Equity in newborn care, evidence from national surveys in low- and middle-income countries

International Journal for Equity in Health

Kimberly Peven¹  Louise T. Day²  Lionel Kadzem³  Edward Purssell⁴  Cath Taylor⁵  Lindsay Mallick⁶  Debra Bick⁷ 

[1] Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK;Maternal and Newborn Health Group, London School of Hygiene & Tropical Medicine, London, UK;Maternal and Newborn Health Group, London School of Hygiene & Tropical Medicine, London, UK;Ministry of Health, Yaoundé, Cameroon;School of Health Sciences, City, University of London, London, UK;School of Health Sciences, University of Surrey, Guildford, UK;University of Maryland, College Park, MD, USA;Avenir Health, Glastonbury, CT, USA;Warwick Clinical Trials Unit, University of Warwick, Coventry, UK;

关键词: Infant;    Newborn;    Health equity;    Socioeconomic factors;    Postnatal care;   

DOI  :  10.1186/s12939-021-01452-z

来源: Springer

【 摘 要 】

BackgroundHigh coverage of care is essential to improving newborn survival; however, gaps exist in access to timely and appropriate newborn care between and within countries. In high mortality burden settings, health inequities due to social and economic factors may also impact on newborn outcomes. This study aimed to examine equity in co-coverage of newborn care interventions in low- and low middle-income countries in sub-Saharan Africa and South Asia.MethodsWe analysed secondary data from recent Demographic and Health Surveys in 16 countries. We created a co-coverage index of five newborn care interventions. We examined differences in coverage and co-coverage of newborn care interventions by country, place of birth, and wealth quintile. Using multilevel logistic regression, we examined the association between high co-coverage of newborn care (4 or 5 interventions) and social determinants of health.ResultsCoverage and co-coverage of newborn care showed large between- and within-country gaps for home and facility births, with important inequities based on individual, family, contextual, and structural factors. Wealth-based inequities were smaller amongst facility births compared to non-facility births.ConclusionThis analysis underlines the importance of facility birth for improved and more equitable newborn care. Shifting births to facilities, improving facility-based care, and community-based or pro-poor interventions are important to mitigate wealth-based inequities in newborn care, particularly in countries with large differences between the poorest and richest families and in countries with very low coverage of care.

【 授权许可】

CC BY