Am J Public Health volume 108, issue 4, P464-471 2018 DOI: 10.2105/ajph.2017.304277 View full text
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Cesar Gomes Victora, Gary Joseph, Inacio C. M. Silva, Fatima S. Maia, J. Patrick Vaughan, Fernando C. Barros, Aluisio J. D. Barros

Abstract: Objectives. To test the inverse equity hypothesis, which postulates that new health interventions are initially adopted by the wealthy and thus increase inequalities-as population coverage increases, only the poorest will lag behind all other groups.Methods. We analyzed the proportion of births occurring in a health facility by wealth quintile in 286 surveys from 89 low-and middle-income countries and developed an inequality pattern index. Positive values indicate that inequality is driven by early adoption …

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