Socioeconomic inequalities in the continuum of care for maternal health in an upper-middle-income country: the case of Mexico.

This cross-sectional study aimed to identify the magnitude of socioeconomic inequalities in the continuum of care for maternal health according to socioeconomic status and the contribution of sociodemographic factors to this inequality. We used data from the Mexican National Continuous Health and Nutrition Survey (2021-2023), which included 2,846 women who had recently given birth. We assessed both independent and conditional coverage indicators across the maternal health care continuum. We analyzed the association with socioeconomic status using logistic regression and measured inequality with the concentration index and Wagstaff-type decomposition analysis. The prevalence of the continuum of care for maternal health was 37.3% (95%CI: 34.6-40.1). Women affiliated with Social Security health services (OR = 1.37, 95%CI: 1.1-1.8), those whose children were born before the pandemic (OR = 1.84, 95%CI: 1.4-2.4), and non-Indigenous women (OR = 2.08, 95%CI: 1.2-3.6) were more likely to receive the continuum of care. The estimated inequality was concentration index = 0.098 (p < 0.05), indicating a pro-rich distribution. The main contributing factors were non-Indigenous status (30%), affiliation with Social Security (31.1%), and pre-pandemic period (9.6%). Our analysis identified the factors contributing to inequalities across various social groups. By decomposition analysis, we found that access to Social Security services, particularly for vulnerable populations such as Indigenous women, plays a crucial role in reducing these disparities.