Sexual and reproductive health and rights in the sustainable development goals and the post-2015 development agenda: less than a year to go

Haslegrave, Marianne

doi:10.1016/s0968-8080(14)44812-2

Cited by 15 publications

(7 citation statements)

References 1 publication

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“…Despite the FHCI, Sierra Leone was unable to meet its target of the millennium development goals 4 and5 (MDG4 and MDG5) –reducing maternal mortality ratio to 450 per 100,000 births and child mortality to 95 per 1000 live births. The FHCI has since entered into the sustainable development goals (SDG) era with significant gaps in the health sector remaining to achieve SDG 3 – health and wellbeing for all [15, 16]. In Sierra Leone, the current neonatal and under-five mortality rates are at 39 and 156 deaths per 1000 live births respectively and the maternal mortality ratio is 1165 death per 10,000 live births [17].…”

Section: Introductionmentioning

confidence: 99%

Impact of the free healthcare initiative on wealth-related inequity in the utilization of maternal & child health services in Sierra Leone

Jalloh

Bah

James

et al. 2019

BMC Health Serv Res

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Background As a result of financial barriers to the utilization of Maternal and Child Health (MCH) services, the Government of Sierra Leone launched the Free Health Care Initiative (FHCI) in 2010. This study aimed to examine the impact of the FHCI on wealth related inequity in the utilization of three MCH services. Methods We analysed data from 2008 to 2013 Sierra Leone Demographic Health Surveys (SLDHS) using 2008 SLDHS as a baseline. Seven thousand three hundred seventy-four and 16,658 women of reproductive age were interviewed in the 2008 and 2013 SLDHS respectively. We employed a binomial logistic regression to evaluate wealth related inequity in the utilization of institutional delivery. Concentration curves and indices were used to measure the inequity in the utilization of antenatal care (ANC) visits and postnatal care (PNC) reviews. Test of significance was performed for the difference in odds and concentration indexes obtained for the 2008 and 2013 SLDHS. Results There was an overall improvement in the utilization of MCH services following the FHCI with a 30% increase in institutional delivery rate, 24% increment in more than four focused ANC visits and 33% increment in complete PNC reviews. Wealth related inequity in institutional delivery has increased but to the advantage of the rich, highly educated, and urban residents. Results of the inequity statistics demonstrate that PNC reviews were more equally distributed in 2008 than ANC visits, and, in 2013, the poorest respondents ranked by wealth index utilized more PNC reviews than their richest counterparts. For ANC visits, the change in concentration index was from 0.008331[95% CI (0.008188, 0.008474)] in 2008 to − 0.002263 [95% CI (− 0.002322, − 0.002204)] in 2013. The change in concentration index for PNC reviews was from − 0.001732 [95% CI (− 0.001746, − 0.001718)] in 2008 to − 0.001771 [95% CI (− 0.001779, − 0.001763)] in 2013. All changes were significant ( p value < 0.001). Conclusion The FHCI appears to be improving access to and utilization of MCH services, narrowing the inequity in ANC visits and PNC reviews, but is insufficient in addressing wealth- related inequity that exists for institutional deliveries. If Sierra Leone is to realize a significant reduction in maternal and child mortality rates, it needs to strengthen the effective implementation of FHCI considering incorporating a sector wide approach (SWAp) or a “Health in all Policy” framework to reach the less educated, rural residents and ensuring culturally sensitive quality services. Electronic supplementary material The online version of this article (10.1186/s12913-019-4181-3) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Impact of the free healthcare initiative on wealth-related inequity in the utilization of maternal & child health services in Sierra Leone

Jalloh

Bah

James

et al. 2019

BMC Health Serv Res

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“…The world is poised to adapt the Sustainable Development Goals (SDG), and the SDG 3.7 calls for universal access to family planning services to ensure healthy lives and well-being [ 1 ]. However, several developing countries including Pakistan step into the post MDG period with national health profile that requires attention [ 2 , 3 ]. The current estimates for Pakistan indicate that fertility rate decline has been slow, and current contraception use prevalence rate is 35%; unmet need of family planning is 20%, and fertility rate is 3.8 [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Socio-Economic Disparities in Use of Family Planning Methods among Pakistani Women: Findings from Pakistan Demographic and Health Surveys

et al. 2016

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BackgroundSeveral developing countries like Pakistan step into Sustainable Development Goals period with crucial maternal and child health needs that need to be addressed for improving health outcomes among people. We aim to explore existent socio-economic disparities in use of family planning methods (FPM) among Pakistani women, and compare any such inequalities between the years 2006 and 2013.SettingPakistan Demographic and Health Surveys (PDHS) 2006–7 (n = 9177) and the most recent 2012–13(n = 13558) data were used to conduct secondary analysis. Participants were ever married women aged between 15 and 49 years. Socio-economic status was assessed by the education level and wealth index. Inequalities were measured through Odds Ratio (OR), Relative Index of inequality (RII), and Slope index of inequality (SII) on non-use of FPM.ResultsAlthough the prevalence of FPM use has increased over time (28% in 2006 versus 54% in 2013), the socio-economic inequalities persistently exist. Comparing results of PDHS 2006 with PDHS 2013, education related absolute inequalities among urban dwellers increased from -0.41 (95% CI -0.67, -0.13, p-value < 0.01) to -0.83 (95% CI -1.02, -0.63, p-value < 0.01); and increased from -0.93 (95% CI -1.21, -0.64, p-value < 0.01) to -0.98 (95% CI -1.20, -0.76, p-value < 0.01) among rural dwellers. Similarly wealth related absolute inequalities are also existent.ConclusionsAlthough the FPM use has increased over time, but it is important to note that socio-economic gap in use of FPM persists. Such differences have disadvantaged the poor and the illiterate. Family planning programs may target the disadvantaged subgroups for ensuring well-being of women and children in Pakistan.

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“…There are great benefits of investing in FP including reduced maternal and neonatal mortality through decline in abortions and pregnancies (6). However, several developing countries including Uganda stepped into the post-millennium development goals (MDG) era with a national health profile that required substantial improvements, including access to FP services (7, 8). Furthermore, in 2019, over 190 million (10%) of married women were estimated to have an unmet need for FP where the prevalence was higher in Africa compared to other parts of the world (9).…”

Section: Introductionmentioning

confidence: 99%

Family planning uptake and its associated factors among women of reproductive age in Uganda: an insight from the Uganda Demographic and Health Survey 2016

Ochen¹,

Che

2022

Preprint

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Despite the government efforts to reduce the high fertility levels and increase uptake of family planning services in Uganda, family planning use was still low at 30% which is the lowest in the East African region. This study was undertaken to determine the prevalence and factors associated with the uptake of family planning methods among women of reproductive age in Uganda. This is a community-based cross-sectional study that utilized secondary data from the Uganda Demographic and Health Survey (UDHS) of 2016. The survey data was downloaded from the Measure Demographic Health Survey website after data use permission was granted. Data was collected from a representative sample of women of the reproductive age group (15-49 years) from all the 15 regions in Uganda. A total of 19,088 eligible women were interviewed but interviews were completed with 18,506 women. Data analysis was performed using SPSS statistical software version 32.0 where univariable, bivariable, and multivariable analyses were conducted. The prevalence of family planning use was found to be 29.3% and that of modern contraceptive use was found to be 26.6%. Multivariable analysis showed higher odds of current family planning use among older women (40-44 years) (aOR=2.09, 95% CI: 1.40-3.12); women who had attained the secondary level of education (aOR=1.91, 95% CI: 1.32-2.76); those living in households with the highest wealth index (aOR=1.87, 95% CI: 1.29-2.72); and awareness of the availability of family planning methods (aOR=1.41, 95% CI: 1.17-1.72). In conclusion, the study found a low prevalence of current family planning use among women of reproductive age and this calls for more efforts toward the advancement of women’s education, awareness creation, designing policies to popularize use of FP among adolescents and young women, and socio-economic empowerment of women.

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Sexual and reproductive health and rights in the sustainable development goals and the post-2015 development agenda: less than a year to go

Cited by 15 publications

References 1 publication

Impact of the free healthcare initiative on wealth-related inequity in the utilization of maternal & child health services in Sierra Leone

Impact of the free healthcare initiative on wealth-related inequity in the utilization of maternal & child health services in Sierra Leone

Socio-Economic Disparities in Use of Family Planning Methods among Pakistani Women: Findings from Pakistan Demographic and Health Surveys

Family planning uptake and its associated factors among women of reproductive age in Uganda: an insight from the Uganda Demographic and Health Survey 2016

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