Abstract

BackgroundInequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania.MethodsWe used the Lives Saved Tool (LiST) to estimate potential reductions in maternal and child mortality and the number of lives saved across wealth quintiles and between rural and urban settings. High impact maternal and child health interventions were modelled for a five-year scale up, by linking intervention coverage, effectiveness and cause of mortality using data from Tanzania. Concentration curves were drawn and the concentration index estimated to measure the equity impact of the scale up.ResultsIn the poorest population quintiles in Tanzania, the lives of more than twice as many mothers and under-fives were likely to be saved, compared to the richest quintile. Scaling up coverage to equal levels across quintiles would reduce inequality in maternal and child mortality from a pro rich concentration index of −0.11 (maternal) and −0.12 (children) to a more equitable concentration index of −0,03 and −0.03 respectively. In rural areas, there would likely be an eight times greater reduction in maternal deaths than in urban areas and a five times greater reduction in child deaths than in urban areas.ConclusionsScaling up priority maternal and child health interventions to equal levels would potentially save far more lives in the poorest populations, and would accelerate equitable progress towards maternal and child health MDGs.

Highlights

  • Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals

  • In case national targets were lower than the current Tanzania Demographic and Health Survey (TDHS) 2010 coverage levels in any of the sub-national or socioeconomic groups, TDHS data were used as endpoint coverage

  • That corresponds to a reduction in inequality from a pro rich concentration index of −0.11 to a more equitable concentration index of −0.03

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Summary

Introduction

Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania. In Tanzania, Inequity in access to and use of child and maternal health interventions has been highlighted as hindering progress towards child and maternal health MDGs [5]. In the least developed countries accounting for more than 90 percent of maternal and child mortality globally, there is inequity in coverage of key health interventions, with a country mean coverage gap of 43 among the poorest and wealthiest quintiles of the population [7]. It is important to generate evidence about inequity that can inform decision making and priority setting

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