Are the poorest poor being left behind? Estimating global inequalities in reproductive, maternal, newborn and child health.

BMJ Global Health
Aluisio J D BarrosCesar G Victora

Abstract

Wealth-related inequalities in reproductive, maternal, neonatal and child health have been widely studied by dividing the population into quintiles. We present a comprehensive analysis of wealth inequalities for the composite coverage index (CCI) using national health surveys carried out since 2010, using wealth deciles and absolute income estimates as stratification variables, and show how these new approaches expand on traditional equity analyses. 83 low-income and middle-income countries were studied. The CCI is a combined measure of coverage with eight key reproductive, maternal, newborn and child health interventions. It was disaggregated by wealth deciles for visual inspection of inequalities, and the slope index of inequality (SII) was estimated. The correlation between coverage in the extreme deciles and SII was assessed. Finally, we used multilevel models to examine how the CCI varies according to the estimated absolute income for each wealth quintile in the surveys. The analyses of coverage by wealth deciles and by absolute income show that inequality is mostly driven by coverage among the poor, which is much more variable than coverage among the rich across countries. Regardless of national coverage, in 61 of the cou...Continue Reading

References

Oct 7, 2004·Lancet·Davidson R GwatkinCesar G Victora
Apr 15, 2008·Lancet·UNKNOWN Countdown 2008 Equity Analysis GroupCesar G Victora
May 2, 2009·Journal of Epidemiology and Community Health·L D HoweS R A Huttly
Oct 15, 2013·Global Health Action·Prashant Kumar SinghChandan Kumar
Sep 17, 2016·BMC Public Health·Nadia AkseerZulfiqar A Bhutta
Dec 21, 2016·Bulletin of the World Health Organization·Fernando C WehrmeisterAluisio Jd Barros
Aug 2, 2017·JAMA Internal Medicine·Md Mizanur RahmanKenji Shibuya
Feb 23, 2018·American Journal of Public Health·Cesar Gomes VictoraAluisio J D Barros

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Citations

Jun 10, 2020·Bulletin of the World Health Organization·Fernando C WehrmeisterUNKNOWN on the behalf of the Countdown to 2030 for Women’s, Children’s and Adolescents’ Health regional collaboration in sub-Saharan
Aug 26, 2020·BMJ Global Health·Peter M MachariaEmelda A Okiro
Jan 12, 2021·BMC Public Health·Manuel Colomé-HidalgoÁngel Gil de Miguel
Jul 30, 2021·PloS One·Carol C Guarnizo-HerreñoGiancarlo Buitrago

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