Abstract
ABSTRACT Background: Maternal health care utilization is at the core of global public health provision and an area of focus in the now-concluded Millennium Development Goal agenda. Objective: This study aims to examine trends in maternal health care utilization over the last 15 years in Nepal, focusing on coverage and equity. Methods: This paper used data from the Demographic Health Survey (DHS) 2001, 2006 and 2011 and Multiple Indicator Cluster Survey (MICS), 2014. Coverage rates were calculated and logistic regression models used to examine inequity. Results: Impressive gains were found in antenatal care (ANC) attendance, which increased from nearly half of women attending (49%) in 2001 to 88% in 2014, and the rate of facility delivery increased from just 7–44%. This development did not, however, influence the equity gap in ANC and skilled attendance at birth, as women from low socioeconomic backgrounds were six times more likely to deliver without skilled assistance than those from high socioeconomic backgrounds (AdjOR 6.38 CI 95% 4.57–8.90) in 2014. Conclusion: These persistent equity gaps call for targeted interventions focusing on the most disadvantaged and vulnerable women in order to achieve the new Sustainable Development Goal of universal health coverage.
Highlights
Maternal health care utilization is at the core of global public health provision and an area of focus in the now-concluded Millennium Development Goal agenda
Impressive gains were found in antenatal care (ANC) attendance, which increased from nearly half of women attending (49%) in 2001 to 88% in 2014, and the rate of facility delivery increased from just 7–44%
These persistent equity gaps call for targeted interventions focusing on the most disadvantaged and vulnerable women in order to achieve the new Sustainable Development Goal of universal health coverage
Summary
Maternal health care utilization is at the core of global public health provision and an area of focus in the now-concluded Millennium Development Goal agenda. The Sustainable Development Goals (SDGs) are an attempt to follow up on the successful creation of a united direction shaped by the Millennium Development Goals (MDGs).[1] The third SDG deals with health and places an emphasis on universal health coverage (UHC),[1] implicitly encompassing the notion of an equitable distribution of health services and outcomes. Access to health is a more complex issue and encompasses the barriers faced by individuals and groups to reap the benefits of a health system offering universal coverage. [2] Access can be measured by utilization, assuming that all individuals would use good quality, acceptable and beneficial health services. The utilization of services becomes a suitable indicator of inequities within health systems and an important measure of how well the third SDG is implemented.[3]
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