Measuring equity in utilization of emergency obstetric care at Wolisso Hospital in Oromiya, Ethiopia: a cross sectional study

International Journal for Equity in Health

Bart Criel⁵  Joshua Vogel¹  Ana Pilar Betrán²  Mario Merialdi²  Andrea Atzori⁶  Wagari Edessa³  Gaetano Azzimonti⁴  Maria Castiglioni⁷  Fabio Manenti⁶  Giovanni Putoto⁶  Calistus Wilunda⁶ 

[1] University of Western Australia, 35 Stirling Highway Crawley, Perth, Australia;Department of Reproductive Health and Research, World Health Organization, Geneva 27 1211, Switzerland;Zonal Health Department, South West Showa Zone, P.O. Box 253, Wolisso, Ethiopia;Wolisso Hospital, P.O. Box 250, Wolisso, Ethiopia;Institute of Tropical Medicine, Nationalestraat 155, Antwerp 2000, Belgium;Doctors with Africa CUAMM, via san Francesco 126, Padua 35121, Italy;Department of Statistical Sciences, University of Padua, via Cesare Battisti 241, Padua 35121, Italy

关键词: Access;    Maternal health;    Emergency obstetrics care;    Socio-economic status;   

Others  :  824917
DOI  :  10.1186/1475-9276-12-27

 received in 2012-10-11, accepted in 2013-04-16,  发布年份 2013

【 摘 要 】

Introduction

Improving equity in access to services for the treatment of complications that arise during pregnancy and childbirth, namely Emergency Obstetric Care (EmOC), is fundamental if maternal and neonatal mortality are to be reduced. Consequently, there is a growing need to monitor equity in access to EmOC. The objective of this study was to develop a simple questionnaire to measure equity in utilization of EmOC at Wolisso Hospital, Ethiopia and compare the wealth status of EmOC users with women in the general population.

Methods

Women in the Ethiopia 2005 Demographic and Health Survey (DHS) constituted our reference population. We cross-tabulated DHS wealth variables against wealth quintiles. Five variables that differentiated well across quintiles were selected to create a questionnaire that was administered to women at discharge from the maternity from January to August 2010. This was used to identify inequities in utilization of EmOC by comparison with the reference population.

Results

760 women were surveyed. An a posteriori comparison of these 2010 data to the 2011 DHS dataset, indicated that women using EmOC were wealthier and more likely to be urban dwellers. On a scale from 0 (poorest) to 15 (wealthiest), 31% of women in the 2011 DHS sample scored less than 1 compared with 0.7% in the study population. 70% of women accessing EmOC belonged to the richest quintile with only 4% belonging to the poorest two quintiles. Transportation costs seem to play an important role.

Conclusions

We found inequity in utilization of EmOC in favour of the wealthiest. Assessing and monitoring equitable utilization of maternity services is feasible using this simple tool.

【 授权许可】

   
2013 Wilunda et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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