Summary indices for monitoring universal coverage in maternal and child health care

Wehrmeister, Fernando César; Restrepo‐Méndez, María Clara; França, Giovanny Vinícius Araújo de; Victora, Cesar G; Barros, Aluísio J D

doi:10.2471/blt.16.173138

Cited by 62 publications

(107 citation statements)

References 14 publications

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“…The Composite Coverage Index (CCI) is a weighted score reflecting the coverage of the following eight preventive and curative Reproductive, Maternal, Neonatal and Child interventions (RMNCH) along the continuum of care-(1) demand for family planning satisfied (modern methods); (2) antenatal care coverage (at least four visits); (3) births attended to by skilled health personnel; (4) BCG immunization coverage among one-year-olds; (5) measles immunization coverage among one-year-olds; (6) DTP3 immunization coverage among one year-olds; (7) children aged less than five years with diarrhea receiving oral rehydration therapy and continued feeding; and (8) children aged less than five years with pneumonia symptoms taken to a health facility [12,13]. The interventions, although not directly linked to nutritional outcomes, are good proxies of access to health care, which is the entry point for most nutrition-specific interventions.…”

Section: Composite Coverage Indexmentioning

confidence: 99%

Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa

Baye

Laillou²,

Chitweke³

2020

Nutrients

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Stunting in children less than five years of age is widespread in Sub-Saharan Africa. We aimed to: (i) evaluate how the prevalence of stunting has changed by socio-economic status and rural/urban residence, and (ii) assess inequalities in children’s diet quality and access to maternal and child health care. We used data from nationally representative demographic and health- and multiple indicator cluster-surveys (DHS and MICS) to disaggregate the stunting prevalence by wealth quintile and rural/urban residence. The composite coverage index (CCI) reflecting weighed coverage of eight preventive and curative Reproductive, Maternal, Neonatal, and Child Health (RMNCH) interventions was used as a proxy for access to health care, and Minimum Dietary Diversity Score (MDDS) was used as a proxy for child diet quality. Stunting significantly decreased over the past decade, and reductions were faster for the most disadvantaged groups (rural and poorest wealth quintile), but in only 50% of the countries studied. Progress in reducing stunting has not been accompanied by improved equity as inequalities in MDDS (p < 0.01) and CCI (p < 0.001) persist by wealth quintile and rural-urban residence. Aligning food- and health-systems’ interventions is needed to accelerate stunting reduction more equitably.

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Section: Composite Coverage Indexmentioning

confidence: 99%

Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa

Baye

Laillou²,

Chitweke³

2020

Nutrients

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“…In middle income countries, the magnitude of the increase in coverage of that composite indicator was higher among the poor, when compared to the rich. 27 In the analysis of antenatal care in Brazil presented in this article, there are no significant differences, in terms of relative and absolute inequalities, in the evaluated indicators, between the years of 2006 and 2013 (Table 1).…”

Section: Trends In Inequalitiesmentioning

confidence: 75%

Mensuração de desigualdades sociais em saúde: conceitos e abordagens metodológicas no contexto brasileiro*

Silva

Restrepo‐Méndez

Costa

et al. 2018

Epidemiologia e Serviços de Saúde

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This study aims to describe methodological approaches to measure and monitor health inequalities and to illustrate their applicability. The measures most frequently used in the literature were reviewed. Data on coverage and quality of antenatal care in Brazil, from the Demographic and Maternal and Child Health Survey (PNDS-2006) and from the National Health Survey (PNS-2013), were used to illustrate their applicability. Absolute and relative measures of inequalities were presented, highlighting their complementary character. Despite the progress achieved at national level in antenatal care, important inequalities were still identified between population subgroups, with no change in the magnitude of the differences throughout the studied period. Brazil has important social inequalities, which consequently lead to health inequalities. Their description and monitoring are highly relevant to support polices focused on those vulnerable population groups who have been left behind.

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“…As every sixth human being belongs to India, it is important that India must achieve SDG targets for global as well as regional accomplishment. The coverage of RMNCH interventions is crucial for the overall improvement of the health outcome in any population [16]. In this regard, several programs have been formulated to improve maternal and child health in aimed to improve the maternal and child health services coverage across all regions and among various population groups.…”

Section: Discussionmentioning

confidence: 99%

“…The 2015 countdown analysis, replaced by the countdown 2030, annually monitors the progress in the coverage indicators of the countdown countries at the national level [6,8,16]. Though there has been substantial progress achieved by many countries, the achievement was uneven and need more significant acceleration [6,[17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

District level inequality in reproductive, maternal, neonatal and child health coverage in India

2020

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Background: As India already missed maternal and child health related millennium development goals, the maternal and child health outcomes are a matter of concern to achieve sustainable development goals (SDGs). This study is focused to assess the gap in coverage and inequality of various reproductive, maternal, neonatal and child health (RMNCH) indicators in 640 districts of India, using data from most recent round of National Family Health Survey. Methods: A composite index named Coverage Gap Index (CGI) was calculated, as the weighted average of eight preventive maternal and child care interventions at different administrative levels. Bivariate and spatial analysis were used to understand the geographical diversity and spatial clustering in districts of India. A socio-economic development index (SDI) was also derived and used to assess the interlinkages between CGI and development. The ratio method was used to assess the socio-economic inequality in CGI and its component at the national level. Results: The average national CGI was 26.23% with the lowest in Kerala (10.48%) and highest in Nagaland (55.07%). Almost half of the Indian districts had CGI above the national average and mainly concentrated in high focus states and north-eastern part. From the geospatial analysis of CGI, 122 districts formed hotspots and 164 districts were in cold spot. The poorest households had 2.5 times higher CGI in comparison to the richest households and rural households have 1.5 times higher CGI as compared to urban households. Conclusion: Evidence from the study suggests that many districts in India are lagging in terms of CGI and prioritize to achieve the desired level of maternal and child health outcomes. Efforts are needed to reduce the CGI among the poorest and rural resident which may curtail the inequality.

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Summary indices for monitoring universal coverage in maternal and child health care

Cited by 62 publications

References 14 publications

Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa

Socio-Economic Inequalities in Child Stunting Reduction in Sub-Saharan Africa

Mensuração de desigualdades sociais em saúde: conceitos e abordagens metodológicas no contexto brasileiro*

District level inequality in reproductive, maternal, neonatal and child health coverage in India

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