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Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries

Summary Background Countdown to 2015 tracks progress towards achievement of Millennium Development Goals (MDGs) 4 and 5, with particular emphasis on within-country inequalities. We assessed how inequalities in maternal, newborn, and child health interventions vary by intervention and country. Method... Full description

Journal Title: The Lancet (British edition) 2012, Vol.379 (9822), p.1225-1233
Main Author: Barros, Aluísio JD, Dr
Other Authors: Ronsmans, Carine, Prof , Axelson, Henrik, MSc , Loaiza, Edilberto, PhD , Bertoldi, Andréa D, PhD , França, Giovanny VA, MSc , Bryce, Jennifer, EdD , Boerma, J Ties, MD , Victora, Cesar G, Prof
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: Kidlington: Elsevier Ltd
ID: ISSN: 0140-6736
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title: Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries
format: Article
creator:
  • Barros, Aluísio JD, Dr
  • Ronsmans, Carine, Prof
  • Axelson, Henrik, MSc
  • Loaiza, Edilberto, PhD
  • Bertoldi, Andréa D, PhD
  • França, Giovanny VA, MSc
  • Bryce, Jennifer, EdD
  • Boerma, J Ties, MD
  • Victora, Cesar G, Prof
subjects:
  • Abridged Index Medicus
  • Biological and medical sciences
  • Child Health Services - supply & distribution
  • Children
  • Cross-Cultural Comparison
  • Developing Countries
  • Equity
  • Female
  • General aspects
  • Global Health - statistics & numerical data
  • Health aspects
  • Health Care Service and Management, Health Policy and Services and Health Economy
  • Health Planning - statistics & numerical data
  • Health Sciences
  • Health services
  • Health Services Accessibility - statistics & numerical data
  • Health Services Research - statistics & numerical data
  • Healthcare Disparities - organization & administration
  • Healthcare Disparities - statistics & numerical data
  • Households
  • Humans
  • Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
  • Hälsovetenskap
  • Inequality
  • Infant, Newborn
  • Internal Medicine
  • Intervention
  • Maternal & child health
  • Maternal and infant welfare
  • Maternal-Child Health Centers - supply & distribution
  • Medical and Health Sciences
  • Medical sciences
  • Medicin och hälsovetenskap
  • Midwifery - statistics & numerical data
  • Pregnancy
  • Prenatal care
  • Prenatal Care - statistics & numerical data
  • Principal components analysis
  • Socioeconomic Factors
  • Studies
  • Surveys
  • Usage
  • Vaccines
  • Wellness programs
ispartof: The Lancet (British edition), 2012, Vol.379 (9822), p.1225-1233
description: Summary Background Countdown to 2015 tracks progress towards achievement of Millennium Development Goals (MDGs) 4 and 5, with particular emphasis on within-country inequalities. We assessed how inequalities in maternal, newborn, and child health interventions vary by intervention and country. Methods We reanalysed data for 12 maternal, newborn, and child health interventions from national surveys done in 54 Countdown countries between Jan 1, 2000, and Dec 31, 2008. We calculated coverage indicators for interventions according to standard definitions, and stratified them by wealth quintiles on the basis of asset indices. We assessed inequalities with two summary indices for absolute inequality and two for relative inequality. Findings Skilled birth attendant coverage was the least equitable intervention, according to all four summary indices, followed by four or more antenatal care visits. The most equitable intervention was early initation of breastfeeding. Chad, Nigeria, Somalia, Ethiopia, Laos, and Niger were the most inequitable countries for the interventions examined, followed by Madagascar, Pakistan, and India. The most equitable countries were Uzbekistan and Kyrgyzstan. Community-based interventions were more equally distributed than those delivered in health facilities. For all interventions, variability in coverage between countries was larger for the poorest than for the richest individuals. Interpretation We noted substantial variations in coverage levels between interventions and countries. The most inequitable interventions should receive attention to ensure that all social groups are reached. Interventions delivered in health facilities need specific strategies to enable the countries' poorest individuals to be reached. The most inequitable countries need additional efforts to reduce the gap between the poorest individuals and those who are more affluent. Funding Bill & Melinda Gates Foundation, Norad, The World Bank.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


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creatorBarros, Aluísio JD, Dr ; Ronsmans, Carine, Prof ; Axelson, Henrik, MSc ; Loaiza, Edilberto, PhD ; Bertoldi, Andréa D, PhD ; França, Giovanny VA, MSc ; Bryce, Jennifer, EdD ; Boerma, J Ties, MD ; Victora, Cesar G, Prof
creatorcontribBarros, Aluísio JD, Dr ; Ronsmans, Carine, Prof ; Axelson, Henrik, MSc ; Loaiza, Edilberto, PhD ; Bertoldi, Andréa D, PhD ; França, Giovanny VA, MSc ; Bryce, Jennifer, EdD ; Boerma, J Ties, MD ; Victora, Cesar G, Prof
descriptionSummary Background Countdown to 2015 tracks progress towards achievement of Millennium Development Goals (MDGs) 4 and 5, with particular emphasis on within-country inequalities. We assessed how inequalities in maternal, newborn, and child health interventions vary by intervention and country. Methods We reanalysed data for 12 maternal, newborn, and child health interventions from national surveys done in 54 Countdown countries between Jan 1, 2000, and Dec 31, 2008. We calculated coverage indicators for interventions according to standard definitions, and stratified them by wealth quintiles on the basis of asset indices. We assessed inequalities with two summary indices for absolute inequality and two for relative inequality. Findings Skilled birth attendant coverage was the least equitable intervention, according to all four summary indices, followed by four or more antenatal care visits. The most equitable intervention was early initation of breastfeeding. Chad, Nigeria, Somalia, Ethiopia, Laos, and Niger were the most inequitable countries for the interventions examined, followed by Madagascar, Pakistan, and India. The most equitable countries were Uzbekistan and Kyrgyzstan. Community-based interventions were more equally distributed than those delivered in health facilities. For all interventions, variability in coverage between countries was larger for the poorest than for the richest individuals. Interpretation We noted substantial variations in coverage levels between interventions and countries. The most inequitable interventions should receive attention to ensure that all social groups are reached. Interventions delivered in health facilities need specific strategies to enable the countries' poorest individuals to be reached. The most inequitable countries need additional efforts to reduce the gap between the poorest individuals and those who are more affluent. Funding Bill & Melinda Gates Foundation, Norad, The World Bank.
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descriptionSummary Background Countdown to 2015 tracks progress towards achievement of Millennium Development Goals (MDGs) 4 and 5, with particular emphasis on within-country inequalities. We assessed how inequalities in maternal, newborn, and child health interventions vary by intervention and country. Methods We reanalysed data for 12 maternal, newborn, and child health interventions from national surveys done in 54 Countdown countries between Jan 1, 2000, and Dec 31, 2008. We calculated coverage indicators for interventions according to standard definitions, and stratified them by wealth quintiles on the basis of asset indices. We assessed inequalities with two summary indices for absolute inequality and two for relative inequality. Findings Skilled birth attendant coverage was the least equitable intervention, according to all four summary indices, followed by four or more antenatal care visits. The most equitable intervention was early initation of breastfeeding. Chad, Nigeria, Somalia, Ethiopia, Laos, and Niger were the most inequitable countries for the interventions examined, followed by Madagascar, Pakistan, and India. The most equitable countries were Uzbekistan and Kyrgyzstan. Community-based interventions were more equally distributed than those delivered in health facilities. For all interventions, variability in coverage between countries was larger for the poorest than for the richest individuals. Interpretation We noted substantial variations in coverage levels between interventions and countries. The most inequitable interventions should receive attention to ensure that all social groups are reached. Interventions delivered in health facilities need specific strategies to enable the countries' poorest individuals to be reached. The most inequitable countries need additional efforts to reduce the gap between the poorest individuals and those who are more affluent. Funding Bill & Melinda Gates Foundation, Norad, The World Bank.
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1Biological and medical sciences
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4Cross-Cultural Comparison
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8General aspects
9Global Health - statistics & numerical data
10Health aspects
11Health Care Service and Management, Health Policy and Services and Health Economy
12Health Planning - statistics & numerical data
13Health Sciences
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15Health Services Accessibility - statistics & numerical data
16Health Services Research - statistics & numerical data
17Healthcare Disparities - organization & administration
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25Internal Medicine
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28Maternal and infant welfare
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30Medical and Health Sciences
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34Pregnancy
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37Principal components analysis
38Socioeconomic Factors
39Studies
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titleEquity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries
authorBarros, Aluísio JD, Dr ; Ronsmans, Carine, Prof ; Axelson, Henrik, MSc ; Loaiza, Edilberto, PhD ; Bertoldi, Andréa D, PhD ; França, Giovanny VA, MSc ; Bryce, Jennifer, EdD ; Boerma, J Ties, MD ; Victora, Cesar G, Prof
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11Health Care Service and Management, Health Policy and Services and Health Economy
12Health Planning - statistics & numerical data
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abstractSummary Background Countdown to 2015 tracks progress towards achievement of Millennium Development Goals (MDGs) 4 and 5, with particular emphasis on within-country inequalities. We assessed how inequalities in maternal, newborn, and child health interventions vary by intervention and country. Methods We reanalysed data for 12 maternal, newborn, and child health interventions from national surveys done in 54 Countdown countries between Jan 1, 2000, and Dec 31, 2008. We calculated coverage indicators for interventions according to standard definitions, and stratified them by wealth quintiles on the basis of asset indices. We assessed inequalities with two summary indices for absolute inequality and two for relative inequality. Findings Skilled birth attendant coverage was the least equitable intervention, according to all four summary indices, followed by four or more antenatal care visits. The most equitable intervention was early initation of breastfeeding. Chad, Nigeria, Somalia, Ethiopia, Laos, and Niger were the most inequitable countries for the interventions examined, followed by Madagascar, Pakistan, and India. The most equitable countries were Uzbekistan and Kyrgyzstan. Community-based interventions were more equally distributed than those delivered in health facilities. For all interventions, variability in coverage between countries was larger for the poorest than for the richest individuals. Interpretation We noted substantial variations in coverage levels between interventions and countries. The most inequitable interventions should receive attention to ensure that all social groups are reached. Interventions delivered in health facilities need specific strategies to enable the countries' poorest individuals to be reached. The most inequitable countries need additional efforts to reduce the gap between the poorest individuals and those who are more affluent. Funding Bill & Melinda Gates Foundation, Norad, The World Bank.
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