ArticleBMJ open2021
Twelve-year persistence of inequalities in antenatal care utilisation among women in Tanzania: a decomposition analysis of population-based cross-sectional surveys.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Utilization of maternal healthcare services in low- and middle-income countries: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Inequity in uptake of maternal health care services in developing countries: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Comparison of urban-rural inequality in quality antenatal care among women in Bangladesh and Pakistan: a multivariable decomposition analysis.Reproductive 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
- Socioeconomic inequality in timing of ANC visit among pregnant women in Ethiopia, 2019.Frontiers in public health · 2024Article
- Explaining changes in educational disparities in competent maternal health care services in urban and rural areas in Ethiopia.Frontiers in public health · 2024Article
- Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens.BMC pregnancy and childbirth · 2022Article
- Inequalities in maternal healthcare use in Sierra Leone: Evidence from the 2008-2019 Demographic and Health Surveys.PloS one · 2022Article
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Authors and funding
2 authors.
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Abstract
objectiveThis study was undertaken to assess the trend and contributors of socioeconomic inequalities in antenatal care (ANC) utilisation among women of reproductive age in Tanzania from 2004 to 2016.
designPopulation-based cross-sectional surveys.
settingThis study analysed nationally representative data for women of reproductive age obtained from the 2004-2016 Tanzania Demographic Health Surveys. PRIMARY OUTCOME MEASURE: The outcome variables analysed in this study are: (1) attendance of ANC and (2) accessing adequate antenatal care. ANALYTICAL
methodsThe concentration curve and the concentration index were used to measure socioeconomic inequality in attending and accessing adequate ANC. The concentration index was decomposed to identify the factors explaining the observed socioeconomic inequality of these two outcomes.
resultsThe concentration index for attending at least four ANC visits increased from 0.169 in 2004 to 0.243 in 2016 (p<0.01). Similarly, for accessing adequate care, the index increased from 0.147 in 2004 to 0.355 in 2016 (p<0.01). This indicates the significant increase in socioeconomic inequalities (favouring wealthier women) for these two outcomes over time. Furthermore, the results show that wealth status was the largest contributor to inequality in both attending at least four visits (71%, 50% and 70%) and accessing adequate ANC (50%, 42% and 51%) in 2004, 2010 and 2016, respectively, in favour of wealthier women (p<0.05). The other contributors to socioeconomic inequalities in ANC utilisation were maternal education and type of residence.
conclusionOver the 12 years of surveys, there was no reduction in socioeconomic inequalities in ANC utilisation in Tanzania. Therefore, the efforts of achieving universal health coverage should focus on reducing wealth-related inequality and improving women's education from poor households.
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