Evidence map›Paper›PMID 40926204›Full record

ArticleBMC health services research2025

Inequalities in effective coverage of the maternal healthcare continuum in Cameroon: a cascade analysis from service contact to input-adjusted coverage.

Moussa Souaibou, Arsène Brunelle Sandie, Aluisio J D Barros, Anaclet Désiré Dzossa, Estelle Monique Sidze

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Moussa SouaibouNational Institute of Statistics, Rue 3025, Quartier du Lac, P.O Box 134, Yaounde, Cameroon. souaiboumoussa@gmail.com.
Arsène Brunelle SandieMuso Health, 3254 19th Street, 2nd Floor, San Francisco, CA 94110, United States.
Aluisio J D BarrosInternational Center for Equity in Health, Federal University of Pelotas, Rua Mal Deodoro 1160, Pelotas 96020-220, , Brazil.
Anaclet Désiré DzossaNational Institute of Statistics, Rue 3025, Quartier du Lac, P.O Box 134, Yaounde, Cameroon.
Estelle Monique SidzeAfrican Population and Health Research Center (APHRC), APHRC Campus, 2nd Floor, Manga Close off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya.

Funding

Countdown to 2030's BMGF INV-042414
6 · The paper itself

Abstract

backgroundMaternal healthcare (MHC) in Cameroon reflects the persistent challenges in Sub-Saharan Africa, where high maternal mortality continues despite improved service utilization, stressing inequitable effective coverage (EC). This study applied EC cascade analysis-including service contact, continuity, and input-adjusted coverage-to quantify geographic and socioeconomic disparities, informing equity-focused strategies to dismantle structural barriers in the MHC continuum.

methodsWe combined population and health facility data (2018 Cameroon Demographic and Health Survey and 2015 Emergency Obstetric and Neonatal Care Assessment) to estimate the input-adjusted coverage of antenatal care (ANC) and intra-and postpartum care (IPC). Inequalities were assessed using absolute and relative measures.

resultsThe MHC cascade showed significant falls in input-adjusted coverage. For ANC, 86.3% service contact eroded to 25.3% continuity and 14.4% input-adjusted coverage. For IPC, the service continuum dropped from 51.4 to 31.4% input-adjusted coverage, revealing steeper losses compared to ANC (20.0% vs. 10.9%). When accounting for service readiness, relative inequalities intensified (e.g., the wealth-based RII for ANC increased by 122%), while absolute gaps narrowed (SII declined by 25%), indicating a greater loss of coverage among socioeconomically privileged groups (IPC input-adjusted coverage dropped by 20.9% for the highest quintile vs. 11.1% for the lowest quintile). At the same time, marginalized populations experienced compounded exclusion-facing severely limited access to care and substandard service quality at available facilities-highlighting the critical need to improve both access and quality.

conclusionCameroon's MHC disparities stem from systemic resource and quality gaps. Integrating absolute and relative inequality metrics into policy frameworks can dismantle structural biases, aligning interventions with continuum-of-care strategies to prevent avoidable mortality.

Indexed as

Continuity of Patient CareHealthcare DisparitiesMaternal Health ServicesAdolescentAdultCameroonFemaleHealth Services AccessibilityHumansMiddle AgedPregnancyPrenatal CareSocioeconomic FactorsYoung AdultContinuum of careEffective coverage cascadeInequalityInput-adjusted coverageMaternal healthcareService readiness

Identifiers

PMID40926204
PMCPMC12418654

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.