Health coverage index vs. Out of school, primary
Holds up after adjusting for income
Across 177 countries, Health coverage index and Out of school, primary rise and fall together at r = -0.55 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to -0.27 (q = 0.017, allowing for the many pairs tested). Much of the first figure is that both measures rise with national income, but a weak negative link remains. Caution: direction is not consistent across regions.
Comparing countries across the middle half of out of school, primary, 0.97% to 9.61% of primary-age children, health coverage index is worse by 6.36 points at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 1.87 points.
Link before adjusting (r)-0.547p = 3.2e-15 · 177 countries
After adjusting for national income-0.272p = 0.000 · likely range [-0.40, -0.13]
p, allowing for regions0.034standard error 0.099 · 7 regions
Check for luck (q)0.017across 12,497 pairs
How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.
Health coverage index · index, 0 to 100link with income +0.88 · proxy
Out of school, primary · % of primary-age childrenlink with income -0.45 · moderate
“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.
Every country as a dot
best-fit line line after adjusting
Four ways to measure the link
| Method | r | p | Countries |
|---|---|---|---|
| Standard (Pearson), not adjusted | -0.547 | 3.2e-15 | 177 |
| By rank (Spearman), not adjusted | -0.499 | 1.6e-12 | 177 |
| Standard (Pearson), adjusted for national income | -0.272 | 0.000 | 177 |
| By rank (Spearman), adjusted for national income | -0.173 | 0.022 | 177 |
The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 177 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.275 (a minus sign means it grew).
How solid is it?
Leaving out one country at a time, r ranges from -0.300 (without PNG) to -0.215 (without GNQ). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: GNQ (+0.057).
Fragile: this link may not hold up.
- direction is not consistent across regions
Within each region
Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.
| n | r | ||
|---|---|---|---|
| East Asia & Pacific | 28 | +0.12 | |
| Europe & Central Asia | 50 | +0.00 | |
| Latin America & Caribbean | 29 | -0.35 | |
| Middle East, North Africa, Afghanistan & Pakistan | 18 | -0.25 | |
| Sub-Saharan Africa | 44 | -0.27 |
By income third
If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.
| n | r | ||
|---|---|---|---|
| Poorest third | 59 | -0.22 | |
| Middle third | 59 | -0.40 | |
| Richest third | 59 | -0.36 |
By largest religious group
Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.
| n | r | ||
|---|---|---|---|
| Christians | 106 | -0.23 | |
| Muslims | 44 | -0.32 |
By last european coloniser
Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.
| n | r | ||
|---|---|---|---|
| France | 23 | -0.05 | |
| Never a European colony | 19 | -0.40 | |
| Spain | 20 | -0.62 | |
| United Kingdom | 59 | -0.14 |
Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.143 after dropping 20 countries.
Two series, one country
Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.
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Over time, within countries
Everything above compares countries with each other at one moment. This section compares each country only with itself over 24years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.
The link shows up within countries over time (r = -0.280) but mostly disappears in year-to-year changes (r = -0.056). That points to slow trends particular to each country, not the two measures moving together from year to year.
Across countries (adjusted)-0.272for comparison
Within countries-0.348each country vs itself
…and vs the same year elsewhere-0.280q = 4.0e-5 · 176 countries
Year-on-year changes-0.056q = 0.282
Read with care.
- Almost all of the second indicator's variation is between countries, so the within-country estimate rests on a small part of the data.
- The association is much weaker in year-on-year changes than in levels, which points to shared country-specific trends.
2,994 country-years (one country in one year), 176 countries, 2000–2023, about 17 years each on average. Share of the variation that happens within countries over time: 19% for Health coverage index, 8% for Out of school, primary. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.
Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.
With one measure years behind the other
Same year (lag 0): -0.280. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.
The largest value on this curve (-0.35 at lag -4) is higher than the same-year one by 0.07. That gap is not a finding. It is the largest of 21 closely related estimates, and picking the biggest of many tests always makes it look bigger. That is exactly why nothing on this site is ranked or chosen by lag.
The data
index, 0 to 100 | % of primary-age children | Years | |
|---|---|---|---|
| Canada CAN | 92 | 4.99% | 2023 |
| Iceland ISL | 90 | 1.82% | 2023 |
| New Zealand NZL | 89 | 2.62% | 2023, 2024 |
| Norway NOR | 89 | 1.38% | 2023, 2024 |
| Australia AUS | 89 | 0.124% | 2023, 2024 |
| United States USA | 88 | 3.98% | 2023, 2022 |
| Singapore SGP | 88 | 0.212% | 2023 |
| Korea, Rep. KOR | 88 | 0.0557% | 2023, 2024 |
| United Kingdom GBR | 88 | 0.0698% | 2023 |
| Germany DEU | 87 | 0.274% | 2023, 2024 |
| Switzerland CHE | 87 | 0.143% | 2023, 2024 |
| Japan JPN | 86 | 0.0684% | 2023 |
| Finland FIN | 86 | 1.77% | 2023, 2024 |
| Belgium BEL | 86 | 1.66% | 2023 |
| Uruguay URY | 85 | 0.0355% | 2023 |
World Health Organization, Global Health Observatory
World Bank, World Development Indicators
Sources
Health coverage index
Universal health coverage service coverage index
World Health Organization · via Our World in Data · CC BY-NC-SA 4.0 · updated annual
Fourteen "tracer" measures of basic health services, combined by WHO into one index. They include vaccination, care during pregnancy, treatment of tuberculosis and HIV, and hospital beds and staff. Several of those measures are on the site on their own. So a link with any of them is partly the index matching a part of itself.
Out of school, primary
Children out of school (% of primary school age)
UNESCO Institute for Statistics · CC BY 4.0 · updated quarterly
Children of primary-school age not enrolled at any level. Treated as measuring the same thing as gross primary enrolment, which is on the site. They are two ways of asking whether children are in school, so their agreement is not a finding.
How this was computed
Data used: most recent value in 2010-2025; values come from 2010–2025. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Health coverage index and Out of school, primary
This page shows that two measures go together. It does not show that Health coverage index changes Out of school, primary, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.
More links with Health coverage index or Out of school, primary
- Basic sanitation vs Health coverage index before +0.88 → after adjusting +0.63
- Health coverage index vs Skilled birth attendance before +0.82 → after adjusting +0.62
- HDI vs Health coverage index before +0.91 → after adjusting +0.57
- Education score vs Health coverage index before +0.86 → after adjusting +0.55
- Health coverage index vs Maternal mortality before -0.80 → after adjusting -0.52
- Health coverage index vs Under-5 mortality before -0.84 → after adjusting -0.51
- Basic water access vs Health coverage index before +0.83 → after adjusting +0.49
- Health coverage index vs Infant mortality before -0.84 → after adjusting -0.47