Global health inequality and women – beyond maternal health

Myatra, Sheila Nainan; Tripathy, Swagata; Einav, Sharon

doi:10.1111/anae.15431

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…Globally, women suffer from healthcare inequalities, which lead to excess mortality in all periods of life. 8 Maternal health service refers to providing health service to women during pregnancy, childbearing and postpartum period, and includes antenatal care visits, delivery care and postnatal care services. 9 Although Sustainable Development Goal (SDG) target 3.8 aims to provide universal health coverage, 400 million people in the world lack access to essential health services.…”

Section: Introductionmentioning

confidence: 99%

Determinants of accessing healthcare in Sub-Saharan Africa: a mixed-effect analysis of recent Demographic and Health Surveys from 36 countries

et al. 2022

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ObjectiveThis study aimed to assess the determinants of accessing healthcare among reproductive-age women in Sub-Saharan Africa (SSA).Design, setting and analysisCross-sectional data were sourced from recent Demographic and Health Surveys in 36 SSA countries. We employed mixed-effect analysis to identify the determinants of accessing healthcare in SSA. OR and its 95% CI were reported for determinants associated with accessing healthcare.OutcomeThe outcome for this study was whether accessing healthcare was a ‘big problem’ or ‘not a big problem’. Responses to these questions were categorised as a big problem and not a big problem.ParticipantsA total weighted sample of 500 439 reproductive-age (15–49 years) women from each country’s recent Demographic and Health Surveys from 2006 to 2018 were included in this study.ResultsThe pooled prevalence of healthcare access among reproductive-age women in SSA was 42.56% (95% CI 42.43% to 42.69%). The results of the mixed-effect analysis revealed that the determinants of accessing healthcare were urban residence (adjusted OR (AOR)=1.25, 95% CI 1.34 to 1.73), ability to read and write (AOR=1.15, 95% CI 1.22 to 1.28), primary education (AOR=1.08, 95% CI 1.07 to 1.12), secondary education and above (AOR=1.12, 95% CI 1.10 to 1.14), husband with primary education (AOR=1.06, 95% CI 1.07 to 1.1.12), husband with secondary education and above (AOR=1.22, 95% CI 1.18 to 1.27), middle wealth index (AOR=1.43, 95% CI 1.40 to 1.47), rich wealth index (AOR=2.19, 95% CI 2.13 to 2.24) and wanted pregnancy (AOR=1.27, 95% CI 1.19 to 1.29).ConclusionHealthcare access in SSA was found at 42.56%, which is very low even if Sustainable Development Goal 3.8 targeted universal health coverage for everyone so they can obtain the health services they need. The major determinants of healthcare access among reproductive-age women in SSA were urban residence, higher educational level, higher wealth index and wanted pregnancy. The findings of this study suggest and recommend strengthening and improving healthcare access for women who reside in the countryside, women with low level of education and women of low socioeconomic status.

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Section: Introductionmentioning

confidence: 99%

Determinants of accessing healthcare in Sub-Saharan Africa: a mixed-effect analysis of recent Demographic and Health Surveys from 36 countries

et al. 2022

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“…However, socioeconomic inequality in maternal mortality was concentrated among women with lower educational status, coinciding with the findings of similar studies. 28,30 For example, maternal mortality has been distributed unequally among women with lower educational status, which indicates that promoting health literacy is imperative. 33 In addition, if education-related inequalities in maternal mortality had been averted, maternal mortality could have been significantly reduced.…”

Section: Discussionmentioning

confidence: 99%

“…29 Moreover, as substantial and persistent geographical and socioeconomic inequalities remain, many of the sociodemographic groups are far from achieving the national and international goals for the year 2030. 30 A study conducted in Tanzania evidenced that there was a huge wealth-based inequality gap in maternal healthcare provision among the poor and rich women. Therefore, addressing this gap could call for integrated equity-oriented policy interventions.…”

Section: Discussionmentioning

confidence: 99%

Geographical and Socioeconomic Inequalities in Maternal Mortality in Ethiopia

Borde

2023

International Journal of Social Determinants of Health and Heal

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In Ethiopia, social inequalities are common among women residing in deprived communities and between the poor and the rich. This study aimed to assess geographical and socioeconomic inequalities in maternal mortality using nationally representative data from Ethiopian Demographic and Health Surveys conducted from 2000 to 2019 (inclusive). Four health-related geographical and socioeconomic factors were assessed. Four relative and absolute health-related inequality measures were also used: rate difference, rate ratio, population attributable risk, and population attributable fraction. A total of 61,610 sister siblings were included. The highest reported inequalities in maternal mortality were residence-related (46% in 2005 among rural women), region-related (66% in 2005 among women in Beshangul–Gumuz regional state), education-related (83% in 2011 among women with primary education), and wealth-related (47% in 2000 among poorer women). So, if education-related inequalities in maternal mortality alone had been averted, the national maternal mortality could have been reduced by 52% in 2000, 51% in 2005, 83% in 2011, and 76% in 2016. In conclusion, inequalities in maternal mortality were high and concentrated among poorer women, women with lower educational status, and rural areas. Therefore, reducing the effects of poverty including social determinants of maternal mortality is recommended.

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“…Consequently, this paper addresses women’s experiences accessing physical healthcare, mental healthcare, accessing both healthcare systems, as well as the impact of diagnosis and illness on their identities and how they navigate the impact of their health needs on their lives. While there is ample literature on women’s health as related to childbearing, there is a need to go beyond seeing women’s unique needs as only related to reproductive capacity ( 14 ), and instead focus on what women themselves say is important. This paper addresses this gap in the literature.…”

Section: Introductionmentioning

confidence: 99%

“I have to fight for them to investigate things”: a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness

Zirnsak,

Elwyn,

McLoughlan

et al. 2024

Front. Public Health

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IntroductionWomen play a significant role in the management of their own healthcare and that of others, however women diagnosed with mental illness and physical health concerns experience significant health inequalities as compared to people living without mental health concerns.MethodsIn this paper, we reflect on the experiences of 20 cis women diagnosed with mental and physical health concerns who agreed to be a part of this research. This qualitative study is part of the larger Healthtalk Australia research project which was not gender specific. Female participants shared many experiences of mental and physical healthcare in interviews with researchers that pointed to the need for a gendered approach to addressing health inequalities. Consequently, we iteratively consolidated transcripts of interviews with participants into thematic categories facilitated by NVIVO 12.ResultsWe identified two broad themes and a set of subthemes: in the doctor’s office – experience of labelling; negotiating medications; and interactions with physical and mental health, and outside the doctor’s office – responses to trauma, financial concerns, and reliance on participant’s internal resources to get healthcare needs met.DiscussionWe conclude that participants in this study undertook significant work to manage their own healthcare needs, despite being challenged by clinicians and systems that failed to see them as whole people with expertise regarding their own health.

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Global health inequality and women – beyond maternal health

Cited by 8 publications

References 22 publications

Determinants of accessing healthcare in Sub-Saharan Africa: a mixed-effect analysis of recent Demographic and Health Surveys from 36 countries

Determinants of accessing healthcare in Sub-Saharan Africa: a mixed-effect analysis of recent Demographic and Health Surveys from 36 countries

Geographical and Socioeconomic Inequalities in Maternal Mortality in Ethiopia

“I have to fight for them to investigate things”: a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness

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