Trend of sociodemographic and economic inequalities in the use of maternal health services in Lao People’s Democratic Republic from 2006 to 2017: MICS data analysis.

Tropical Medicine and Health

Research

Manami Uehara¹  Daisuke Nonaka¹  Noudéhouénou Credo Adelphe Ahissou¹  Rie Takeuchi¹  Jun Kobayashi¹  Calvin de los Reyes²  Phongluxa Khampheng³  Sengchanh Kounnavong³ 

[1] Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Nishihara, Japan;Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Nishihara, Japan;College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines;Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao PDR;

关键词: Free maternal and child health policy;    Antenatal care;    Institutional delivery;    Postnatal care;    Inequality;    Lao PDR;   

DOI  :  10.1186/s41182-023-00548-2

 received in 2023-03-29, accepted in 2023-10-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMaternal mortalities remain high in the Lao People’s Democratic Republic (Lao PDR). Since 2012, to improve access to maternal health services for all women, the country implemented several policies and strategies including user fee removal interventions for childbirth-related care. However, it remains unclear whether inequalities in access to services have reduced in the post-2012 period compared to pre-2012. Our study compared the change in sociodemographic and economic inequalities in access to maternal health services between 2006 to 2011–12 and 2011–12 to 2017.MethodsWe used the three most recent Lao Social Indicator Survey datasets conducted in 2006, 2011–12, and 2017 for this analysis. We assessed wealth, area of residence, ethnicity, educational attainment, and women’s age-related inequalities in the use of at least one antenatal care (ANC) visit with skilled personnel, institutional delivery, and at least one facility-based postnatal care (PNC) visit by mothers. The magnitude of inequalities was measured using concentration curves, concentration indices (CIX), and equiplots.ResultsThe coverage of at least one ANC with skilled personnel increased the most between 2012 and 2017, by 37.1% in Hmong minority ethnic group women, 36.1% in women living in rural areas, 31.1%, and 28.4 in the poorest and poor, respectively. In the same period, institutional deliveries increased the most among women in the middle quintiles by 32.8%, the poor by 29.3%, and Hmong women by 30.2%. The most significant reduction in inequalities was related to area of residence between 2006 and 2012 while it was based on wealth quintiles in the period 2011–12 to 2017. Finally, in 2017, wealth-related inequalities in institutional delivery remained high, with a CIX of 0.193 which was the highest of all CIX values.ConclusionThere was a significant decline in inequalities based on the area of residence in the use of maternal health services between 2006 and 2011–12 while between 2011–12 and 2017, the largest decrease was based on wealth quintiles. Policies and strategies implemented since 2011–12 might have been successful in improving access to maternal health services in Lao PDR. Meanwhile, more attention should be given to improving the uptake of facility-based PNC visits.

【 授权许可】

CC BY   
© Japanese Society of Tropical Medicine 2023

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