. We retrieved and screened a total of 7,120 records of which 119 articles were included. We identified a total of 54 unique indices (25 universal healthcare coverage; 13 reproductive, maternal, newborn, child health (RMNCH) coverage; 10 nutritional status, food security, or nutrition intervention coverage; and 6 health service coverage measures). We identified three major formula construction methodologies: normative (n=33), statistical (n=12), and participatory (n=10). Together, the indices employed 6 different aggregation methods: weighted linear mean (n=23), geometric mean (n=11), linear mean (n=9), weighted geometric mean (n=4), random-effects meta-analysis (n=5), and summation (n=2). More than one third of the indices identified have not been validated in the literature (n=20). Our review identified a significant gap in composite nutrition intervention coverage index availability, methodological frameworks for index design, and index validation. There is a need for additional resources for guiding policy and program actors to develop validated, fit to purpose composite nutrition specific and sensitive coverage indices. We propose that a framework be developed for stakeholders to guide composite index construction for multisectoral nutrition intervention coverage measurement.
