Analysis of maternal and child health indicators: the composite coverage index (CCI) used in Guinea from 2012 to 2018

Abstract

Introduction The composite coverage index (CCI) is the weighted average coverage of eight preventive and curative interventions received along the maternal and child care continuum. We analysed maternally and child health indicators using CCI.Methods We performed a secondary analysis of demographic and health surveys (DHS) focused on women aged 15 to 49 and children aged 1 to 4. The CCI is optimal if the weighted proportion of interventions is less than 50%; otherwise, it is partial. We identified the factors associated with CCI using the following statistics: the Wilcoxon rank-sum test for complex survey samples, the chi-squared tests of Rao & Scott’s second-order correction, and the spatial autocorrelation statistic and the multivariate logistic regression.Results The optimal coverage of the ICC has increased from 43% in 2012 to 61% in 2018. In multivariate analysis, in 2012: the poor had a lower probability of having an optimal CCI than the richest; OR=0.11 [95% CI; 0.07, 0.18]. Those who had done four antenatal care visits (ANC) were 2.78 times more likely to have an optimal CCI than those with less OR=2.78 [95% CI;2.24, 3.45]. In 2018: the poor had a lower probability of having an optimal CCI than the richest OR=0.27 [95% CI; 0.19, 0.38]. Women who planned their pregnancies were 28% more likely to have an optimal CCI than those who had not planned OR= 1.28 [95% CI;1.05, 1.56]. Finally, women with more than 4 ANC were 2.43 times more likely to have an optimal CCI than those with the least OR = 2.43 [95% CI; 2.03, 2.90]. The spatial analysis reveals significant disparities with an aggregation of high partial ICC in Labé between 2012 and 2018.ConclusionThis study showed an increase in CCI between 2012 and 2018. Policies should improve access to care and information for poor women. Besides, strengthening ANC visits and reducing regional inequalities will increase optimal CCI.