Improving the effective maternal-child health care coverage through synergies between supply and demand-side interventions: evidence from Mexico

Serván‐Mori, Edson; Cerecero-García, Diego; Heredia-Pi, Ileana; Pineda-Antúnez, Carlos; Sosa-Rubí, Sandra G.; Nigenda, Gustavo

doi:10.7189/jogh.09.020433

Cited by 14 publications

(18 citation statements)

References 36 publications

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“…Positive synergies between Prospera and Seguro Popular de Salud in the reduction of gaps in effective coverage for maternal health services have recently been assessed. 40 Another successful health-care policy is the 2001 Arranque Parejo en la Vida programme that aimed to improve access to specialized delivery care, particularly in rural areas where the highest numbers of maternal mortality are reported. The government introduced the Seguro Popular de Salud in 2003 as part of the efforts to expand health coverage for those members of the population without social security; 22 , 41 , 42 by 2018, about 45% of the Mexican population were covered by the Seguro Popular de Salud .…”

Section: Discussionmentioning

confidence: 99%

Assessing the continuum of care for maternal health in Mexico, 1994–2018

Serván‐Mori

Heredia-Pi

Garcia

et al. 2020

Bull. World Health Organ.

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Objective To describe the temporal and geographical patterns of the continuum of maternal health care in Mexico, as well as the sociodemographic characteristics that affect the likelihood of receiving this care. Methods We conducted a pooled cross-sectional analysis using the 1997, 2009, 2014 and 2018 waves of the National Survey of Demographic Dynamics, collating sociodemographic and obstetric characteristics of 93 745 women aged 12–54 years at last delivery. We defined eight variables along the antenatal–postnatal continuum, both independently and conditionally. We used a pooled fixed-effects multivariable logistic model to determine the likelihood of receiving the continuum of care for various properties. We also mapped the quintiles of adjusted state-level absolute change in continuum of care coverage during 1994–2018. Findings We observed large absolute increases in the proportion of women receiving timely antenatal and postnatal care (from 48.9% to 88.2% and from 39.1% to 68.7%, respectively). In our conditional analysis, we found that the proportion of women receiving adequate antenatal care doubled over this period. We showed that having social security and a higher level of education is positively associated with receiving the continuum of care. We observed the largest relative increases in continuum of care coverage in Chiapas (181.5%) and Durango (160.6%), assigned human development index categories of low and medium, respectively. Conclusion Despite significant progress in coverage of the continuum of maternal health care, disparities remain. While ensuring progress towards achievement of the health-related sustainable development goal, government intervention must also target underserved populations.

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Section: Discussionmentioning

confidence: 99%

Assessing the continuum of care for maternal health in Mexico, 1994–2018

Serván‐Mori

Heredia-Pi

Garcia

et al. 2020

Bull. World Health Organ.

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“…Sixteen studies evaluated an intervention in Asia,37–52 13 studies in Africa,53–65 7 in South America66–72 and 1 study evaluated interventions in multiple countries in South America and Asia 73. The most studied country in this review was India (n=10).…”

Section: Resultsmentioning

confidence: 99%

“…The most studied country in this review was India (n=10). Eight studies sampled households,37 41 47 49 59 67 72 8 studies sampled currently pregnant women44 53–55 58 61 63 64 and 23 studies sampled women with previous pregnancy experience 38–40 42 44–48 50 51 57 59 62 64–66 68–71. Of those 23 studies, 4 studies were limited to married women 42 45 46 52.…”

Section: Resultsmentioning

confidence: 99%

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Effects of women’s economic empowerment interventions on antenatal care outcomes: a systematic review

et al. 2023

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ObjectivesEarly and adequate antenatal care (ANC) has been shown to reduce maternal morbidity and mortality globally. Increasing evidence suggests that women’s economic empowerment (WEE) is a critical factor that may influence uptake of ANC during pregnancy. However, existing literature lacks a comprehensive synthesis of studies on WEE interventions and their effects on ANC outcomes. This systematic review analyses WEE interventions at the household, community and national levels and their effects on ANC outcomes in low-income and middle-income countries, where the majority of maternal deaths occur.MethodsSix electronic databases were systematically searched as well as 19 websites of relevant organisations. Studies published in English and after 2010 were included.ResultsFollowing abstract and full-text review, 37 studies were included in this review. Seven studies used an experimental study design, 26 studies used a quasi-experimental study design, 1 study used an observational design and 1 study was a systematic review with meta-analysis. Thirty-one included studies evaluated a household-level intervention, and six studies evaluated a community-level intervention. No included studies examined a national-level intervention.ConclusionMost included studies on household-level and community-level interventions found a positive association between the intervention and the number of ANC visits women received. This review emphasises the need for more WEE interventions that empower women at the national level, for the expansion of the definition of WEE to be more inclusive of the multidimensionality of WEE interventions and the social determinants of health, and the standardisation of ANC outcome measurement globally.

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“…Positive synergies between these two policies in transforming public health efforts into greater EC and better MCH outcomes have been assessed. These successful initiatives specifically targeted the economically and socially disadvantaged population ( Serván-Mori et al. , 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluations of effective coverage of maternal and child health services: A systematic review

Gebremedhin

Dawson

Hayen

2022

Health Policy and Planning

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Conventionally used coverage measures do not reflect the quality of care. Effective coverage assesses the extent to which health care services deliver potential health gains to the population by integrating concepts of utilization, need, and quality. We aimed to conduct a systematic review of studies evaluating effective coverage of maternal and child health services, quality measurement strategies, and disparities across wealth quantiles. A systematic search was performed in six electronic databases (MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and Maternity and Infant Care) and grey literature. We also undertook a hand search of references. We developed search terms having no restrictions based on publication period, country, or language. We included studies, which reported effective coverage estimates based on the World Health Organization framework of measuring effective coverage. Twenty-seven studies, all from low and middle-income settings (49 countries), met the criteria and were included in the narrative synthesis of the results. Maternal and child health intervention(s) and program(s) were assessed either at an individual level or as an aggregated measure of health system performance, or both. The effective coverage ranged from 0% for postpartum care to 95% for breastfeeding. When crude coverage measures were adjusted to account for the quality of care, the effective coverage values turned lower. The gap between crude coverage and effective coverage was as high as 86%, and it signified a low quality of care. The assessment of quality of care addressed structural, process, and outcome domains, individually or combined. The wealthiest 20% had higher effective coverage of services than the poorest 20%, an inequitable distribution of coverage. More efforts are needed to improve the quality of maternal and child health services and to eliminate the disparities. Moreover, considering multiple dimensions of quality and the use of standard measurements are recommended to monitor coverage effectively.

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Improving the effective maternal-child health care coverage through synergies between supply and demand-side interventions: evidence from Mexico

Cited by 14 publications

References 36 publications

Assessing the continuum of care for maternal health in Mexico, 1994–2018

Assessing the continuum of care for maternal health in Mexico, 1994–2018

Effects of women’s economic empowerment interventions on antenatal care outcomes: a systematic review

Evaluations of effective coverage of maternal and child health services: A systematic review

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