ArticleMaternal and child health journal2025
Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature.
Article in Maternal and child health journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between caesarean birth and childhood acute respiratory infection in low- and middle-income countries: a meta-analysis of population-based data.BMC medicine · 2026Pooled it
- Integrated maternal, newborn and child-health strategies and interventions for reducing maternal and child mortality in Nigeria: a systematic review.BMC public health · 2026Pooled it
- Health-seeking in fragile and conflict-affected settings: how armed violent conflict shapes maternal and child health-seeking behaviours.BMC public health · 2026Article
- Zero-inflated negative binomial modelling of antenatal care utilization and it's predictors in Somaliland:Frontiers in global women's health · 2026Article
- Barriers and Facilitators of Compliance with Iron-Folic Acid Supplementation Among Pregnant Women in Southern Afghanistan: A Qualitative Study.Patient preference and adherence · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInequality in maternal healthcare service (MHS) utilization is a significant global health challenge in low- and middle-income countries (LMICs). Recently, the literature on MHS inequality in LMICs has expanded. We conducted a scoping review to synthesize existing evidence and identify knowledge gaps.
methodsFollowing PRISMA-ScR guidelines, we systematically searched PubMed, Scopus, and CINAHL Ultimate in June 2023 for literature published since January 1, 2015. We included empirical studies using nationally representative data to measure inequality in at least one of five MHS indicators: antenatal care (ANC), skilled birth attendance (SBA), facility-based delivery (FBD), caesarean-section (C-section) delivery, and postnatal care (PNC). Our review encompassed 132 peer-reviewed articles on MHS inequality in LMICs.
resultsANC, FBD, and SBA were more frequently analyzed indicators for inequality measurement compared to PNC and C-section delivery. None of the 132 studies assessed all five MHS indicators together. The concentration index was the most frequently used inequality measure across all MHS indicators. Included studies were predominantly focused on economic (wealth) and geographic (residence, region) inequalities, while sociocultural factors (e.g., religion, ethnicity) remain underexplored. Inequality was most pronounced in low-income (LICs) and lower-middle-income countries (LwMICs). The extant literature mainly concentrates on India and Ethiopia as research settings.
conclusionOur review highlights significant gaps in health inequality research, particularly in LICs and upper-middle-income countries (UMICs), with a heavy reliance on cross-sectional data, limited assessment of PNC and C-section delivery and lack of comprehensive analysis across all five common MHS indicators. Future research in LMICs should address the gaps identified in this review.
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