Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors
Introduction Universal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding of national progress and how socioeconomic and de...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-01-01
|
| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/1/e002230.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850214802493800448 |
|---|---|
| author | Inácio Crochemore Mohnsam da Silva Margaret E Kruk Purnima Menon Chika Hayashi Doris Chou Ties Boerma Jennifer Requejo Allisyn Moran Honorati Masanja Shams El Arifeen Liliana Carvajal-Aguirre Youssouf Keita Hannah Leslie Abdoulaye Maïga Safia S Jiwani Agbessi Amouzou Lara M E Vaz Robert Black Liliana Carvajal-Valez Monica Fox Sennen Hounton Safia S. Jiwani Lois Park Lara ME Vaz Shelley Walton Bill Weiss |
| author_facet | Inácio Crochemore Mohnsam da Silva Margaret E Kruk Purnima Menon Chika Hayashi Doris Chou Ties Boerma Jennifer Requejo Allisyn Moran Honorati Masanja Shams El Arifeen Liliana Carvajal-Aguirre Youssouf Keita Hannah Leslie Abdoulaye Maïga Safia S Jiwani Agbessi Amouzou Lara M E Vaz Robert Black Liliana Carvajal-Valez Monica Fox Sennen Hounton Safia S. Jiwani Lois Park Lara ME Vaz Shelley Walton Bill Weiss |
| author_sort | Inácio Crochemore Mohnsam da Silva |
| collection | DOAJ |
| description | Introduction Universal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding of national progress and how socioeconomic and demographic subgroups of women and children are being reached by health interventions.Methods We accessed coverage databases produced by the International Centre for Equity in Health, which were based on reanalysis of Demographic and Health Surveys, Multiple Indicator Cluster Surveys and Reproductive and Health Surveys. We limited the data to 58 countries with at least two surveys since 2008. We fitted multilevel linear regressions of coverage of RMNCH, divided into four main components—reproductive health, maternal health, child immunisation and child illness treatment—to estimate the average annual percentage point change (AAPPC) in coverage for the period 2008–2017 across these countries and for subgroups defined by maternal age, education, place of residence and wealth quintiles. We also assessed change in the pace of coverage progress between the periods 2000–2008 and 2008–2017.Results Progress in RMNCH coverage has been modest over the past decade, with statistically significant AAPPC observed only for maternal health (1.25, 95% CI 0.90 to 1.61) and reproductive health (0.83, 95% CI 0.47 to 1.19). AAPPC was not statistically significant for child immunisation and illness treatment. Progress, however, varied largely across countries, with fast or slow progressors spread throughout the low-income and middle-income groups. For reproductive and maternal health, low-income and lower middle-income countries appear to have progressed faster than upper middle-income countries. For these two components, faster progress was also observed in older women and in traditionally less well-off groups such as non-educated women, those living in rural areas or belonging to the poorest or middle wealth quintiles than among groups that are well off. The latter groups however continue to maintain substantially higher coverage levels over the former. No acceleration in RMNCH coverage was observed when the periods 2000–2008 and 2008–2017 were compared.Conclusion At the dawn of the SDGs, progress in coverage in RMNCH remains insufficient at the national level and across equity dimensions to accelerate towards UHC by 2030. Greater attention must be paid to child immunisation to sustain the past gains and to child illness treatment to substantially raise its coverage across all groups. |
| format | Article |
| id | doaj-art-c534cd30cf7244e7ab32d2752857d2c6 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-c534cd30cf7244e7ab32d2752857d2c62025-08-20T02:08:47ZengBMJ Publishing GroupBMJ Global Health2059-79082020-01-015110.1136/bmjgh-2019-002230Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressorsInácio Crochemore Mohnsam da Silva0Margaret E Kruk1Purnima Menon2Chika HayashiDoris ChouTies Boerma3Jennifer RequejoAllisyn MoranHonorati Masanja4Shams El Arifeen5Liliana Carvajal-Aguirre6Youssouf Keita7Hannah Leslie8Abdoulaye Maïga9Safia S Jiwani10Agbessi Amouzou11Lara M E Vaz12Robert Black13Liliana Carvajal-ValezMonica FoxSennen HountonSafia S. Jiwani14Lois ParkLara ME VazShelley WaltonBill WeissInternational Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, RS, BrazilDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USAPoverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USACommunity Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Dar es Salaam, United Republic of TanzaniaMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, BangladeshData and Analytics Section, UNICEF, New York, New York, USA9 Innovation & Learning, Muso, Bamako, MaliGlobal Health and Population, University of California San Francisco, San Francisco, California, USAInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAJohns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAGlobal Health, Save the Children, Washington DC, District of Columbia, USAInternational Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAInternational Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAIntroduction Universal Health Coverage (UHC) is a critical goal under the Sustainable Development Goals (SDGs) for health. Achieving this goal for reproductive, maternal, newborn and child health (RMNCH) service coverage will require an understanding of national progress and how socioeconomic and demographic subgroups of women and children are being reached by health interventions.Methods We accessed coverage databases produced by the International Centre for Equity in Health, which were based on reanalysis of Demographic and Health Surveys, Multiple Indicator Cluster Surveys and Reproductive and Health Surveys. We limited the data to 58 countries with at least two surveys since 2008. We fitted multilevel linear regressions of coverage of RMNCH, divided into four main components—reproductive health, maternal health, child immunisation and child illness treatment—to estimate the average annual percentage point change (AAPPC) in coverage for the period 2008–2017 across these countries and for subgroups defined by maternal age, education, place of residence and wealth quintiles. We also assessed change in the pace of coverage progress between the periods 2000–2008 and 2008–2017.Results Progress in RMNCH coverage has been modest over the past decade, with statistically significant AAPPC observed only for maternal health (1.25, 95% CI 0.90 to 1.61) and reproductive health (0.83, 95% CI 0.47 to 1.19). AAPPC was not statistically significant for child immunisation and illness treatment. Progress, however, varied largely across countries, with fast or slow progressors spread throughout the low-income and middle-income groups. For reproductive and maternal health, low-income and lower middle-income countries appear to have progressed faster than upper middle-income countries. For these two components, faster progress was also observed in older women and in traditionally less well-off groups such as non-educated women, those living in rural areas or belonging to the poorest or middle wealth quintiles than among groups that are well off. The latter groups however continue to maintain substantially higher coverage levels over the former. No acceleration in RMNCH coverage was observed when the periods 2000–2008 and 2008–2017 were compared.Conclusion At the dawn of the SDGs, progress in coverage in RMNCH remains insufficient at the national level and across equity dimensions to accelerate towards UHC by 2030. Greater attention must be paid to child immunisation to sustain the past gains and to child illness treatment to substantially raise its coverage across all groups.https://gh.bmj.com/content/5/1/e002230.full |
| spellingShingle | Inácio Crochemore Mohnsam da Silva Margaret E Kruk Purnima Menon Chika Hayashi Doris Chou Ties Boerma Jennifer Requejo Allisyn Moran Honorati Masanja Shams El Arifeen Liliana Carvajal-Aguirre Youssouf Keita Hannah Leslie Abdoulaye Maïga Safia S Jiwani Agbessi Amouzou Lara M E Vaz Robert Black Liliana Carvajal-Valez Monica Fox Sennen Hounton Safia S. Jiwani Lois Park Lara ME Vaz Shelley Walton Bill Weiss Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors BMJ Global Health |
| title | Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors |
| title_full | Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors |
| title_fullStr | Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors |
| title_full_unstemmed | Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors |
| title_short | Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors |
| title_sort | closing the inequality gaps in reproductive maternal newborn and child health coverage slow and fast progressors |
| url | https://gh.bmj.com/content/5/1/e002230.full |
| work_keys_str_mv | AT inaciocrochemoremohnsamdasilva closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT margaretekruk closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT purnimamenon closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT chikahayashi closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT dorischou closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT tiesboerma closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT jenniferrequejo closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT allisynmoran closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT honoratimasanja closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT shamselarifeen closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT lilianacarvajalaguirre closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT youssoufkeita closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT hannahleslie closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT abdoulayemaiga closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT safiasjiwani closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT agbessiamouzou closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT laramevaz closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT robertblack closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT lilianacarvajalvalez closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT monicafox closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT sennenhounton closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT safiasjiwani closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT loispark closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT laramevaz closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT shelleywalton closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors AT billweiss closingtheinequalitygapsinreproductivematernalnewbornandchildhealthcoverageslowandfastprogressors |