Trends of socioeconomic inequality in using maternal health care services in Lao People’s Democratic Republic (July 2018)

2018
작성자
CGM
작성일
2018-10-05 10:03
Trends of socioeconomic inequality in using maternal health care services in Lao People’s Democratic Republic from year 2000 to 2012

Ngan Do, Huong Thi Giang Tran, Alay Phonvisay , Juhwan Oh

 

ABSTRACT

 

Background: Socioeconomic inequalities in access to maternal health care have received more attention as it challenges the sustainability of the ongoing achievement in reducing maternal mortality. By promoting access to maternal health care as one of the core targets of the Health Sector Reform, Lao People’s Democratic Republic has reduced maternal mortality dramatically over the last decade. In spite of this improvement, little has been known about the secular trends in disparities of service utilization across different socioeconomic subgroups.

 

Methods: Two waves of the Multiple Indicator Cluster Survey in the years 2000 and 2012 were pooled for the analysis. We used logistic regression to estimate the likelihood of using antenatal care (ANC) and delivery services with skilled birth attendants (SBA) across different socioeconomic subgroups. Difference-in-difference method was applied to examine the inequality trends across the years by analyzing the interaction terms of the survey years and socioeconomic factors (education, wealth, ethnicity, and residential areas).

Results: Urban-rural disparity was improved over time while there were no educational disparity changes. Rural residential areas showed significant changes than urban areas over time [OR = 2.40; 95% CI: 1.52–3.77 for ANC and OR = 2.16; 95% CI: 1.36–3.42 for SBA]. However, there were aggravations in the disparities between major and minor ethnic group as well as worsening disparities between the rich and poor: i.e. Ethnic minority showed significant aggravation over time [OR = 0.62; 95% CI: 0.44–0.89 for ANC and OR = 0.65; 95% CI: 0.44–0.97 for SBA].

Conclusion: Efforts to increase maternal health service utilization in poor and minority ethnic groups should be emphasized to reduce social inequalities, thus encompassing multiple-sector interventions rather than focusing only on health sector related interventions.

Keywords: Trends, Inequality, Socioeconomic factors, Maternal health services, Lao People’s Democratic Republic

 

FULL TEXT (read more)

 

Published: 13 July 2018

Trends of socioeconomic inequality in using maternal health care services in Lao People’s Democratic Republic from 2000 to 2012. BMC Public Health 2018 18:875
DOI: 10.1186/s12889-018-5811-0

©The Author(s). 2018