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Table 1 Summary of features, proxies, and metrics to identify the worst-off

From: How can health systems research reach the worst-off? A conceptual exploration

Worst off in health Systematic disadvantage
National level features or proxies Possible metrics National level features or proxies Possible metrics
 Low health achievement Life expectancy, infant mortality rate, maternal mortality rate, other health indicators Poverty; Domination Gross domestic product data, Gross national product data, Multidimensional Poverty Index data
 Low health security Frequency of droughts, storms, flooding; Ranking on Fragile State Index
 Long duration Performance on health indicators for 5-10+ years
 High within-country health inequality Health and health system indicators—life expectancy, infant mortality rate, maternal mortality rate, access to particular health services—by gender, income, caste, education, geography, etc.
Sub-national level features or proxies Possible metrics Sub-national level features or proxies Possible metrics
 Individual or community characteristics associated with poor health and/or social arrangements that create or entrench poor health Substantial gap between health and health system indicators for sub-national population versus relevant comparator sub-national population shown by, for example, Lorenz curve, Concentration curve and index, and/or Slope and relative indices of inequality Poverty; Domination; Lack of community capability Below the poverty line data, Multidimensional Poverty Index data