ArticleInternational journal for equity in health2020
Socioeconomic inequalities in women's access to health care: has Ecuadorian health reform been successful?
Article in International journal for equity in health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Microtia, Hearing Disability, and Health Inequity: Socioeconomic Disparities in Rehabilitation and Specialized Care in Ecuador.International journal of environmental research and public health · 2026Article
- Socioeconomic Inequalities in Health Service Utilization in the Peruvian Population: A National Population-Based Study.Healthcare (Basel, Switzerland) · 2026Article
- Observational
- Public-private configuration in health systems and inequalities in Latin America: a scoping review.Cadernos de saude publica · 2026Article
- Ethnic inequalities and contraception in Latin America and the Caribbean: a scoping review.International journal for equity in health · 2025Article
- Primary health care reforms: a scoping review.Primary health care research & development · 2025Article
- Article
- 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
- Prevalence of chronic pelvic pain and primary dysmenorrhea in women of reproductive age in Ecuador.BMC women's health · 2022Article
- How and why buy-in for health in all policies was facilitated in Ecuador: a realist case study of Plan Nacional para el Buen Vivir.International journal for equity in health · 2022Article
- Ethnic inequalities in reproductive, maternal, newborn and child health interventions in Ecuador: A study of the 2004 and 2012 national surveys.EClinicalMedicine · 2022Article
- Learning from success cases: ecological analysis of potential pathways to universal access to family planning care in low- and middle-income countries.Gates open research · 2022Article
- Assessing the impact of the 2008 health reform in Ecuador on the performance of primary health care services: an interrupted time series analysis.International journal for equity in health · 2021Article
- National and subnational coverage and inequalities in reproductive, maternal, newborn, child, and sanitary health interventions in Ecuador: a comparative study between 1994 and 2012.International journal for equity in health · 2021Article
- Article
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4 authors.
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Abstract
backgroundOver the last 12 years, Ecuador has implemented comprehensive health sector reform to ensure equitable access to health care services according to need. While there have been important achievements in terms of health care coverage, the effects of these reforms on socioeconomic inequalities in health care have not been analysed. The present study assesses whether the health care reforms implemented in the decade between 2007 and 2017 have contributed to reducing the socioeconomic inequalities in women's health care access.
methodsThe present study was based on two waves (2006 and 2014) of the Living Standards Measurement Survey conducted in Ecuador. Data from women of reproductive age (15 to 49 years) were analysed to evaluate health care coverage across three indicators: skilled birth attendance, cervical cancer screening, and the use of modern contraceptives. Absolute risk differences were calculated between the heath care indicators and the socioeconomic variables using binomial regression analysis for each time period. The Slope Index of Inequality (SII) was also calculated for each socioeconomic variable and period. A multiplicative interaction term between the socioeconomic variables and period was included to assess the changes in socioeconomic inequalities in health care over time.
resultsAccess to health care increased in the three studied outcomes during the health sector reform. Significant reductions in inequality in skilled birth attendance were observed in all socioeconomic variables except in the occupational class. Cervical cancer screening inequalities increased according to education and occupation, but decreased by wealth. Only a poorer education was observed for modern contraceptive use.
conclusionsWhile most socioeconomic inequalities in skilled birth attendance decreased during the reform period, this was not the case for inequalities in cervical cancer screening or the use of modern contraceptives. Further studies are needed to address the social determinants of these health inequalities.
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