ArticleBMJ global health2017
Is governance, gross domestic product, inequality, population size or country surface area associated with coverage and equity of health interventions? Ecological analyses of cross-sectional surveys from 80 countries.
Article in BMJ global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Assessing and adjusting for bias in ecological analysis using multiple sample datasets.BMC medical research methodology · 2025Article
- Article
- Sociodemographic inequities in nurturing care for early childhood development across Brazilian municipalities.Maternal & child nutrition · 2022Article
- Is women's empowerment associated with coverage of RMNCH interventions in low- and middle-income countries? An analysis using a survey-based empowerment indicator, the SWPER.Journal of global health · 2021Article
- Article
- Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries.BMJ global health · 2020Article
- COVID-19 Outbreak, Mitigation, and Governance in High Prevalent Countries.Annals of global health · 2020Article
- Large and persistent subnational inequalities in reproductive, maternal, newborn and child health intervention coverage in sub-Saharan Africa.BMJ global health · 2020Review
- Are the poorest poor being left behind? Estimating global inequalities in reproductive, maternal, newborn and child health.BMJ global health · 2020Article
- Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us?BMJ global health · 2019Review
- Lenses and levels: the why, what and how of measuring health system drivers of women's, children's and adolescents' health with a governance focus.BMJ global health · 2019Review
- Do less populous countries receive more development assistance for health per capita? Longitudinal evidence for 143 countries, 1990-2014.BMJ global health · 2018Article
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4 authors.
Funding
Abstract
objectiveTo assess associations between national characteristics, including governance indicators, with a proxy for universal health coverage in reproductive, maternal, newborn and child health (RMNCH).
designEcological analysis based on data from national standardised cross-sectional surveys.
settingLow-income and middle-income countries with a Demographic and Health Survey or a Multiple Indicator Cluster Survey since 2005.
participants1 246 710 mothers and 2 129 212 children from 80 national surveys. EXPOSURES OF INTEREST: Gross domestic product (GDP), country surface area, population, Gini index and six governance indicators (control of corruption, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and voice and accountability). MAIN OUTCOMES: Levels and inequality in the composite coverage index (CCI), a weighted average of eight RMNCH interventions. Relative and absolute inequalities were measured through the concentration index (CIX) and slope index of inequality (SII) for CCI, respectively.
resultsThe average values of CCI (70.5% (SD=13.3)), CIX (5.3 (SD=5.1)) and mean slope index (19.8 (SD=14.7)) were calculated. In the unadjusted analysis, all governance variables and GDP were positively associated with the CCI and negatively with inequalities. Country surface showed inverse associations with both inequality indices. After adjustment, among the governance indicators, only political stability and absence of violence was directly related to CCI (β=6.3; 95% CI 3.6 to 9.1; p<0.001) and inversely associated with relative (CIX; β=-1.4; 95% CI -2.4 to -0.4; p=0.007) and absolute (SII; β=-5.3; 95% CI -8.9 to -1.7; p=0.005) inequalities. The strongest associations with governance indicators were found in the poorest wealth quintile. Similar patterns were observed for GDP. Country surface area was inversely related to inequalities on CCI.
conclusionsLevels and equity in RMNCH interventions are positively associated with political stability and absence of violence, and with GDP, and inversely associated with country surface area.
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