1. Repositório Institucional da UFMG
  2. Publicações Científicas e Culturais
  3. Artigo de Periódico
Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/52188
Full metadata record
DC FieldValueLanguage
dc.creatorNancyfullmanpt_BR
dc.creatorVictor Aboyanspt_BR
dc.creatorEttore Beghipt_BR
dc.creatorMasoud Behzadifarpt_BR
dc.creatorMeysam Behzadifarpt_BR
dc.creatorBayu Begashaw Bekelept_BR
dc.creatorAbate Bekele Belachewpt_BR
dc.creatorSaba Abraham Belaypt_BR
dc.creatorYihalem Abebe Belaypt_BR
dc.creatorMichelle l Bellpt_BR
dc.creatorAminu k Bellopt_BR
dc.creatorGiorgia Giussanipt_BR
dc.creatorWilliam w Godwinpt_BR
dc.creatorSrinivas Golipt_BR
dc.creatorHector Gomez-dantespt_BR
dc.creatorPhilimon n Gonapt_BR
dc.creatorAmador Goodridgept_BR
dc.creatorSameer Vali Gopalanipt_BR
dc.creatorYevgeniy Goryakinpt_BR
dc.creatorRufus Olusola Akinyemipt_BR
dc.creatorAshish Bhallapt_BR
dc.creatorAshkan Afshinpt_BR
dc.creatorAlessandra Carvalho Goulartpt_BR
dc.creatorAyman Gradapt_BR
dc.creatorMax Griswoldpt_BR
dc.creatorGiuseppe Grossopt_BR
dc.creatorHarish Chander Gugnanipt_BR
dc.creatorYuming Guopt_BR
dc.creatorRahul Guptapt_BR
dc.creatorRajeev Guptapt_BR
dc.creatorTanush Guptapt_BR
dc.creatorTarun Guptapt_BR
dc.creatorRobert p Dellavallept_BR
dc.creatorPaurvi Bhattpt_BR
dc.creatorTomi f Akinyemijupt_BR
dc.creatorVipin Guptapt_BR
dc.creatorJuanita a Haagsmapt_BR
dc.creatorVladimir Hachinskipt_BR
dc.creatorNima Hafezi-nejadpt_BR
dc.creatorGessessew Bugssa Hailupt_BR
dc.creatorRandah Ribhi Hamadehpt_BR
dc.creatorSamer Hamidipt_BR
dc.creatorGraeme j Hankeypt_BR
dc.creatorGebre Demozpt_BR
dc.creatorHilda l Harbpt_BR
dc.creatorSoumyadeep Bhaumikpt_BR
dc.creatorHeather c Harewoodpt_BR
dc.creatorNadia Akseerpt_BR
dc.creatorSivadasanpillai Harikrishnanpt_BR
dc.creatorJosep Maria Haropt_BR
dc.creatorHamid Yimam Hassenpt_BR
dc.creatorRasmus Havmoellerpt_BR
dc.creatorCaitlin Hawleypt_BR
dc.creatorSimon i Haypt_BR
dc.creatorKebede Deribept_BR
dc.creatorJiawei hept_BR
dc.creatorStephen j c Hearpspt_BR
dc.creatorZulfiqar a Bhuttapt_BR
dc.creatorMohamed i Hegazypt_BR
dc.creatorBehzad Heibatipt_BR
dc.creatorSolomon m Abaypt_BR
dc.creatorFaris Hasan al Lamipt_BR
dc.creatorMohsen Heidaript_BR
dc.creatorDelia Hendriept_BR
dc.creatorNathaniel j Henrypt_BR
dc.creatorDon c Des Jarlaispt_BR
dc.creatorVictor Hugo Herrera Ballesterospt_BR
dc.creatorClaudiu Herteliupt_BR
dc.creatorDesalegn Tsegaw Hibstupt_BR
dc.creatorDaisy Maria Xavier de Abreupt_BR
dc.creatorMolla Kahssay Hilufpt_BR
dc.creatorHans w Hoekpt_BR
dc.creatorEnayatollah Homaie Radpt_BR
dc.creatorNobuyuki Horitapt_BR
dc.creatorFares Alahdabpt_BR
dc.creatorh Dean Hosgoodpt_BR
dc.creatorSubhojit Deypt_BR
dc.creatorMostafa Hosseinipt_BR
dc.creatorSeyed Reza Hosseinipt_BR
dc.creatorMihaela Hostiucpt_BR
dc.creatorSorin Hostiucpt_BR
dc.creatorBelete Biadgopt_BR
dc.creatorDamian g Hoypt_BR
dc.creatorMohamed Hsaiript_BR
dc.creatorAung Soe Htetpt_BR
dc.creatorGuoqing hupt_BR
dc.creatorJohn j Huangpt_BR
dc.creatorSamath d Dharmaratnept_BR
dc.creatorZiyad Al-alypt_BR
dc.creatorKim Moesgaard Iburgpt_BR
dc.creatorFachmi Idrispt_BR
dc.creatorEhimario Uche Igumborpt_BR
dc.creatorChad Ikedapt_BR
dc.creatorAli Bijanipt_BR
dc.creatorBogdan Vasile Ileanupt_BR
dc.creatorOlayinka s Ilesanmipt_BR
dc.creatorKaire Innospt_BR
dc.creatorSeyed Sina Naghibi Irvanipt_BR
dc.creatorMeghnath Dhimalpt_BR
dc.creatorCaleb m s Irvinept_BR
dc.creatorFarhad Islamipt_BR
dc.creatorKhurshid Alampt_BR
dc.creatorTroy a Jacobspt_BR
dc.creatorKathryn h Jacobsenpt_BR
dc.creatorNader Jahanmehrpt_BR
dc.creatorBoris Bikbovpt_BR
dc.creatorRajesh Jainpt_BR
dc.creatorSudhir Kumar Jainpt_BR
dc.creatorMihajlo b Jakovljevicpt_BR
dc.creatorShirin Djalaliniapt_BR
dc.creatorMoti Tolera Jalupt_BR
dc.creatorAmr a Jamalpt_BR
dc.creatorMehdi Javanbakhtpt_BR
dc.creatorAchala Upendra Jayatillekept_BR
dc.creatorTahiya Alampt_BR
dc.creatorPanniyammakal Jeemonpt_BR
dc.creatorRavi Prakash Jhapt_BR
dc.creatorCharles Birungipt_BR
dc.creatorVivekanand Jhapt_BR
dc.creatorJacek Jóúwiakpt_BR
dc.creatorDavid Teye Dokupt_BR
dc.creatorOommen Johnpt_BR
dc.creatorSarah Charlotte Johnsonpt_BR
dc.creatorJost b Jonaspt_BR
dc.creatorVasna Joshuapt_BR
dc.creatorMikk Jürissonpt_BR
dc.creatorZubair Kabirpt_BR
dc.creatorDeena Alasfoorpt_BR
dc.creatorRajendra Kadelpt_BR
dc.creatorStan Biryukovpt_BR
dc.creatorAmaha Kahsaypt_BR
dc.creatorDerrick a Bennettpt_BR
dc.creatorRizwan Kalanipt_BR
dc.creatorChittaranjan Karpt_BR
dc.creatorMarina Karanikolospt_BR
dc.creatorAndré Karchpt_BR
dc.creatorCorine Kakizi Karemapt_BR
dc.creatorSeyed m Karimipt_BR
dc.creatorAmir Kasaeianpt_BR
dc.creatorDessalegn Haile Kassapt_BR
dc.creatorMohammed i Albittarpt_BR
dc.creatorHailemichael Bizunehpt_BR
dc.creatorKate Dolanpt_BR
dc.creatorGetachew Mullu Kassapt_BR
dc.creatorTesfaye Dessale Kassapt_BR
dc.creatorNicholas j Kassebaumpt_BR
dc.creatorSrinivasa Vittal Katikireddipt_BR
dc.creatorAnil Kaulpt_BR
dc.creatorNorito Kawakamipt_BR
dc.creatorKonstantin Kazanjanpt_BR
dc.creatorSeifu Kebedept_BR
dc.creatorPeter Njenga Keiyoropt_BR
dc.creatorGrant Rodgers Kemppt_BR
dc.creatorJamal Yearwoodpt_BR
dc.creatorIan w Bolligerpt_BR
dc.creatorKefyalew Addis Alenept_BR
dc.creatorAndre Pascal Kengnept_BR
dc.creatorMaia Kereselidzept_BR
dc.creatorEzra Belay Ketemapt_BR
dc.creatorYousef Saleh Khaderpt_BR
dc.creatorMorteza Abdullatif Khafaiept_BR
dc.creatorAlireza Khajavipt_BR
dc.creatorIbrahim a Khalilpt_BR
dc.creatorEjaz Ahmad Khanpt_BR
dc.creatorGina Agarwalpt_BR
dc.creatorGulfaraz Khanpt_BR
dc.creatorKaylin Boltpt_BR
dc.creatormd Nuruzzaman Khanpt_BR
dc.creatorAyman Al-eyadhypt_BR
dc.creatorMuhammad Ali Khanpt_BR
dc.creatorMukti Nath Khanalpt_BR
dc.creatorYoung-ho Khangpt_BR
dc.creatorMona m Khaterpt_BR
dc.creatorAbdullah Tawfih Abdullah Khojapt_BR
dc.creatorArdeshir Khosravipt_BR
dc.creatore Ray Dorseypt_BR
dc.creatorJagdish Khubchandanipt_BR
dc.creatorGetiye Dejenu Kibretpt_BR
dc.creatorIbrahim r Bou-ormpt_BR
dc.creatorDaniel Ngari Kiirithiopt_BR
dc.creatorDaniel Kimpt_BR
dc.creatorSyed Danish Alipt_BR
dc.creatorYun Jin Kimpt_BR
dc.creatorRuth w Kimokotipt_BR
dc.creatorYohannes Kinfupt_BR
dc.creatorSanjay Kinrapt_BR
dc.creatorKadine Priscila Bender Dos Santospt_BR
dc.creatorAdnan Kisapt_BR
dc.creatorNiranjan Kissoonpt_BR
dc.creatorSonali Kochharpt_BR
dc.creatorKayvan Bozorgmehrpt_BR
dc.creatorYoshihiro Kokubopt_BR
dc.creatorJacek a Kopecpt_BR
dc.creatorSoewarta Kosenpt_BR
dc.creatorCristiana Abbafatipt_BR
dc.creatorMehran Alijanzadehpt_BR
dc.creatorParvaiz a Koulpt_BR
dc.creatorKerrie e Doylept_BR
dc.creatorai Koyanagipt_BR
dc.creatorMichael Kravchenkopt_BR
dc.creatorKewal Krishanpt_BR
dc.creatorKristopher j Krohnpt_BR
dc.creatorLaith j Abu-raddadpt_BR
dc.creatorBarthelemy Kuate Defopt_BR
dc.creatorg Anil Kumarpt_BR
dc.creatorPushpendra Kumarpt_BR
dc.creatorMichael Kutzpt_BR
dc.creatorIgor Kuzinpt_BR
dc.creatorTim r Driscollpt_BR
dc.creatorSyed m Aljunidpt_BR
dc.creatorHmwe h Kyupt_BR
dc.creatorDeepesh Pravinkumar Ladpt_BR
dc.creatorAlessandra Lafranconipt_BR
dc.creatorDharmesh Kumar Lalpt_BR
dc.creatorOliver Jerome Bradypt_BR
dc.creatorRatilal Lalloopt_BR
dc.creatorHilton Lampt_BR
dc.creatorQing Lanpt_BR
dc.creatorJustin j Langpt_BR
dc.creatorManisha Dubeypt_BR
dc.creatorVan c Lansinghpt_BR
dc.creatorSonia Lanskypt_BR
dc.creatorAla'a Alkerwipt_BR
dc.creatorAnders Larssonpt_BR
dc.creatorArman Latifipt_BR
dc.creatorJeffrey Victor Lazaruspt_BR
dc.creatorAlexandra Brazinovapt_BR
dc.creatorJanet l Leasherpt_BR
dc.creatorPaul h Leept_BR
dc.creatorYirga Legessept_BR
dc.creatorEleonora Dubljaninpt_BR
dc.creatorJames Leighpt_BR
dc.creatorCheru Tesema Leshargiept_BR
dc.creatorSamson Letapt_BR
dc.creatorJanni Leungpt_BR
dc.creatorFrançois Allapt_BR
dc.creatorRicky Leungpt_BR
dc.creatorMiriam Levipt_BR
dc.creatorNicholas j k Breitbordept_BR
dc.creatorYongmei lipt_BR
dc.creatorJuan Liangpt_BR
dc.creatorBruce Bartholow Duncanpt_BR
dc.creatorMisgan Legesse Libenpt_BR
dc.creatorLee-ling Limpt_BR
dc.creatorStephen s Limpt_BR
dc.creatorMargaret Lindpt_BR
dc.creatorShai Linnpt_BR
dc.creatorStefan Listlpt_BR
dc.creatorPeter Allebeckpt_BR
dc.creatorPatrick Liupt_BR
dc.creatorHermann Brennerpt_BR
dc.creatorShiwei Liupt_BR
dc.creatorHaftom Niguse Abrahapt_BR
dc.creatorRakesh Lodhapt_BR
dc.creatorAlan d Lopezpt_BR
dc.creatorScott a Lorchpt_BR
dc.creatorStefan Lorkowskipt_BR
dc.creatorPaulo a Lotufopt_BR
dc.creatorTimothy c d Lucaspt_BR
dc.creatorRaimundas Luneviciuspt_BR
dc.creatorGrégoire Lurtonpt_BR
dc.creatorChristine Allenpt_BR
dc.creatorGabrielle Brittonpt_BR
dc.creatorMichelle Echkopt_BR
dc.creatorRonan a Lyonspt_BR
dc.creatorFadi Maaloufpt_BR
dc.creatorErlyn Rachelle King Macarayanpt_BR
dc.creatorMark t Mackaypt_BR
dc.creatorEmilie r Maddisonpt_BR
dc.creatorFabiana Madottopt_BR
dc.creatorHassan Magdy Abd el Razekpt_BR
dc.creatorMohammed Magdy Abd el Razekpt_BR
dc.creatorMarek Majdanpt_BR
dc.creatorReza Majdzadehpt_BR
dc.creatorDumessa Edessapt_BR
dc.creatorTraolach s Brughapt_BR
dc.creatorMahmoud a Alomaript_BR
dc.creatorAzeem Majeedpt_BR
dc.creatorReza Malekzadehpt_BR
dc.creatorRajesh Malhotrapt_BR
dc.creatorDeborah Carvalho Maltapt_BR
dc.creatorAbdullah a Mamunpt_BR
dc.creatorTrey Manhertzpt_BR
dc.creatorHelena Manguerrapt_BR
dc.creatorMohammad Ali Mansourniapt_BR
dc.creatorDavid Edvardssonpt_BR
dc.creatorLorenzo g Mantovanipt_BR
dc.creatorZahid a Buttpt_BR
dc.creatorTsegahun Manyazewalpt_BR
dc.creatorRajaa Al-raddadipt_BR
dc.creatorChabila c Mapomapt_BR
dc.creatorChristopher Margonopt_BR
dc.creatorJose Martinez-ragapt_BR
dc.creatorSheila Cristina Ouriques Martinspt_BR
dc.creatorFrancisco Rogerlândio Martins-melopt_BR
dc.creatorIra Martopullopt_BR
dc.creatorDominic Agiuspt_BR
dc.creatorWinfried Märzpt_BR
dc.creatorBenjamin Ballard Massenburgpt_BR
dc.creatorLucero Cahuana-hurtadopt_BR
dc.creatorManu Raj Mathurpt_BR
dc.creatorPallab k Maulikpt_BR
dc.creatorUbai Alsharifpt_BR
dc.creatorMohsen Mazidipt_BR
dc.creatorColm Mcalindenpt_BR
dc.creatorJohn j Mcgrathpt_BR
dc.creatorMartin Mckeept_BR
dc.creatorJoshua r Ehrlichpt_BR
dc.creatorSuresh Mehatapt_BR
dc.creatorRavi Mehrotrapt_BR
dc.creatorKala m Mehtapt_BR
dc.creatorIsmael Ricardo Campos-nonatopt_BR
dc.creatorVarshil Mehtapt_BR
dc.creatorToni Meierpt_BR
dc.creatorFabiola Mejia-rodriguezpt_BR
dc.creatorKhalid a Altirkawipt_BR
dc.creatorKidanu Gebremariam Melespt_BR
dc.creatorMulugeta Melkupt_BR
dc.creatorErika Eldrenkamppt_BR
dc.creatorPeter Memiahpt_BR
dc.creatorZiad a Memishpt_BR
dc.creatorWalter Mendozapt_BR
dc.creatorDegu Abate Mengistept_BR
dc.creatorJulio Cesar Campuzanopt_BR
dc.creatorDesalegn Tadese Mengistupt_BR
dc.creatorBereket Gebremichael Menotapt_BR
dc.creatorGeorge a Mensahpt_BR
dc.creatorAtte Meretojapt_BR
dc.creatorFoad Abd-allahpt_BR
dc.creatorZiad Ziad El-khatibpt_BR
dc.creatorNelson Alvis-guzmanpt_BR
dc.creatorTuomo j Meretojapt_BR
dc.creatorHaftay Berhane Mezgebept_BR
dc.creatorTomasz Miazgowskipt_BR
dc.creatorRenata Michapt_BR
dc.creatorAkilew Awoke Adanept_BR
dc.creatorRobert Milampt_BR
dc.creatorAnoushka Millearpt_BR
dc.creatorTed r Millerpt_BR
dc.creatorgk Minipt_BR
dc.creatorMatthias Endrespt_BR
dc.creatorShawn Minnigpt_BR
dc.creatorAndreea Miricapt_BR
dc.creatorAzmeraw t Amarept_BR
dc.creatorErkin m Mirrakhimovpt_BR
dc.creatorAwoke Misganawpt_BR
dc.creatorPhilip b Mitchellpt_BR
dc.creatorJosip Carpt_BR
dc.creatorFitsum Weldegebreal Mlashupt_BR
dc.creatorBabak Moazenpt_BR
dc.creatorKarzan Abdulmuhsin Mohammadpt_BR
dc.creatorAman Yesuf Endriespt_BR
dc.creatorRoghayeh Mohammadibakhshpt_BR
dc.creatorEbrahim Mohammedpt_BR
dc.creatorMohammed a Mohammedpt_BR
dc.creatorShafiu Mohammedpt_BR
dc.creatorKebede Amenupt_BR
dc.creatorAli h Mokdadpt_BR
dc.creatorGlen Liddell Molapt_BR
dc.creatorMate Carpt_BR
dc.creatorMariam Molokhiapt_BR
dc.creatorFatemeh Momenihapt_BR
dc.creatorBabak Eshratipt_BR
dc.creatorLorenzo Monastapt_BR
dc.creatorJulio Cesar Montañez Hernandezpt_BR
dc.creatorMahmood Moosazadehpt_BR
dc.creatorMaziar Moradi-lakehpt_BR
dc.creatorPaula Moragapt_BR
dc.creatorLidia Morawskapt_BR
dc.creatorWalid Ammarpt_BR
dc.creatorIlais Moreno Velasquezpt_BR
dc.creatorRosario Cárdenaspt_BR
dc.creatorRintaro Moript_BR
dc.creatorJames r Bennettpt_BR
dc.creatorShane d Morrisonpt_BR
dc.creatorMark Mosespt_BR
dc.creatorSeyyed Meysam Mousavipt_BR
dc.creatorUlrich o Muellerpt_BR
dc.creatorManoj Murhekarpt_BR
dc.creatorGudlavalleti Venkata Satyanarayana Murthypt_BR
dc.creatorSrinivas Murthypt_BR
dc.creatorJonah Musapt_BR
dc.creatorYaw Ampem Amoakopt_BR
dc.creatorJuan Jesus Carreropt_BR
dc.creatorSharareh Eskandariehpt_BR
dc.creatorKamarul Imran Musapt_BR
dc.creatorGhulam Mustafapt_BR
dc.creatorSaravanan Muthupandianpt_BR
dc.creatorChie Nagatapt_BR
dc.creatorGabriele Nagelpt_BR
dc.creatorMohsen Naghavipt_BR
dc.creatorAliya Naheedpt_BR
dc.creatorGurudatta a Naikpt_BR
dc.creatorNitish Naikpt_BR
dc.creatorFarid Najafipt_BR
dc.creatorAlireza Esteghamatipt_BR
dc.creatorFelix Carvalhopt_BR
dc.creatorNahla Anberpt_BR
dc.creatorLuigi Naldipt_BR
dc.creatorVinay Nangiapt_BR
dc.creatorJobert Richie Njingang Nansseupt_BR
dc.creatorkm Venkat Narayanpt_BR
dc.creatorBruno Ramos Nascimentopt_BR
dc.creatorIonut Negoipt_BR
dc.creatorRuxandra Irina Negoipt_BR
dc.creatorCharles r Newtonpt_BR
dc.creatorMahdi Fakharpt_BR
dc.creatorJosephine Wanjiku Ngunjiript_BR
dc.creatorCarlos a Castañeda-orjuelapt_BR
dc.creatorGrant Nguyenpt_BR
dc.creatorCatalina Liliana Andreipt_BR
dc.creatorLong Nguyenpt_BR
dc.creatorTrang Huyen Nguyenpt_BR
dc.creatorEmma Nicholspt_BR
dc.creatorDina Nur Anggraini Ningrumpt_BR
dc.creatorEllen Noltept_BR
dc.creatorVuong Minh Nongpt_BR
dc.creatorTamer Faragpt_BR
dc.creatorOle f Norheimpt_BR
dc.creatorbo Norrvingpt_BR
dc.creatorJacqueline Castillo Rivaspt_BR
dc.creatorJean Jacques n Noubiappt_BR
dc.creatorAlypio Nyandwipt_BR
dc.creatorSofia Androudipt_BR
dc.creatorCarla Makhlouf Obermeyerpt_BR
dc.creatorRichard Ofori-asensopt_BR
dc.creatorFelix Akpojene Ogbopt_BR
dc.creatorIn-hwan ohpt_BR
dc.creatorAnurag Agrawalpt_BR
dc.creatorOlanrewaju Oladimejipt_BR
dc.creatorAndrew Toyin Olagunjupt_BR
dc.creatorTinuke Oluwasefunmi Olagunjupt_BR
dc.creatorFerrán Catalá-lópezpt_BR
dc.creatorPedro r Olivarespt_BR
dc.creatorPatricia Pereira Vasconcelos de Oliveirapt_BR
dc.creatorHelen e Olsenpt_BR
dc.creatorCarl Abelardo t Antoniopt_BR
dc.creatorBolajoko Olubukunola Olusanyapt_BR
dc.creatorJacob Olusegun Olusanyapt_BR
dc.creatorMahbobeh Faramarzipt_BR
dc.creatorKanyin Ongpt_BR
dc.creatorJohn Nelson Opiopt_BR
dc.creatorEyal Orenpt_BR
dc.creatorDoris v Ortega-altamiranopt_BR
dc.creatorKelly Cercypt_BR
dc.creatorAlberto Ortizpt_BR
dc.creatorRaziye Ozdemirpt_BR
dc.creatorMahesh papt_BR
dc.creatorAmanda w Painpt_BR
dc.creatorValdelaine e m Araújopt_BR
dc.creatorEmerito Jose Aquino Faraonpt_BR
dc.creatorMarcos Roberto Tovani Palonept_BR
dc.creatorAdrian Panapt_BR
dc.creatorSonghomitra Panda-jonaspt_BR
dc.creatorJeyaraj d Pandianpt_BR
dc.creatorEun-kee Parkpt_BR
dc.creatorJulian Chalekpt_BR
dc.creatorHadi Parsianpt_BR
dc.creatorTejas Patelpt_BR
dc.creatorSanghamitra Patipt_BR
dc.creatorSnehal t Patilpt_BR
dc.creatorAndré Faropt_BR
dc.creatorAjay Patlept_BR
dc.creatorJemal Abdelapt_BR
dc.creatorOlatunde Aremupt_BR
dc.creatorGeorge c Pattonpt_BR
dc.creatorVishnupriya Rao Patuript_BR
dc.creatorDeepak Paudelpt_BR
dc.creatorRufus Adesoji Adedoyinpt_BR
dc.creatorMarcel de Moares Pedrosopt_BR
dc.creatorSandra p Pedrozapt_BR
dc.creatorDavid m Pereirapt_BR
dc.creatorFarshad Farzadfarpt_BR
dc.creatorNorberto Pericopt_BR
dc.creatorHannah Petersonpt_BR
dc.creatorMax Petzoldpt_BR
dc.creatorNiloofar Peykaript_BR
dc.creatorJohan Ärnlövpt_BR
dc.creatorMichael Robert Phillipspt_BR
dc.creatorFrédéric b Pielpt_BR
dc.creatorHsing-yi Changpt_BR
dc.creatorDavid m Pigottpt_BR
dc.creatorJulian David Pillaypt_BR
dc.creatorAdesegun Fatusipt_BR
dc.creatorMichael a Piradovpt_BR
dc.creatorSuzanne Polinderpt_BR
dc.creatorConstance d Pondpt_BR
dc.creatorMaarten j Postmapt_BR
dc.creatorFarshad Pourmalekpt_BR
dc.creatorSwayam Prakashpt_BR
dc.creatoral Artamanpt_BR
dc.creatorv Prakashpt_BR
dc.creatorJung-chen Changpt_BR
dc.creatorNarayan Prasadpt_BR
dc.creatorIsabela m Bensenorpt_BR
dc.creatorNoela Marie Prasadpt_BR
dc.creatorCaroline Purcellpt_BR
dc.creatorMostafa Qorbanipt_BR
dc.creatorHedley Knewjen Quintanapt_BR
dc.creatorAmir Radfarpt_BR
dc.creatorAnwar Rafaypt_BR
dc.creatorAlireza Rafieipt_BR
dc.creatorKazem Rahimipt_BR
dc.creatorKrishna Kumar Aryalpt_BR
dc.creatorAparajita Chattopadhyaypt_BR
dc.creatorMir Sohail Fazelipt_BR
dc.creatorAfarin Rahimi-movagharpt_BR
dc.creatorVafa Rahimi-movagharpt_BR
dc.creatorMahfuzar Rahmanpt_BR
dc.creatorMuhammad Aziz Rahmanpt_BR
dc.creatorSajjad ur Rahmanpt_BR
dc.creatorRajesh Kumar Raipt_BR
dc.creatorSree Bhushan Rajupt_BR
dc.creatorUsha Rampt_BR
dc.creatorSaleem m Ranapt_BR
dc.creatorZane Rankinpt_BR
dc.creatorValery l Feiginpt_BR
dc.creatorPankaj Chaturvedipt_BR
dc.creatorHamid Asayeshpt_BR
dc.creatorDavide Rasellapt_BR
dc.creatorDavid Laith Rawafpt_BR
dc.creatorSalman Rawafpt_BR
dc.creatorSarah e Raypt_BR
dc.creatorChristian Aspacia Razo-garcíapt_BR
dc.creatorPriscilla Reddypt_BR
dc.creatorRobert c Reinerpt_BR
dc.creatorCesar Reispt_BR
dc.creatorAndrea b Feiglpt_BR
dc.creatorMarissa b Reitsmapt_BR
dc.creatorPeggy Pei-chia Chiangpt_BR
dc.creatorGiuseppe Remuzzipt_BR
dc.creatorEphrem Tsegay Asfawpt_BR
dc.creatorAndre m n Renzahopt_BR
dc.creatorSerge Resnikoffpt_BR
dc.creatorSatar Rezaeipt_BR
dc.creatorMohammad Sadegh Rezaipt_BR
dc.creatorAntonio l Ribeiropt_BR
dc.creatorMaria Jesus Rios Blancaspt_BR
dc.creatorNetsanet Fentahunpt_BR
dc.creatorJuan a Riverapt_BR
dc.creatorLeonardo Roeverpt_BR
dc.creatorVesper Hichilombwe Chisumpapt_BR
dc.creatorLuca Ronfanipt_BR
dc.creatorGholamreza Roshandelpt_BR
dc.creatorSolomon Weldegebreal Asgedompt_BR
dc.creatorAli Rostamipt_BR
dc.creatorGregory a Rothpt_BR
dc.creatorDietrich Rothenbacherpt_BR
dc.creatorAmbuj Roypt_BR
dc.creatorSeyed-mohammad Fereshtehnejadpt_BR
dc.creatorNobhojit Roypt_BR
dc.creatorGeorge Mugambage Ruhagopt_BR
dc.creatorYogesh Damodar Sabdept_BR
dc.creatorJee-young j Choipt_BR
dc.creatorPerminder s Sachdevpt_BR
dc.creatorNafis Sadatpt_BR
dc.creatorMahdi Safdarianpt_BR
dc.creatorRana Jawad Asgharpt_BR
dc.creatorSaeid Safiript_BR
dc.creatorRajesh Sagarpt_BR
dc.creatorSutapa Agrawalpt_BR
dc.creatorAmirhossein Sahebkarpt_BR
dc.creatorMohammad Ali Sahraianpt_BR
dc.creatorHaniye Sadat Sajadipt_BR
dc.creatorJoseph Salamapt_BR
dc.creatorHanne Christensenpt_BR
dc.creatorPayman Salamatipt_BR
dc.creatorRaphael de Freitas Saldanhapt_BR
dc.creatorHamideh Salimzadehpt_BR
dc.creatorJoshua a Salomonpt_BR
dc.creatorMengistu Mitiku Ashebirpt_BR
dc.creatorEduarda Fernandespt_BR
dc.creatorAbdallah m Samypt_BR
dc.creatorJuan Ramon Sanabriapt_BR
dc.creatorParag k Sanchetipt_BR
dc.creatorMaria Dolores Sanchez-niñopt_BR
dc.creatorDamian Santomauropt_BR
dc.creatorDevasahayam Jesudas Christopherpt_BR
dc.creatorItamar s Santospt_BR
dc.creatorMilena m Santric Milicevicpt_BR
dc.creatorAbdur Razzaque Sarkerpt_BR
dc.creatorNizal Sarrafzadeganpt_BR
dc.creatorJoão c Fernandespt_BR
dc.creatorBenn Sartoriuspt_BR
dc.creatorNetsanet Abera Asseffapt_BR
dc.creatorMaheswar Satpathypt_BR
dc.creatorMiloje Savicpt_BR
dc.creatorMonika Sawhneypt_BR
dc.creatorSonia Saxenapt_BR
dc.creatorSheng-chia Chungpt_BR
dc.creatorMete i Saylanpt_BR
dc.creatorElke Schaeffnerpt_BR
dc.creatorJosef Schmidhuberpt_BR
dc.creatorDaniel Obadare Fijabipt_BR
dc.creatorMaria Inês Schmidtpt_BR
dc.creatorIone j c Schneiderpt_BR
dc.creatorAustin e Schumacherpt_BR
dc.creatorAhmed Abdelalimpt_BR
dc.creatorTesfay Mehari Ateypt_BR
dc.creatorAletta e Schuttept_BR
dc.creatorDavid c Schwebelpt_BR
dc.creatorOlatunji Adetokunbohpt_BR
dc.creatorFalk Schwendickept_BR
dc.creatorMario Sekerijapt_BR
dc.creatorIrina Filippt_BR
dc.creatorSadaf g Sepanloupt_BR
dc.creatorEdson e Servan-moript_BR
dc.creatorAzadeh Shafieesabetpt_BR
dc.creatorMasood Ali Shaikhpt_BR
dc.creatorMarina Shakh-nazarovapt_BR
dc.creatorMehran Shams-beyranvandpt_BR
dc.creatorSachin r Atrept_BR
dc.creatorHeidar Sharafipt_BR
dc.creatorLiliana g Ciobanupt_BR
dc.creatorMahdi Sharif-alhoseinipt_BR
dc.creatorDerbew Fikadu Berhept_BR
dc.creatorSheikh Mohammed Shariful Islampt_BR
dc.creatorMeenakshi Sharmapt_BR
dc.creatorRajesh Sharmapt_BR
dc.creatorJun Shept_BR
dc.creatorAziz Sheikhpt_BR
dc.creatorMebrahtu Teweldemedhin Shfarept_BR
dc.creatorPeilin Shipt_BR
dc.creatorChloe Shieldspt_BR
dc.creatorMadhu s Atterayapt_BR
dc.creatorMassimo Cirillopt_BR
dc.creatorFlorian Fischerpt_BR
dc.creatorMika Shigematsupt_BR
dc.creatorYukito Shinoharapt_BR
dc.creatorRahman Shiript_BR
dc.creatorReza Shirkoohipt_BR
dc.creatorIvy Shiuept_BR
dc.creatorMark g Shrimept_BR
dc.creatorSharvari Rahul Shuklapt_BR
dc.creatorSoraya Siabanipt_BR
dc.creatorInga Dora Sigfusdottirpt_BR
dc.creatorDonald h Silberbergpt_BR
dc.creatorChristina Fitzmauricept_BR
dc.creatorDanny Colombarapt_BR
dc.creatorLeticia Avila-burgospt_BR
dc.creatorDiego Augusto Santos Silvapt_BR
dc.creatorJoão Pedro Silvapt_BR
dc.creatorDayane Gabriele Alves Silveirapt_BR
dc.creatorJasvinder a Singhpt_BR
dc.creatorLavanya Singhpt_BR
dc.creatorNarinder Pal Singhpt_BR
dc.creatorVirendra Singhpt_BR
dc.creatorDhirendra Narain Sinhapt_BR
dc.creatorAbraham d Flaxmanpt_BR
dc.creatorAbiy Hiruye Sinkept_BR
dc.creatorSara Contipt_BR
dc.creatorMekonnen Sisaypt_BR
dc.creatorEuripide Frinel g Arthur Avokpahopt_BR
dc.creatorVegard Skirbekkpt_BR
dc.creatorKaren Sliwapt_BR
dc.creatorAlison Smithpt_BR
dc.creatorAdauto Martins Soares Filhopt_BR
dc.creatorBadr h a Sobaihpt_BR
dc.creatorMelek Somaipt_BR
dc.creatorLuisa Sorio Florpt_BR
dc.creatorSamir Sonejipt_BR
dc.creatorMoslem Soofipt_BR
dc.creatorCyrus Cooperpt_BR
dc.creatorReed j d Sorensenpt_BR
dc.creatorJoan b Sorianopt_BR
dc.creatorAshish Awasthipt_BR
dc.creatorIreneous n Soyiript_BR
dc.creatorLuciano a Sposatopt_BR
dc.creatorChandrashekhar t Sreeramareddypt_BR
dc.creatorVinay Srinivasanpt_BR
dc.creatorNataliya Foigtpt_BR
dc.creatorJeffrey d Stanawaypt_BR
dc.creatorVasiliki Stathopouloupt_BR
dc.creatorNicholas Steelpt_BR
dc.creatorLeslie Cornabypt_BR
dc.creatorDan j Steinpt_BR
dc.creatorMark Andrew Stokespt_BR
dc.creatorLela Sturuapt_BR
dc.creatorBeatriz Paulina Ayala Quintanillapt_BR
dc.creatorMuawiyyah Babale Sufiyanpt_BR
dc.creatorRizwan Abdulkader Suliankatchipt_BR
dc.creatorKyle j Foremanpt_BR
dc.creatorBruno f Sunguyapt_BR
dc.creatorPatrick j Surpt_BR
dc.creatorBryan l Sykespt_BR
dc.creatorpn Sylajapt_BR
dc.creatorPaolo Angelo Cortesipt_BR
dc.creatorRafael Tabarés-seisdedospt_BR
dc.creatorSantosh Kumar Tadakamadlapt_BR
dc.creatorAndualem Henok Tadessept_BR
dc.creatorGetachew Redae Tafferept_BR
dc.creatorAnimut Alebel Ayalewpt_BR
dc.creatorAliasghar Ahmad Kiadaliript_BR
dc.creatorNikhil Tandonpt_BR
dc.creatorAmare Tariku Tarikupt_BR
dc.creatorNuno Taveirapt_BR
dc.creatorArash Tehrani-banihashemipt_BR
dc.creatorGirma Temam Shifapt_BR
dc.creatorMonica Cortinovispt_BR
dc.creatorMohamad-hani Temsahpt_BR
dc.creatorAbdullah Sulieman Terkawipt_BR
dc.creatorAzeb Gebresilassie Tesemapt_BR
dc.creatorDawit Jember Tesfayept_BR
dc.creatorJoseph j Frostadpt_BR
dc.creatorBelay Tessemapt_BR
dc.creatorHenok Tadesse Ayelept_BR
dc.creatorjs Thakurpt_BR
dc.creatorNihal Thomaspt_BR
dc.creatorMatthew j Thompsonpt_BR
dc.creatorTaavi Tillmannpt_BR
dc.creatorAlexandre Costa Pereirapt_BR
dc.creatorQuyen g topt_BR
dc.creatorRuoyan Tobe-gaipt_BR
dc.creatorMarcello Tonellipt_BR
dc.creatorThomas Fürstpt_BR
dc.creatorRoman Topor-madrypt_BR
dc.creatorFotis Topouzispt_BR
dc.creatorAnna Torrept_BR
dc.creatorRakesh Ayerpt_BR
dc.creatorMiguel Tortajadapt_BR
dc.creatorBach Xuan Tranpt_BR
dc.creatorKhanh Bao Tranpt_BR
dc.creatorEwerton Cousinpt_BR
dc.creatorAvnish Tripathipt_BR
dc.creatorSrikanth Prasad Tripathypt_BR
dc.creatorNeal d Futranpt_BR
dc.creatorChristopher Troegerpt_BR
dc.creatorThomas Truelsenpt_BR
dc.creatorDerrick Tsoipt_BR
dc.creatorLorainne Tudor Carpt_BR
dc.creatorKald Beshir Tuempt_BR
dc.creatorZegeye Abebept_BR
dc.creatorTambe Betrand Ayukpt_BR
dc.creatorStefanos Tyrovolaspt_BR
dc.creatorTara Ballav Adhikaript_BR
dc.creatorUche s Uchendupt_BR
dc.creatorEduardo Bernabépt_BR
dc.creatorKingsley n Ukwajapt_BR
dc.creatorIrfan Ullahpt_BR
dc.creatorRachel Updikept_BR
dc.creatorOlalekan a Uthmanpt_BR
dc.creatorBenjamin s Chudi Uzochukwupt_BR
dc.creatorPascual Rubén Valdezpt_BR
dc.creatorJob f m Van Bovenpt_BR
dc.creatorSantosh Varughesept_BR
dc.creatorPeter Azzopardipt_BR
dc.creatorMichael h Criquipt_BR
dc.creatorEmmanuela Gakidoupt_BR
dc.creatorTommi Vasankaript_BR
dc.creatorFrancesco s Violantept_BR
dc.creatorSergey k Vladimirovpt_BR
dc.creatorVasiliy Victorovich Vlassovpt_BR
dc.creatorStein Emil Vollsetpt_BR
dc.creatorTheo Vospt_BR
dc.creatorFasil Wagnewpt_BR
dc.creatorYasir Waheedpt_BR
dc.creatorMitchell t Wallinpt_BR
dc.creatorJudd l Walsonpt_BR
dc.creatorSilvano Galluspt_BR
dc.creatorElizabeth a Cromwellpt_BR
dc.creatorNatasha Azzopardi-muscatpt_BR
dc.creatorYafeng Wangpt_BR
dc.creatorYuan-pang Wangpt_BR
dc.creatorMolla Mesele Wassiept_BR
dc.creatorMarcia r Weaverpt_BR
dc.creatorElisabete Weiderpasspt_BR
dc.creatorRobert g Weintraubpt_BR
dc.creatorJordan Weisspt_BR
dc.creatorKidu Gidey Weldegwergspt_BR
dc.creatorKetevan Gambashidzept_BR
dc.creatorAndrea Werdeckerpt_BR
dc.creatorChristopher Stephen Crowept_BR
dc.creatort Eoin Westpt_BR
dc.creatorTesleem Kayode Babalolapt_BR
dc.creatorRonny Westermanpt_BR
dc.creatorRichard g Whitept_BR
dc.creatorHarvey a Whitefordpt_BR
dc.creatorJustyna Wideckapt_BR
dc.creatorAndrea Sylvia Winklerpt_BR
dc.creatorCharles Shey Wiysongept_BR
dc.creatorAmiran Gamkrelidzept_BR
dc.creatorCharles da Wolfept_BR
dc.creatorYohanes Ayele Wondimkunpt_BR
dc.creatorJohn a Crumppt_BR
dc.creatorAbdulhalik Workichopt_BR
dc.creatorGrant m a Wyperpt_BR
dc.creatorHamid Badalipt_BR
dc.creatorDenis Xavierpt_BR
dc.creatorGelin xupt_BR
dc.creatorLijing l Yanpt_BR
dc.creatorYuichiro Yanopt_BR
dc.creatorMorsaleh Ganjipt_BR
dc.creatorMehdi Yaseript_BR
dc.creatorNigus Bililign Yimerpt_BR
dc.creatorPeng Yinpt_BR
dc.creatorAlemneh Kabeta Dabapt_BR
dc.creatorPaul Yippt_BR
dc.creatorBiruck Desalegn Yirsawpt_BR
dc.creatorNaohiro Yonemotopt_BR
dc.creatorAlaa Badawipt_BR
dc.creatorGerald Yongapt_BR
dc.creatorSeok-jun Yoonpt_BR
dc.creatorAbadi Kahsu Gebrept_BR
dc.creatorMarcel Yotebiengpt_BR
dc.creatorMustafa z Younispt_BR
dc.creatorChuanhua yupt_BR
dc.creatorVesna Zadnikpt_BR
dc.creatorBerihun Assefa Dachewpt_BR
dc.creatorZoubida Zaidipt_BR
dc.creatorMaysaa el Sayed Zakipt_BR
dc.creatorSojib Bin Zamanpt_BR
dc.creatorMohammad Zamanipt_BR
dc.creatorMaciej Banachpt_BR
dc.creatorTsegaye Tewelde Gebrehiwotpt_BR
dc.creatorZerihun Menlkalew Zenebept_BR
dc.creatorMaigeng Zhoupt_BR
dc.creatorJun Zhupt_BR
dc.creatorStephanie r m Zimsenpt_BR
dc.creatorBen Zipkinpt_BR
dc.creatorAbel Fekadu Dadipt_BR
dc.creatorSanjay Zodpeypt_BR
dc.creatorLiesl Joanna Zuhlkept_BR
dc.creatorChristopher j l Murraypt_BR
dc.creatorRafael Lozanopt_BR
dc.creatorMiloud Taki Eddine Aichourpt_BR
dc.creatorAmitava Banerjeept_BR
dc.creatorAmrit Banstolapt_BR
dc.creatorRyan m Barberpt_BR
dc.creatorTeshome Abuka Abebopt_BR
dc.creatorMiguel a Barbozapt_BR
dc.creatorSuzanne l Barker-collopt_BR
dc.creatorLalit Dandonapt_BR
dc.creatorTill Bärnighausenpt_BR
dc.creatorSimon Barquerapt_BR
dc.creatorLope h Barreropt_BR
dc.creatorAmanuel Tesfay Gebremedhinpt_BR
dc.creatorQuique Bassatpt_BR
dc.creatorSanjay Basupt_BR
dc.creatorBernhard t Baunept_BR
dc.creatorShahrzad Bazargan-hejazipt_BR
dc.creatorNeeraj Bedipt_BR
dc.creatorRakhi Dandonapt_BR
dc.creatorPaul i Darganpt_BR
dc.creatorMohsen Afaridehpt_BR
dc.creatorAhmad Daryanipt_BR
dc.creatorMaryam Daryanipt_BR
dc.creatorYalemzewod Assefa Gelawpt_BR
dc.creatorJai Daspt_BR
dc.creatorSiddharth Kumar Daspt_BR
dc.creatorJosé Das Nevespt_BR
dc.creatorNicole Davis Weaverpt_BR
dc.creatorKairat Davletovpt_BR
dc.creatorBarbora de Courtenpt_BR
dc.creatorDiego de Leopt_BR
dc.creatorJan-walter de Nevept_BR
dc.creatorRobert Steven Bernsteinpt_BR
dc.creatorJohanna m Geleijnsept_BR
dc.creatorDemeke Geremewpt_BR
dc.creatorPeter w Gethingpt_BR
dc.creatorReza Ghadimipt_BR
dc.creatorKhalil Ghasemi Falavarjanipt_BR
dc.creatorMaryam Ghasemi-kasmanpt_BR
dc.creatorParamjit Singh Gillpt_BR
dc.creatorAbabi Zergaw Girefpt_BR
dc.creatorMohammed Akibupt_BR
dc.creatorMaurice Giroudpt_BR
dc.creatorMircea Beuranpt_BR
dc.creatorMelkamu Dedefo Gishupt_BR
dc.date.accessioned2023-04-18T20:46:56Z-
dc.date.available2023-04-18T20:46:56Z-
dc.date.issued2018-
dc.citation.volume391pt_BR
dc.citation.issue10136pt_BR
dc.citation.spage2236pt_BR
dc.citation.epage2271pt_BR
dc.identifier.doi10.1016/s0140-6736(18)30994-2pt_BR
dc.identifier.issn01406736pt_BR
dc.identifier.urihttp://hdl.handle.net/1843/52188-
dc.description.resumoBackground A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries.Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations.pt_BR
dc.description.resumoBackground A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries.Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations.pt_BR
dc.format.mimetypepdfpt_BR
dc.languageengpt_BR
dc.publisherUniversidade Federal de Minas Geraispt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.departmentENF - DEPARTAMENTO DE ENFERMAGEM MATERNO INFANTIL E SAÚDE PÚBLICApt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE CLÍNICA MÉDICApt_BR
dc.publisher.initialsUFMGpt_BR
dc.relation.ispartofThe Lancet-
dc.rightsAcesso Abertopt_BR
dc.subjectCarga global de doençapt_BR
dc.subjectCarga global de doençapt_BR
dc.subjectCarga global de doençapt_BR
dc.subjectCarga global de doençapt_BR
dc.subjectAcesso efetivo aos serviços de saúdept_BR
dc.subjectAcesso efetivo aos serviços de saúdept_BR
dc.subjectPolítica de saúdept_BR
dc.subjectPolítica de saúdept_BR
dc.subject.otherAcesso efetivo aos serviços de saúdept_BR
dc.subject.otherAcesso efetivo aos serviços de saúdept_BR
dc.subject.otherAcesso efetivo aos serviços de saúdept_BR
dc.subject.otherAcesso efetivo aos serviços de saúdept_BR
dc.subject.otherCarga global de doençapt_BR
dc.subject.otherCarga global de doençapt_BR
dc.subject.otherCarga global de doençapt_BR
dc.subject.otherCarga global de doençapt_BR
dc.titleMeasuring performance on the healthcare access and quality index for 195 countries and territories and selected subnational locations: a systematic analysis from the global burden of disease study 2016pt_BR
dc.typeArtigo de Periódicopt_BR
dc.url.externahttps://doi:10.1016/s0140-6736(18)30994-2pt_BR
dc.identifier.orcidhttps://orcid.org/0000-0002-8214-5734pt_BR
Appears in Collections:Artigo de Periódico

Files in This Item:
File Description SizeFormat 
Measuring perfomance on the healthcare acess and quality index for 195 countries and territories and selected subantional locations a systematic analys from the Global burden of Disease Study 2016pdfa.pdf9.62 MBAdobe PDFView/Open
Show simple item record


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.