BackgroundAccess to maternal and child health care in low- and middle-income countries such as Togo is characterized by significant inequalities. Most studies in the Togolese context have examined the total inequality of health and the determinants of individuals’ health. Few empirical studies in Togo have focused on inequalities of opportunity in maternal and child health. To fill this gap, we estimated changes in inequality of opportunity in access to maternal and child health services between 1998 and 2013 using data from Togo Demographic and Health Surveys (DHS).MethodWe computed the Human Opportunity Index (HOI)—a measure of how individual, household, and geographic characteristics like sex and place of residence can affect individuals’ access to services or goods that should be universal—using five indicators of access to healthcare and one composite indicator of access to adequate care for children. The five indicators of access were: birth in a public or private health facility; whether the child had received any vaccinations; access to prenatal care; prenatal care given by qualified staff; and having at least four antenatal visits. We then examined differences across the two years.ResultsBetween 1998 and 2013, inequality of opportunities decreased for four out of six indicators. However, inequalities increased in access to antenatal care provided by qualified staff (5.9% to 12.5%) and access to adequate care (27.7% to 28.6%).ConclusionsAlthough inequality of opportunities reduced between 1998 and 2013 for some of the key maternal and child health indicators, the average coverage and access rates underscore the need for sustained efforts to ensure equitable access to primary health care for mothers and children.

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Background Inequality of opportunity in health and nutrition is a major public health issue in the developing regions. This study analyzed the patterns and extent of inequality of opportunity in health and nutrition among children under-five across three countries sub-Saharan Africa with low Human development index (HDI). Methods We used data from the Multiple Indicator Cluster Survey of the Democratic Republic of Congo (20,792 households, 21,756 women aged 15 to 49 and 21,456 children under five), Guinea Bissau (6601 households, 10,234 women aged 15–49 and 7573 children under five) and Mali (11,830 households, 18,409 women in 15–49 years and 16,468 children under five) to compute the human opportunity index (HOI) and the dissimilarity index (D-index). Secondly, the Shapley decomposition method was used to estimate the relative contribution of circumstances that are beyond the control of children under-five and affecting their development outcomes in later life stages. Results The study revealed that children belonging to the most favorable group had higher access rates for immunization (93.64%) and water and sanitation facilities (73.59%) in Guinea Bissau. In Congo DR, the access rate was high for immunization (93.9%) for children in the most favorable group. In Mali, access rates stood at 6.56% for children in the most favorable group. In Guinea Bissau, the inequality of opportunity was important in access to health services before and after delivery (43.85%). In Congo DR, the inequality of opportunity was only high for the immunization composite indicator (83.79%) while in Mali, inequality of opportunity was higher for access to health services before and after delivery (41.67%). Conclusion The results show that there are efforts in some places to promote access to health and nutrition services in order to make access equal without distinction linked to the socio-economic and demographic characteristics in which the children live. However, the inequalities of opportunity observed between the children of the most favorable group and those of the least favorable group, remain in general at significant levels and call on government of these countries to implement policies taking them into account.

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Résumé Les conséquences socio‐économiques de la crise sanitaire liée à la COVID‐19 ont montré la nécessité de s'interroger sur les effets de cette crise sur les objectifs de développement comme la réduction de la pauvreté afin d'apporter aux décideurs les informations nécessaires pour la mise en œuvre des politiques efficaces. Dans cet article, nous apportons notre contribution à la littérature récente qui traite des effets de la COVID‐19 sur la pauvreté dans l'UEMOA. Nous avons estimé les effets potentiels de court‐terme de la COVID‐19 sur la pauvreté dans les pays de l'UEMOA suivant trois scénarios de réduction du revenu des ménages de 5%; 10% et 25% et en utilisant l'outil PovcalNet. Les résultats montrent que l'incidence de la pauvreté pourrait augmenter dans les pays de l'UEMOA et la dynamique de réduction de la pauvreté observée depuis les années 2000 risque d'être ébranlée par la pandémie. En effet, le nombre de nouveaux pauvres dans l'Union pourrait s'établir entre 4 et 21 millions au seuil de pauvreté de 1,9 $US. Cette situation qui constitue une véritable menace à l'élimination de la pauvreté d'ici 2030 est plus accentuée dans certains pays comme le Sénégal, la Côte d'Ivoire et le Bénin.