Supplement File - Income-Based Analysis of Health Security in Western Asia through an Integrated GHSI, MCDM, and Clustering Model

This supplementary material supports our study titled "Income-Based Analysis of Health Security in Western Asia through an Integrated GHSI, MCDM, and Clustering Model." Additional context and data tables are provided to enrich the main analysis and findings. The document is divided into four primary sections. It begins by outlining the key health security criteria used to evaluate countries: prevention, detection and reporting, rapid response, health system adequacy, commitment to international norms, and overall risk environment. These criteria were applied to decision matrices for 2019 and 2021. This section also includes the development of matrices that determine the weights of the health security criteria, rank countries, and group them by performance. Comprehensive scores are presented for different income groups, including high-income (HIC), upper-middle-income (UMC), lower-middle-income (LMC), and low-income (LIC) countries. The second section details the results of the D-CRITIC calculations used to establish the relative importance of health security indicators for Western Asian nations, broken down by income category (LIC, LMC, UMC, HIC) for both 2019 and 2021. The third section explores the application of the D-CRITIC-CoCoSo model in ranking the health security performance of these countries for the same years. It includes normalized values, weighted comparability sequences, and final rankings that highlight the changes over time. The final section presents the clustering analysis, which segments countries based on their health security performance scores derived from the D-CRITIC-CoCoSo model. This analysis identified distinct performance clusters and assigned grades, showing the distribution of countries across income levels in both years.