Socioeconomic inequalities in the use of delivery care services in Bangladesh: a comparative study between 2004 and 2007

Shabnam, Jahan; Gifford, Mervyn; Dalal, Koustuv

doi:10.4236/health.2011.312127

Cited by 16 publications

(20 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in line with the findings of previous studies that revealed distributions in general health care that favoured the rich [18,27]. Similarly, pro-rich distributions have been reported in studies from other developing countries [6,7,39]. …”

Section: Discussionsupporting

confidence: 92%

Inequalities in public health care delivery in Zambia

Phiri

Ataguba

2014

International Journal for Equity in Health

View full text Add to dashboard Cite

BackgroundAccess to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documents, there is evidence suggesting that those needing health services are not receiving their fair share. This study seeks therefore, to assess if socioeconomic related inequalities/inequities in public health service utilisation in Zambia still persist.MethodsThe 2010 nationally representative Zambia Living Conditions and Monitoring Survey data are used. Inequality is assessed using concentration curves and concentrations indices while inequity is assessed using a horizontal equity index: an index of inequity across socioeconomic status groups, based on standardizing health service utilisation for health care need. Public health services considered include public health post visits, public clinic visits, public hospital visits and total public facility visits.ResultsThere is evidence of pro-poor inequality in public primary health care utilisation but a pro-rich inequality in hospital visits. The concentration indices for public health post visits and public clinic visits are −0.28 and −0.09 respectively while that of public hospitals is 0.06. After controlling for need, the pro-poor distribution is maintained at primary facilities and with a pro-rich distribution at hospitals. The horizontal equity indices for health post and clinic are estimated at −0.23 and −0.04 respectively while that of public hospitals is estimated at 0.11. A pro-rich inequity is observed when all the public facilities are combined (horizontal equity index = 0.01) though statistically insignificant.ConclusionThe results of the paper point to areas of focus in ensuring equitable access to health services especially for the poor and needy. This includes strengthening primary facilities that serve the poor and reducing access barriers to ensure that health care utilisation at higher-level facilities is distributed in accordance with need for it. These initiatives may well reduce the observed inequities and accelerate the move towards universal health coverage in Zambia.

show abstract

Section: Discussionsupporting

confidence: 92%

Inequalities in public health care delivery in Zambia

Phiri

Ataguba

2014

International Journal for Equity in Health

View full text Add to dashboard Cite

show abstract

“…Analysis of trend and pattern of institutional delivery in Bangladesh from 1993 to 2007 in relation to residency and education also revealed low utilisation of health facility among women in rural settings [33]. On the contrary, a Nigerian study [34] noted that most urban dwellers deliver at home. This disparity might be attributable to variation in other factors prevailing in these two different study areas such as attitude of healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Ameyaw

Tanle

Kissah-Korsah

et al. 2016

International Journal of Reproductive Medicine

View full text Add to dashboard Cite

Delivering in health facility under the supervision of skilled birth attendant is an important way of mitigating impacts of delivery complications. Empirical evidence suggests that decision-making autonomy is aligned with holistic wellbeing especially in the aspect of maternal and child health. The objective of this paper was to examine the relationship between women's health decision-making autonomy and place of delivery in Ghana. We extracted data from the 2014 Ghana Demographic and Health Survey. Descriptive and logistic regression techniques were applied. The results indicated that women with health decision-making autonomy have higher tendency of health facility delivery as compared to those who are not autonomous [OR = 1.27, CI = 1.09–1.48]. However, those who have final say on household large purchases [OR = 0.71, CI = 0.59–0.84] and those having final say on visits [OR = 0.86, CI = 0.73–1.01] were less probable to deliver in health facility than those without such decision-making autonomy. Consistent with existing evidence, wealthier, urban, and highly educated women had higher inclination of health facility delivery. This study has stressed the need for interventions aimed at enhancing health facility delivery to target women without health decision-making autonomy and women with low education and wealth status, as this can play essential role in enhancing health facility delivery.

show abstract

“…Public health policies may have contributed to this decline; for more than one decade, Bangladesh has adopted a health, nutrition, and population sector program with defined national strategies for reducing maternal mortality, focusing especially on early detection and appropriate referral of complications, and improvement of quality of care [ 11 , 13 - 15 ]. In spite of overall progress made in the maternal health sector, evidence suggests that there are pronounced social gradients in utilization of key maternal care services and maternal health outcomes in Bangladesh [ 14 , 16 , 17 ]. There are, in fact, huge geographic and socioeconomic inequalities in access to maternal health services across the country [ 16 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is also critical for targeting interventions to those areas and population subgroups in greatest need. To date, a number of studies have examined utilization of maternal care in Bangladesh [ 11 , 14 , 17 , 20 ]. However, the previous works did not provide a detailed account of social inequalities in the utilization of maternal care across different regions and socioeconomic groups.…”

Section: Introductionmentioning

confidence: 99%

Social inequalities in the utilization of maternal care in Bangladesh: Have they widened or narrowed in recent years?

Hajizadeh

Alam

Nandi

2014

Int J Equity Health

View full text Add to dashboard Cite

BackgroundNotwithstanding the significant progress in reducing maternal mortality in recent years, social inequalities in the utilization of maternal care continue to be a challenge in Bangladesh. In this study, we aim to provide a comprehensive analysis of trends in social inequalities in utilization of antenatal care (ANC), facility based delivery (FBD), and skilled birth attendance (SBA) in Bangladesh between 1995 and 2010.MethodsData were extracted from the five latest rounds of Bangladesh Demographic Health Surveys (BDHS). The Theil index (T) and between-group variance (BGV) were used to calculate relative and absolute disparities in the utilization of three measures (ANC, FBD, and SBA) of maternal care across six administrative regions. The relative and slope indices of inequality (RII and SII, respectively) were also used to calculate wealth- and education-based inequality in the utilization of maternal care.ResultsThe results of the T-index suggest that relative inequality in SBA has declined by 0.2% per year. Nevertheless, the estimated BGV demonstrated that absolute inequalities in all three measures of maternal care have increased across administrative divisions. For all three measures of maternal care, the RII and SII indicated consistent socioeconomic inequalities favouring wealthier and more educated women. The adjusted RII suggested that wealth- and education-related inequalities for ANC declined by 9% and 6%, respectively, per year during the study period. The adjusted SII, however, showed that wealth- and education-related inequalities for FBD increased by 0.6% per year.ConclusionsAlthough socially disadvantaged mothers increased their utilization of care relative to mothers of higher socioeconomic status, the absolute gap in utilization of care between socioeconomic groups has increased over time. Our findings indicate that wealthier and more educated women, as well as those living in urban areas, are the major users of ANC, FBD and SBA in Bangladesh. Thus, priority focus should be given to implementing and evaluating interventions that benefit women who are poorer, less educated and live in rural areas.

show abstract

Socioeconomic inequalities in the use of delivery care services in Bangladesh: a comparative study between 2004 and 2007

Cited by 16 publications

References 20 publications

Inequalities in public health care delivery in Zambia

Inequalities in public health care delivery in Zambia

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Social inequalities in the utilization of maternal care in Bangladesh: Have they widened or narrowed in recent years?

Contact Info

Product

Resources

About