Wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions in 36 countries in the African Region

Bulletin of the World Health Organization
Fernando C Wehrmeisteron the behalf of the Countdown to 2030 for Women’s, Children’s and Adolescents’ Health regional collaboration in sub-Saharan

Abstract

To investigate whether sub-Saharan African countries have succeeded in reducing wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions. We analysed survey data from 36 countries, grouped into Central, East, Southern and West Africa subregions, in which at least two surveys had been conducted since 1995. We calculated the composite coverage index, a function of essential maternal and child health intervention parameters. We adopted the wealth index, divided into quintiles from poorest to wealthiest, to investigate wealth-related inequalities in coverage. We quantified trends with time by calculating average annual change in index using a least-squares weighted regression. We calculated population attributable risk to measure the contribution of wealth to the coverage index. We noted large differences between the four regions, with a median composite coverage index ranging from 50.8% for West Africa to 75.3% for Southern Africa. Wealth-related inequalities were prevalent in all subregions, and were highest for West Africa and lowest for Southern Africa. Absolute income was not a predictor of coverage, as we observed a higher coverage in Southern (around 70%) compared with Cen...Continue Reading

References

Apr 15, 2008·Lancet·UNKNOWN Countdown 2008 Equity Analysis GroupCesar G Victora
Jan 25, 2012·Bulletin of the World Health Organization·Ahmad Reza HosseinpoorTies Boerma
Apr 10, 2016·BMC Health Services Research·Felix Sayinzoga, Leon Bijlmakers
Dec 21, 2016·Bulletin of the World Health Organization·Fernando C WehrmeisterAluisio Jd Barros
Feb 23, 2018·American Journal of Public Health·Cesar Gomes VictoraAluisio J D Barros

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Citations

Dec 2, 2020·Proceedings of the National Academy of Sciences of the United States of America·Giacomo FalchettaSoheil Shayegh
Mar 19, 2021·BMJ : British Medical Journal·Danzhen YouKathleen Strong
Jun 1, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Gbemisola Allwell-BrownEmily White Johansson

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Methods Mentioned

BETA
contraception

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