Concept of Universal Health Coverage enunciates the principle that people have access to effective health coverage while ensuring the protection from financial hardship when paying for them. While basic definition of effective coverage is conceptually straight forward, translating it to a feasible metric is quite intractable. Coverage metric obtained from household survey alone in not succinct as it only captures service contact which cannot be construed as actual service delivery as it ignores comprehensive assessment of provider-client interaction and quality of care components. Thus, this study was undertaken to estimate a comprehensive metric of effective coverage for different packages of healthcare services viz. Ambulatory care, Maternal care, Inpatient care and Immunization care using mixed-method approach. The study was conducted in Poonch district of Jammu and Kashmir, which is a remote, rural, impoverished and conflict-prone area bounded by LoC with Pakistan. District representative field surveys encompassing household survey, health facility assessment and patient exit survey in tandem with Key informant interviews and Focused Group Discussions with various stakeholders were conducted in study area to discern the measure and barriers to effective coverage. Various domains embedded in Tanahashi framework of effective coverage viz. Availability, Accessibility, Acceptability, Contact Coverage and Effective coverage were elucidated. Furthermore, linking of various surveys were done by using a suite of GIS (Geographical Information Systems) techniques using both vector and raster based methods to develop indices of effective coverage. Results indicated a significant drop along the cascade from Availability to Effective coverage. Quality-adjusted effective coverage estimates were 20%-48% lesser than crude coverage estimates, this divergence was most exacerbated for ambulatory care, where supply did not commensurate with need of target population. Additionally, analysis indicated other major bottlenecks of Geographical Inaccessibility and Poor Supply-side readiness as major impediments to Effective Coverage.