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. 2016 Feb 12:16:51.
doi: 10.1186/s12913-016-1296-7.

Inequalities in utilization of maternal and child health services in Ethiopia: the role of primary health care

Solomon Tessema Memirie  1 , Stéphane Verguet  2 , Ole F Norheim  3 , Carol Levin  4 , Kjell Arne Johansson  3
Affiliations

Inequalities in utilization of maternal and child health services in Ethiopia: the role of primary health care

Solomon Tessema Memirie et al. BMC Health Serv Res. .

Abstract

Background: Health systems aim to narrow inequality in access to health care across socioeconomic groups and area of residency. However, in low-income countries, studies are lacking that systematically monitor and evaluate health programs with regard to their effect on specific inequalities. We aimed to measure changes in inequality in access to maternal and child health (MCH) interventions and the effect of Primary Health Care (PHC) facilities expansion on the inequality in access to care in Ethiopia.

Methods: The Demographic and Health Survey datasets from Ethiopia (2005 and 2011) were used. We calculated changes in utilization of MCH interventions and child morbidity. Concentration and horizontal inequity indices were estimated. Decomposition analysis was used to calculate the contribution of each determinant to the concentration index.

Results: Between 2005 and 2011, improvements in aggregate coverage have been observed for MCH interventions in Ethiopia. Wealth-related inequality has remained persistently high in all surveys. Socioeconomic factors were the main predictors of differences in maternal and child health services utilization and child health outcome. Utilization of primary care facilities for selected maternal and child health interventions have shown marked pro-poor improvement over the period 2005-2011.

Conclusions: Our findings suggest that expansion of PHC facilities in Ethiopia might have an important role in narrowing the urban-rural and rich-poor gaps in health service utilization for selected MCH interventions.

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References

    1. Victora CG, Barros AJD, Axelson H, Bhutta ZA, Chopra M, França G, et al. How changes in coverage affect equity in maternal and child health interventions in 35 countdown to 2015 countries: an analysis of national surveys. Lancet. 2012;380:1149–56. doi: 10.1016/S0140-6736(12)61427-5. - DOI - PubMed
    1. Gwatkin D, Rutstein S, Johnson K, Suliman E, Wagstaff A, Amozou A. Initial country-level information about socioeconomic differences in health, nutrition, and population. Washington: The World Bank; 2007. - PubMed
    1. Boerma JT, Bryce J, Kinfu Y, Axelson H, Victora CG. Mind the gap: equity and trends in coverage of maternal, newborn, and child health services in 54 Countdown countries. Lancet. 2008;371:1259–67. doi: 10.1016/S0140-6736(08)60560-7. - DOI - PubMed
    1. Moser KA, Leon DA, Gwatkin DR. How does progress towards the child mortality millennium development goal affect inequalities between the poorest and least poor? Analysis of Demographic and Health Survey data. BMJ. 2005;331(7526):1180–2. doi: 10.1136/bmj.38659.588125.79. - DOI - PMC - PubMed
    1. Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M, Habicht JP. Applying an equity lens to child health and mortality: more of the same is not enough. Lancet. 2003;362(9379):233–41. doi: 10.1016/S0140-6736(03)13917-7. - DOI - PubMed

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