Wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions in 36 countries in the African Region

Wehrmeister, Fernando César; Faye, Cheikh; Silva, Inácio Crochemore Mohnsam da; Amouzou, Agbessi; Ferreira, Leonardo Zanini; Jiwani, Safia S; Melesse, Dessalegn Y.; Mutua, Martin Kavao; Maïga, Abdoulaye; Cá, Tomé; Sidze, Estelle; Taylor, Chelsea Maria; Strong, Kathleen; Carvajal-Aguirre, Liliana; Porth, Tyler; Hosseinpoor, Ahmad Reza; Barros, Aluísio J. D.; Boerma, Ties

doi:10.2471/blt.19.249078

Cited by 17 publications

(21 citation statements)

References 12 publications

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“…More so, declining poverty rates (World Bank, 2020) could imply increasing financial access to health services and essential medicines in LMIC populations. Second, many countries implemented programs to extend the reach of health services to underserved populations during this period (WHO, 2019;Wehrmeister et al, 2020): for example, the integrated community case management (iCCM) program aimed at extending the coverage of essential fever-care services to remote rural areas, including antibiotics for suspected pediatric pneumonia cases (Diaz et al, 2014). Third, and importantly, there has also been increasing availability of antibiotics in these settings (McGettigan et al, 2017;Malik and Figueras, 2019), especially in South-East Asia where the most substantial increases in reported antibiotic use were seen among sick children aged <5 years in the various user groups.…”

Section: Discussionmentioning

confidence: 99%

Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005–17: A systematic analysis of user characteristics based on 132 national surveys from 73 countries

Allwell-Brown

Hussain-Alkhateeb

Sewe

et al. 2021

International Journal of Infectious Diseases

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This study aimed to analyze any reported antibiotic use for children aged <5 years with fever, diarrhea or cough with fast or difficult breathing (outcome) from low-income and middle-income countries (LMICs) during 2005-2017 by user characteristics: rural/urban residence, maternal education, household wealth, and healthcare source visited. Methods: Based on 132 demographic and health surveys and multiple indicator cluster surveys from 73 LMICs, the outcome by user characteristics for all country-years was estimated using a hierarchical Bayesian linear regression model. Results: Across LMICs during 2005-2017, the greatest relative increases in the outcome occurred in rural areas, poorest quintiles and least educated populations, particularly in low-income countries and South-East Asia. In low-income countries, rural areas had a 72% relative increase from 17.8% (Uncertainty Interval (UI): 5.2%-44.9%) in 2005 to 30.6% (11.7%-62.1%) in 2017, compared to a 29% relative increase in urban areas from 27.1% (8.7%-58.2%) in 2005 to 34.9% (13.3%-67.3%) in 2017. Despite these increases, the outcome was consistently highest in urban areas, wealthiest quintiles, and populations with the highest maternal education. Conclusion: These estimates suggest that the increasing reported antibiotic use for sick children aged <5 years in LMICs during 2005-2017 was driven by gains among groups often underserved by formal health services.

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Section: Discussionmentioning

confidence: 99%

Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005–17: A systematic analysis of user characteristics based on 132 national surveys from 73 countries

Allwell-Brown

Hussain-Alkhateeb

Sewe

et al. 2021

International Journal of Infectious Diseases

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“…8 These examples highlight the need for countries to take actions according to the current status of health services and outcomes and future population changes. 27 In 2018 To keep current density Additional number needed to meet WHO minimum threshold of density Unicef analysis based on WHO Global Health Observatory (https://apps.who.int/gho/data/ node.main.SDG3C?lang=en).…”

Section: A Renewed Approachmentioning

confidence: 99%

“…8 These examples highlight the need for countries to take actions according to the current status of health services and outcomes and future population changes. 27 …”

Section: A Renewed Approachmentioning

confidence: 99%

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Demographic challenges and opportunities for child health programming in Africa and Asia

You

Beise

Lee

et al. 2021

BMJ

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Child health Redesign Demographic challenges and opportunities for child health programming in Africa and Asia Danzhen You and colleagues call for child health programming to take into consideration changing population sizes and dynamics on 29 March 2021 by guest. Protected by copyright. http://www.bmj.com/ BMJ: first published as 10.1136/bmj.n19 on 17 March 2021. Downloaded from This article is part of a series proposed by WHO and Unicef and commissioned by The BMJ, which peer reviewed, edited, and made the decision to publish. Article handling fees, including open access are funded by WHO and Unicef.

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“…Inequalities in access to healthcare, in particular maternal and child care are still rampant despite major improvements made through targeted policies over the past few years [4]. The poorest mothers are still far behind in terms of coverage of essential reproductive and maternal and child health services.…”

Section: Introductionmentioning

confidence: 99%

The impact of i-PUSH on maternal and child health outcomes, health care utilization and financial protection: a cluster randomised controlled trial based on Financial and Health Diaries data

Janssens¹

2020

AEA Randomized Controlled Trials

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Background: Universal Health Coverage (UHC) ensures access to quality health services for all, with no financial hardship when accessing the needed services. Nevertheless, access to quality health services is marred by substantial resource shortages creating service delivery gaps in low-and middle-income countries (LMICs), including Kenya. The Innovative Partnership for Universal Sustainable Healthcare (i-PUSH) program, developed by AMREF Health Africa and PharmAccess Foundation (PAF), aims to empower low-income women of reproductive age and their families through innovative digital tools. This study aims to evaluate the impact of i-PUSH on maternal and child health care utilization, women's health including their knowledge, behavior and uptake of respective services, as well as women's empowerment and financial protection. It also aims to evaluate the impact of the LEAP training tool on empowering and enhancing CHVs' health literacy and to evaluate the impact of the M-TIBA health wallet on savings for health and health insurance uptake.Methods: This is a cluster randomised controlled trial (RCT) study that uses a four-pronged approach -including year-long weekly financial and health diaries interviews, baseline and endline surveys, a qualitative study and behavioral lab-in-the-field experiments-in Kakemega County, Kenya. In total, 240 households from 24 villages in Kakamega will be followed to capture their health, health knowledge, health-seeking behavior, health expenditures and enrolment in health insurance over time. A random half of the households live in villages assigned to the treatment group where i-PUSH will be implemented after the baseline, while the other half of the households live in control village where i-PUSH will not be implemented until after the endline. The study protocol was reviewed and approved by the AMREF Ethical and Scientific Review Board (AMREF-ESRC). Research permits were obtained from the National Commission for Science, Technology and Innovation (NACOSTI) agency of Kenya.Discussion: People in LMICs often suffer from high out-of-pocket healthcare expenditures, which in turn, impedes access to quality health services. Saving for healthcare as well as enrolment in health insurance can improve access to healthcare by building capacities at all levels-individuals, families and communities. Notable, i-PUSH fosters savings for health care through the mobile-phone based "health wallet", it enhances enrolment in subsidized health insurance through the mobile platform-M-TIBA-developed by PAF, and it seeks to improve health knowledge and behavior through Community Health Volunteers (CHVs) who are trained using the LEAP tool-AMREF's mHealth platform. The findings will inform stakeholders to formulate better strategies to ensure access to UHC in general, and for a highly vulnerable segment of the population in particular, including low-income mothers and their children.

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Wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions in 36 countries in the African Region

Cited by 17 publications

References 12 publications

Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005–17: A systematic analysis of user characteristics based on 132 national surveys from 73 countries

Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005–17: A systematic analysis of user characteristics based on 132 national surveys from 73 countries

Demographic challenges and opportunities for child health programming in Africa and Asia

The impact of i-PUSH on maternal and child health outcomes, health care utilization and financial protection: a cluster randomised controlled trial based on Financial and Health Diaries data

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