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. 2024 Nov;101(Suppl 1):57-67.
doi: 10.1007/s11524-024-00931-2. Epub 2024 Nov 22.

Trends in Coverage and Content of Maternal and Neonatal Care in Bamako, Mali

Mariam Traoré  1 , Djeneba Coulibaly  2   3 , Fatou Diawara  2   3 , Ibrahim Terera  2 , Haoua Dembelé  2 , Ababacar I Maiga  2   3 , Akory Ag Iknane  2   3 , Abdoulaye Maïga  4 , Agbessi Amouzou  4
Affiliations

Trends in Coverage and Content of Maternal and Neonatal Care in Bamako, Mali

Mariam Traoré et al. J Urban Health. 2024 Nov.

Abstract

Coverage levels of maternal and neonatal health services in Mali's major cities vary due to the combined effect of several factors, including poverty and migration to urban centers. This worsened from 2012 due to the security crisis. We conducted an analysis of the trends and differences in several indicators of maternal and neonatal care coverage in Bamako using secondary data from Mali's Demographic and Health Surveys from 2001 to 2018. Our results highlighted differential access to antenatal and childbirth care for non-poor and non-migrant women compared to their counterparts categorized as poor and migrant. The gaps were much larger depending on migration status (i.e., number of years since resettling in Bamako) and even tended to increase over time. This was particularly the case regarding the number of antenatal visits (ANC 4+), with differences according to poverty level at 7 percentage points in 2001 and 8.3 percentage points in 2018. Migration status showed even larger gaps to the disadvantage of migrant women of 13.4 percentage points (2006) and 24.4 percentage points (2018). There is a higher proportion of cesarean section among non-poor women. The results suggested an opposite pattern for postnatal care of newborns, with a difference of 6.8 percentage points of coverage in favor of the poor in 2018. The high coverage of maternal and newborn health interventions in Bamako city conceals intra-urban disparities to the detriment of poor migrant women and those who recently migrated to the city, partly due to the conflicts and security issues. A redefinition of health programs to include such targets would be desirable from an equity perspective.

Keywords: Bamako; Care; Inequalities; Mother; Newborn.

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Figures

Map 1
Map 1
Administrative and health divisions of Bamako in 2018. CSCom, community health center; CSRef, referral health center. Source: INSP 2023
Fig. 1
Fig. 1
Coverage and content of maternal and neonatal care according to the status of poverty and migration in Bamako in 2018
Fig. 2
Fig. 2
Trends in coverage and content of maternal and neonatal care by poverty status from 2001 to 2018 in Bamako, Mali
Fig. 3
Fig. 3
Trends and inequalities in coverage and quality of maternal care by migration status in 2006 and 2018 in Bamako
Fig. 4
Fig. 4
Trends and inequalities in coverage and quality of maternal care by duration of migration in 2006 and 2018 in Bamako
See this image and copyright information in PMC

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