ArticleBulletin of the World Health Organization2020
Wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions in 36 countries in the African Region.
Article in Bulletin of the World Health Organization, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Inequalities in Access and Utilization of Maternal, Newborn and Child Health Services in sub-Saharan Africa: A Special Focus on Urban Settings.Maternal and child health journal · 2022Pooled it
- Wealth-based inequality in maternal health service utilization among ever-married women of reproductive age in Somaliland; secondary analysis of the 2020 Demographic and Health Survey.Frontiers in public health · 2026Article
- Universal health coverage for women of reproductive ages: a survey-based comprehensive assessment of service utilisation and health expenditure in Tanzania.BMJ public health · 2025Article
- Equity of access to free maternal and child health services among reproductive-age women in Delta State, Nigeria.Ghana medical journal · 2024Article
- Wealth-based inequality in the continuum of maternal health service utilisation in 16 sub-Saharan African countries.International journal for equity in health · 2023Article
- Reproductive, maternal, newborn, and child health intervention coverage in 70 low-income and middle-income countries, 2000-30: trends, projections, and inequities.The Lancet. Global health · 2023Article
- Evaluation of maternal and child care continuum in Guinea: a secondary analysis of two demographic and health surveys using the composite coverage index (CCI).BMC pregnancy and childbirth · 2023Article
- How Zambia reduced inequalities in under-five mortality rates over the last two decades: a mixed-methods study.BMC health services research · 2023Article
- Tale of 22 cities: utilisation patterns and content of maternal care in large African cities.BMJ global health · 2022Article
- Article
- Demographic challenges and opportunities for child health programming in Africa and Asia.BMJ (Clinical research ed.) · 2021Article
- Effect of the COVID-19 pandemic on health facility delivery in Ethiopia; results from PMA Ethiopia's longitudinal panel.PLOS global public health · 2021Article
- Planning universal accessibility to public health care in sub-Saharan Africa.Proceedings of the National Academy of Sciences of the United States of America · 2020Article
Corrections and comments
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Authors and funding
19 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether sub-Saharan African countries have succeeded in reducing wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions.
methodsWe analysed survey data from 36 countries, grouped into Central, East, Southern and West Africa subregions, in which at least two surveys had been conducted since 1995. We calculated the composite coverage index, a function of essential maternal and child health intervention parameters. We adopted the wealth index, divided into quintiles from poorest to wealthiest, to investigate wealth-related inequalities in coverage. We quantified trends with time by calculating average annual change in index using a least-squares weighted regression. We calculated population attributable risk to measure the contribution of wealth to the coverage index.
findingsWe noted large differences between the four regions, with a median composite coverage index ranging from 50.8% for West Africa to 75.3% for Southern Africa. Wealth-related inequalities were prevalent in all subregions, and were highest for West Africa and lowest for Southern Africa. Absolute income was not a predictor of coverage, as we observed a higher coverage in Southern (around 70%) compared with Central and West (around 40%) subregions for the same income. Wealth-related inequalities in coverage were reduced by the greatest amount in Southern Africa, and we found no evidence of inequality reduction in Central Africa.
conclusionOur data show that most countries in sub-Saharan Africa have succeeded in reducing wealth-related inequalities in the coverage of essential health services, even in the presence of conflict, economic hardship or political instability.
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