Mind the gap: equity and trends in coverage of maternal, newborn, and child health services in 54 Countdown countries

Jt, Boerma; Bryce, Jennifer; Kinfu, Yohannes; Axelson, Henrik; Victora, Cesar G

doi:10.1016/s0140-6736(08)60560-7

Cited by 242 publications

(167 citation statements)

References 14 publications

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“…A 2010 UNICEF report found that progress measured by national aggregates often conceals large and widening disparities in child health—despite apparent statistical success in reducing under-five mortality, inequalities between the poorest and the richest households grew by more than 10% [37]. As the Countdown equity analysis indicates, child health interventions tend to reach the wealthiest children first in the absence of policy instruments for addressing inequality [14]. The second salient finding is that the progress made in reducing child health inequalities differs greatly by country, with some countries making significant improvements between 2000 and 2014, some significantly deteriorating, and others remaining statistically unchanged.…”

Section: Discussionmentioning

confidence: 99%

“…We identified 88 developing countries with available DHS or MICS data subsequent to 2000. Following previous studies [13,14], we divided the surveys into three rounds according to the date of their implementation: round 1 for 2000–2004, round 2 for 2005–2009, and round 3 for 2010–2014. Of the 88 countries, three conducted their latest surveys in survey round 1, 20 in survey round 2, and 65 in survey round 3.…”

Section: Methodsmentioning

confidence: 99%

“…These studies provided firm evidence that socioeconomic status is an essential factor associated with child health. Studies by Barros AJ et al, Victora CG et al, and the Countdown 2008 equity analysis group have investigated the levels and trends of socioeconomic inequality in maternal and child health interventions in the Countdown countries (a maximum of 54 Countdown countries) (Countdown countries—a group of high-burden priority countries, which together represent 95% of maternal and child mortality [11]) between 1990 and 2008 [12–14]. These studies showed that, although there was noticeable improvement in child health interventions, inequalities persisted in many countries.…”

Section: Introductionmentioning

confidence: 99%

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Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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Background: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. Objective: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. Methods: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. Results: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries’ progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [−3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. Conclusions: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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“…13,14 Consequently, significant inequity between the rich and poor remains in access to health-care services and their utilization. 7,[14][15][16][17][18] Although Bangladesh is likely to achieve several Abstracts in ‫,عريب‬ 中文, Français, Pусский and Español at the end of each article.…”

Section: Introductionmentioning

confidence: 99%

“…Health inequities are ubiquitous; 7,15,17 they exist in both developed and developing societies. 17,18 Most development advocates, planners and practitioners view them as unacceptable, unfair 7,11,19 and rooted in broader social injustice. 15,20 Such inequities pose critical challenges across countries and cultures 15 and are becoming an important social concern.…”

Section: Introductionmentioning

confidence: 99%

Trends in sociodemographic and health-related indicators in Bangladesh, 1993–2007: will inequities persist?

Khan

Krämer

Aklimunnessa

et al. 2011

Bull. World Health Organ.

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Assessment of Inequalities in Coverage of Essential Reproductive, Maternal, Newborn, Child, and Adolescent Health Interventions in Kenya

et al. 2018

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Key Points Question How equitable was coverage of essential reproductive, maternal, newborn, child, and adolescent health interventions in Kenya throughout the Millennium Development Goal period? Findings In this population-based, cross-sectional study of 31 380 women of reproductive age and 29 743 children, regional and socioeconomic inequalities in coverage of several key interventions persisted throughout the study period (2003-2014), placing both the rural and urban poor as well as populations in the northern and eastern regions of Kenya at a significant disadvantage. Meaning For Kenya to improve health equity and achieve its 2030 goals, a targeted approach will be needed to reach populations that are currently lagging behind.

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Mind the gap: equity and trends in coverage of maternal, newborn, and child health services in 54 Countdown countries

Cited by 242 publications

References 14 publications

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Trends in sociodemographic and health-related indicators in Bangladesh, 1993–2007: will inequities persist?

Assessment of Inequalities in Coverage of Essential Reproductive, Maternal, Newborn, Child, and Adolescent Health Interventions in Kenya

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