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Table 5 Benefits of combined approach for measuring equity in health outcomes and intervention exposure

From: Equity monitoring for social marketing: use of wealth quintiles and the concentration index for decision making in HIV prevention, family planning, and malaria programs

Equity Metric Disadvantage of Using Method Alone Benefit of Combined Method
Concentration Index Challenging to assess programmatic significance of a statistically significant concentration index Threshold still unknown, but more data provided to understand programmatic significance, so equity and progress towards program goals can be measured simultaneously
  Cannot detect non-linear outcomes Graphical analyses of quintiles show non-linear differences in outcomes
  Does not indicate which proportion of population outcome or if outcome is high or low Wealth quintile graphs show levels of outcome in population
  Does not indicate how the wealth distribution of the sample compares with the national population Use of standard asset list and DHS data as reference population shows wealth distribution relative to broader population
Proportion by Wealth Quintile Challenging to do longitudinal, multi-country, or multi-outcome comparisons Concentration index as a summary number enables statistical comparisons between multiple datasets
  Does not give a conclusive determination of equity Provides a numerical estimate of equity with statistical significance, with the stratification by wealth quintile providing a comprehensive and nuanced equity assessment of the outcome measure