­SDG3-Related Inequalities in Women’s, Children’s, and Adolescents’ Health: A Baseline for Latin America and the Caribbean

Abstract

Background: Latin American and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal targets related to health (SDG3) at the national level. However, vast socioeconomic inequalities in health remain within countries. There is an urgent need for baseline data on inequalities against which progress towards the SDGs can be monitored. Methods: Data for 21 LAC countries were analyzed from Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Survey (MICS) carried out from 2011-2016. Related SDG3 indicators for women’s, children’s, and adolescents’ (WCA) health were computed. The analyses included stratification of indicators by household wealth quintiles, urban-rural residence, subnational regions and, when applicable, women’s education and age, and sex of the child. Absolute and relative inequalities were assessed. Results: In most countries, subnational geographic health gradients were observed for nearly all WCA indicators. Coverage of key interventions was higher in urban areas and among the richest, compared to rural areas and poorer quintiles. Analyses by woman’s age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries. Interpretation: Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children, and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries. Funding Statement: The work was funded by the Pan American Health Organization (PAHO), who did not have any say in the design, analysis or writing. Declaration of Interests: None to declare Ethics Approval Statement: This manuscript is totally based in publicly available data and the ethical clearance and approval was obtained by the institutions responsible for the original studies.