Exploring wealth-related inequalities in maternal and child health coverage in Latin America and the Caribbean

Manuel Colomé-Hidalgo,Ángel Gil De Miguel,Juan Donado Campos

doi:10.1186/s12889-020-10127-3

Manuel Colomé-Hidalgo, Ángel Gil De Miguel + Show 1 more

Open Access

https://doi.org/10.1186/s12889-020-10127-3

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Abstract

BackgroundMaternal and child health have shown important advances in the world in recent years. However, national averages indicators hide large inequalities in access and quality of care in population subgroups. We explore wealth-related inequalities affecting health coverage and interventions in reproductive, maternal, newborn, and child health in Latin America and the Caribbean.MethodsWe analyzed representative national surveys from 15 countries conducted between 2001 and 2016. We estimated maternal-child health coverage gaps using the Composite Coverage Index – a weighted average of interventions that include family planning, maternal and newborn care, immunizations, and treatment of sick children. We measured absolute and relative inequality to assess gaps by wealth quintile. Pearson’s correlation coefficient was used to test the association between the coverage gap and population attributable risk.ResultsThe Composite Coverage Index showed patterns of inequality favoring the wealthiest subgroups. In eight countries the national coverage was higher than the global median (78.4%; 95% CI: 73.1–83.6) and increased significantly as inequality decreased (Pearson r = 0.9; p < 0.01).ConclusionsThere are substantial inequalities between socioeconomic groups. Reducing inequalities will improve coverage indicators for women and children. Additional health policies, programs, and practices are required to promote equity.

Highlights

Maternal and child health have shown important advances in the world in recent years
This was a descriptive study based on secondary RMNC H coverage data obtained from the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) software version 3.1 [13]
The Composite Coverage Index (CCI) is a weighted score based on aggregate estimates of eight essential interventions for the continuum of care for women and children, from before pregnancy to delivery, the immediate postnatal period, and childhood [7, 15]

Summary

Introduction

Maternal and child health have shown important advances in the world in recent years. National averages indicators hide large inequalities in access and quality of care in population subgroups. We explore wealth-related inequalities affecting health coverage and interventions in reproductive, maternal, newborn, and child health in Latin America and the Caribbean. The Millennium Development Goals (MDGs) contributed enormously to the health of women and children, managing to reduce maternal and under-5 years’ old mortality and improved other indicators such as access to contraceptives, skilled attendance at childbirth, and measles vaccination [2]. The SDG-3.8 promotes universal health coverage in terms of access to quality healthcare services, medicines, and vaccines for all [5]. More granular analysis of indicators can show whether all subgroups of the population will benefit from national progress or not [6].

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