ArticleBMC pregnancy and childbirth2016
Growing inequities in maternal health in South Africa: a comparison of serial national household surveys.
Article in BMC pregnancy and childbirth, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed.
- The role of a community health worker-delivered preconception and pregnancy intervention in achieving a more positive pregnancy experience: the Bukhali trial in Soweto, South Africa.BMC women's health · 2024Trial
- Long-term effects of unintended pregnancy on antiretroviral therapy outcomes among South African women living with HIV.AIDS (London, England) · 2019Trial
- A setback for Sustainable Development Goal 3.1: Documenting the coronavirus disease 2019 pandemic's impact on maternal mortality through a National Confidential Enquiry in South Africa.African journal of primary health care & family medicine · 2026Article
- "Motherhood is a work in progress": a qualitative longitudinal study of maternal subjectivity and well-being of women in the Bukhali trial in Soweto, South Africa.Frontiers in global women's health · 2026Article
- Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature.Maternal and child health journal · 2025Article
- Article
- Indirect effects of COVID-19 on maternal and child health in South Africa.Global health action · 2023Article
- Impact of COVID-19 pandemic on mother and child health in Sub-Saharan Africa - a review.Pediatric research · 2023Review
- Reflections on Digital Maternal and Child Health Support for Mothers and Community Health Workers in Rural Areas of Limpopo Province, South Africa.International journal of environmental research and public health · 2023Article
- Intimate partner violence and HIV treatment adherence in urban South Africa: Mediating role of perinatal common mental disorders.SSM. Mental health · 2022Article
- Impact of COVID-19 on maternal healthcare in Africa and the way forward.Archives of public health = Archives belges de sante publique · 2021Article
- Socioeconomic inequalities in effective service coverage for reproductive, maternal, newborn, and child health: a comparative analysis of 39 low-income and middle-income countries.EClinicalMedicine · 2021Article
- Article
- Evaluating the effect of maternal mHealth text messages on uptake of maternal and child health care services in South Africa: a multicentre cohort intervention study.Reproductive health · 2020Article
- Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa.BMC public health · 2020Article
- Improving the validity, relevance and feasibility of the continuum of care framework for maternal health in South Africa: a thematic analysis of experts' perspectives.Health research policy and systems · 2020Article
- Elucidating challenges and solutions in the maternal healthcare, identified by medical doctors in northern South Africa: a qualitative study.The Pan African medical journal · 2020Article
- Patients' perspectives of acceptability of ART, TB and maternal health services in a subdistrict of Johannesburg, South Africa.BMC health services research · 2018Article
- The rise and fall of mortality inequality in South Africa in the HIV era.SSM - population health · 2018Article
- Attendance at antenatal clinics in inner-city Johannesburg, South Africa and its associations with birth outcomes: analysis of data from birth registers at three facilities.BMC public health · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundRates of maternal mortality and morbidity vary markedly, both between and within countries. Documenting these variations, in a very unequal society like South Africa, provides useful information to direct initiatives to improve services. The study describes inequalities over time in access to maternal health services in South Africa, and identifies differences in maternal health outcomes between population groups and across geographical areas.
methodsData were analysed from serial population-level household surveys that applied multistage-stratified sampling. Access to maternal health services and health outcomes in 2008 (n = 1121) were compared with those in 2012 (n = 1648). Differences between socio-economic quartiles were quantified using the relative (RII) and slope (SII) index of inequality, based on survey weights.
resultsHigh levels of inequalities were noted in most measures of service access in both 2008 and 2012. Inequalities between socio-economic quartiles worsened over time in antenatal clinic attendance, with overall coverage falling from 97.0 to 90.2 %. Nationally, skilled birth attendance remained about 95 %, with persistent high inequalities (SII = 0.11, RII = 1.12 in 2012). In 2012, having a doctor present at childbirth was higher than in 2008 (34.4 % versus 27.8 %), but inequalities worsened. Countrywide, levels of planned pregnancy declined from 44.6 % in 2008 to 34.7 % in 2012. The RII and SII rose over this period and in 2012, only 22.4 % of the poorest quartile had a planned pregnancy. HIV testing increased substantially by 2012, though remains low in groups with a high HIV prevalence, such as women in rural formal areas, and from Gauteng and Mpumalanga provinces. Marked deficiencies in service access were noted in the Eastern Cape ad North West provinces.
conclusionsThough some population-level improvements occurred in access to services, inequalities generally worsened. Low levels of planned pregnancy, antenatal clinic access and having a doctor present at childbirth among poor women are of most concern. Policy makers should carefully balance efforts to increase service access nationally, against the need for programs targeting underserved populations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.