Disparities in maternal health services in sub-Saharan Africa

Abstract

Objectives: To examine the progress of and disparities in the provision of key maternal health services in the sub-Saharan Africa (SSA) region.

Methods: A time-trend analysis of disparities in antenatal care (ANC) and skilled birth attendance (SBA) coverage in SSA over the last 25 years was conducted. The average values of each country's 5-year period data were used for analysis. Absolute and relative disparities were examined by time period, economic class, geographic group and clusters. Analysis of variance was used to compare progresses in coverage across time.

Results: Regional median ANC coverage and SBA increased by 8% points and 15% points, respectively, during the 25-year period. The rank score of SBA has shown significant improvement only in the recent period. A 33.3% disparity between ANC and SBA was observed in the most recent period. The relative disparity by economic class and cluster was higher for SBA than ANC coverage.

Conclusions: The region showed improvement in both indicators across time. Regional disparity in ANC narrowed down while that of SBA remained high. These were mainly associated with economic class and cluster of countries.

Keywords: Antenatal care; Disparity; Skilled birth attendance; Sub-Saharan Africa.