Characterizing ‘health equity’ as a national health sector priority for maternal, newborn, and child health in Ethiopia

Bergen, Nicole; Rückert, Arne; Abebe, Lakew; Asfaw, Shifera; Kiros, Getachew; Mamo, Abebe; Sudhakar, Morankar; Kulkarni, Manisha A.; Labonté, Ronald

doi:10.1080/16549716.2020.1853386

Cited by 8 publications

(4 citation statements)

References 35 publications

(34 reference statements)

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“…Inequality in health refers to the systematic differences in health across population subgroups based on underlying socioeconomic, demographic, political and geographical factors and modifiable through appropriate intervention. [36][37][38] The most popular approaches to quantify living standard are income and consumption measures. 39 However, in the absence of such measures, we used wealth index as proxy of living standard variable at household level and used it to measure inequality.…”

Section: Inequality Measurementmentioning

confidence: 99%

Predictors of health insurance enrolment and wealth-related inequality in Nepal: evidence from Multiple Indicator Cluster Survey (MICS) 2019

Bhusal¹,

Sapkota

2021

BMJ Open

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ObjectivesWe analysed predictors of health insurance enrolment in Nepal, measured wealth-related inequality and decomposed inequality into its contributing factors.DesignCross-sectional study.SettingWe used nationally representative data based on Nepal Multiple Indicator Cluster Survey 2019. Out of 10 958 households included in this study, 6.95% households were enroled in at least one health insurance scheme.Primary outcomemeasures health insurance (of any type) enrolment.ResultsHouseholds were more likely to have health insurance membership when household head have higher secondary education or above compared with households without formal education (adjusted OR 1.87; 95% CI: 1.32 to 2.64)). Households with mass media exposure were nearly three times more likely to get enroled into the schemes compared with their counterparts (adjusted OR 2.96; 95% CI 2.03 to 4.31). Hindus had greater odds of being enroled (adjusted OR 1.82; 95% CI 1.20 to 2.77) compared with non-Hindus. Dalits were less likely to get enroled compared with Brahmin, Chhetri and Madhesi (adjusted OR 0.66; 95% CI 0.47 to 0.94). Households from province 2, Bagmati and Sudurpaschim were less likely to have membership compared with households from province 1. Households from Richer and Richest wealth quintiles were more than two times more likely to have health insurance membership compared with households from the poorest wealth quintile. A positive concentration index 0.25 (95% CI 0.21 to 0.30; p<0.001) indicated disproportionately higher health insurance enrolment among wealthy households.ConclusionsEducation of household head, exposure to mass media, religious and ethnic background, geographical location (province) and wealth status were key predictors of health insurance enrolment in Nepal. There was a significant wealth-related inequality in health insurance affiliation. The study recommends regular monitoring of inequality in health insurance enrolment across demographic and socioeconomic groups to ensure progress towards Universal Health Coverage.

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Section: Inequality Measurementmentioning

confidence: 99%

Predictors of health insurance enrolment and wealth-related inequality in Nepal: evidence from Multiple Indicator Cluster Survey (MICS) 2019

Bhusal¹,

Sapkota

2021

BMJ Open

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“…Successful financing models prioritize quality of care and equity in healthcare access, ensuring that all women, regardless of socioeconomic status, geographic location, or other factors, have access to essential maternal health services. By addressing disparities in healthcare access and outcomes, these models contribute to reducing maternal mortality rates and advancing gender equality goals (Bergen, 2020).…”

Section: Lessons Learned and Best Practicesmentioning

confidence: 99%

Financing Models for Global Health Initiatives: Lessons From Maternal and Gender Equality Programs

Kevin Namiiro Kuteesa,

Chidiogo Uzoamaka Akpuokwe,

Chioma Ann Udeh

2024

imsrj

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Financing models play a pivotal role in sustaining and advancing global health initiatives, particularly those aimed at addressing maternal health and promoting gender equality. This review provides a comprehensive overview of financing strategies employed in such initiatives, drawing insights from successful programs and highlighting key lessons learned. Maternal health remains a critical area of concern worldwide, with millions of women facing risks during pregnancy and childbirth. Gender disparities exacerbate these challenges, further underscoring the importance of targeted interventions. Financing models for maternal health initiatives have evolved over the years, with a shift towards innovative approaches that prioritize sustainability and scalability. One prominent financing model is the use of public-private partnerships (PPPs), which leverage resources from both governmental and non-governmental entities. These partnerships facilitate greater efficiency in resource allocation and enable the mobilization of additional funding streams. Examples such as the Global Financing Facility (GFF) demonstrate how PPPs have catalyzed investments in maternal health, leading to tangible improvements in access to quality care. Furthermore, results-based financing (RBF) mechanisms have gained traction in incentivizing the achievement of specific health outcomes. Through performance-based incentives, RBF encourages healthcare providers to deliver high-quality services while ensuring accountability and transparency. Initiatives like the World Bank's RBF programs have shown promising results in enhancing maternal health outcomes and narrowing gender gaps in access to healthcare. Additionally, innovative financing mechanisms such as social impact bonds (SIBs) and development impact bonds (DIBs) offer new avenues for mobilizing private capital towards maternal and gender equality programs. By aligning financial returns with social impact goals, these instruments attract investors seeking both financial and social returns, thereby diversifying funding sources and promoting sustainability. Financing models for global health initiatives targeting maternal and gender equality programs are diverse and dynamic, reflecting the multifaceted nature of these challenges. Lessons learned from successful initiatives underscore the importance of collaboration, innovation, and adaptability in achieving sustainable progress towards maternal health and gender equality goals on a global scale. Keywords: Finance, Models, Global Health, Maternal, Gender Equity, Review.

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“…Equitable care is a priority for the Ethiopian Ministry of Health [13]. However, equity analyses based on the nationally representative DHS are based on relatively long periods.…”

Section: Introductionmentioning

confidence: 99%

Wealth-based equity in essential newborn care practices in Ethiopia: a cross-sectional study

Delele,

Persson,

Alemu

et al. 2024

Preprint

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Background The World Health Organization has listed several newborn care practices as essential for health and survival. Reports from low-income countries, including Ethiopia, show inequities in practices but need more comprehensiveness. We aimed to analyze wealth-based equity of selected essential newborn care practices, i.e., skin-to-skin care, delayed bathing, proper cord care, and timely breastfeeding initiation among neonates born at health facilities and homes in Ethiopia. Methods The Performance Monitoring for Action Ethiopia 2019–2020 survey was conducted in five Ethiopian regions, representing 90% of the total population. We used data on 2,493 newborns. Wealth quintiles were based on principal component analysis of household assets. Wealth-based equity of selected essential newborn care practices was analyzed separately for facility and home deliveries using equiplot, equity gaps, equity ratios, and concentration indices. Results Overall, the equiplots for skin-to-skin care and delayed bathing practices showed minimal inequities for babies born in health facilities. When comparing the extreme groups, socio-economic differences were seen in delayed bathing and timely breastfeeding initiation. Using wealth as a continuous variable across all respondents, delayed bathing and proper cord care were more frequent in the better-off households. In home births, the equiplots showed that all selected essential newborn care practices were more common in the least poor groups. While comparing the extreme groups, socio-economic inequities were present in skin-to-skin care and delayed bathing practices. Using wealth as a continuous variable, skin-to-skin care and delayed bathing were more common in better-off households. Conclusion The coverage of selected essential newborn care practices was higher in facility deliveries. There were minimal socio-economic differences in newborn care of facility births, while inequities in skin-to-skin care and delayed bathing were prominent in home births. Initiatives should focus on increasing facility delivery and improving newborn care practices at home to ensure newborn care equity in Ethiopia.

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Characterizing ‘health equity’ as a national health sector priority for maternal, newborn, and child health in Ethiopia

Cited by 8 publications

References 35 publications

Predictors of health insurance enrolment and wealth-related inequality in Nepal: evidence from Multiple Indicator Cluster Survey (MICS) 2019

Predictors of health insurance enrolment and wealth-related inequality in Nepal: evidence from Multiple Indicator Cluster Survey (MICS) 2019

Financing Models for Global Health Initiatives: Lessons From Maternal and Gender Equality Programs

Wealth-based equity in essential newborn care practices in Ethiopia: a cross-sectional study

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