ArticleBMC public health2023
Decomposing inequality in Maternal and Child Health (MCH) services in Nepal.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Socioeconomic inequality in recommended childhood vaccinations in Germany: evidence from insurance claims and concentration index decomposition.BMC medicine · 2026Article
- Comparison of urban-rural inequality in quality antenatal care among women in Bangladesh and Pakistan: a multivariable decomposition analysis.Reproductive health · 2026Article
- Parenting under the triple burden of violence, depression, and poor diet quality: An intergenerational mother-child syndemic in Nepal.PLOS global public 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
- Wealth-based inequalities in early childhood development (ECD) outcomes in Bangladesh: A decomposition analysis using MICS 2019.PLOS global public health · 2025Article
- Correction: Decomposing inequality in Maternal and Child Health (MCH) services in Nepal.BMC public health · 2023Article
- Examining the Effect of Maternity Cash Incentives Under Nepal's Aama Program on the Continuum of Maternity Care: A Difference-in-Differences Analysis of NDHS 2011 to 2022.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
- Erratum issued
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAbout 75.5% of women in Nepal's urban areas receive at least four ANC visits, compared to 61.7% of women in the country's rural areas. Similarly, just 34% of women in the lowest wealth quintile give birth in a medical facility compared to 90% of women in the richest group. As a result of this inequality, the poor in emerging nations suffer since those who are better off can make greater use of the healthcare than those who are less fortunate. This study aims to examine and decompose the contributions of various socioeconomic factors towards MCH service inequality in Nepal in the years 2011 and 2016.
methodsInequality in MCH services was estimated using concentration curves and their corresponding indices using data from Nepal Demographic Health Survey (NDHS) 2011 and 2016. We examined the inequality across three MCH service outcomes: less than 4 ANC visits, no postnatal checkups within 2 months of delivery and no SBA delivery and decomposed them across observed characteristics of the mothers aged between 15 and 49. Furthermore, Oaxaca-blinder decomposition approach was used to measure and decompose the inequality differential between two time periods.
resultsInequality in MCH services was prevalent for all 3 MCH outcomes in 2011 and 2016, respectively. However, the concentration indices for <4 ANC visits, no SBA delivery, and no postnatal checkups within 2 months of birth increased from -0.2184, -0.1643, and -0.1284 to -0.1871, -0.0504, and -0.0218 correspondingly, showing the decrease in MCH services inequality over two time periods. Wealth index, women's literacy, place of living, mother's employment status, and problem of distance to reach nearest health facility were the main contributors.
conclusionWe find that MCH services are clearly biased towards the women with higher living standards. National policies should focus on empowering women through education and employment, along with the creation of health facilities and improved educational institutions, in order to address inequalities in living standards, women's education levels, and the problem of distance. Leveraging these factors can reduce inequality in MCH services.
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