Socioeconomic inequalities in maternal health care utilization in Ghana

Novignon, J; Ofori, B; Tabiri, KG; Pulok, MH

Socioeconomic inequalities in maternal health care utilization in Ghana

Novignon, J Ofori, B Tabiri, KG Pulok, MH

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Publication Type:: Journal Article
Citation:: International journal for equity in health, 2019, 18 (1), pp. 141 - ?
Issue Date:: 2019-09-05

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Field	Value	Language
dc.contributor.author	Novignon, J	en_US
dc.contributor.author	Ofori, B	en_US
dc.contributor.author	Tabiri, KG	en_US
dc.contributor.author	Pulok, MH https://orcid.org/0000-0002-9168-5732	en_US
dc.date.available	2019-08-28	en_US
dc.date.issued	2019-09-05	en_US
dc.identifier.citation	International journal for equity in health, 2019, 18 (1), pp. 141 - ?	en_US
dc.identifier.uri	http://hdl.handle.net/10453/138571
dc.description.abstract	BACKGROUND: Improving maternal and child health remains a public health priority in Ghana. Despite efforts made towards universal coverage, there are still challenges with access to and utilization of maternal health care. This study examined socioeconomic inequalities in maternal health care utilization related to pregnancy and identified factors that account for these inequalities. METHODS: We used data from three rounds of the Ghana Demographic and Health Surveys (2003, 2008 and 2014). Two health care utilization measures were used; (i) four or more antenatal care (ANC) visits and (ii) delivery by trained attendants (DTA). We first constructed the concentration curve (CC) and estimated concentration indices (CI) to examine the trend in inequality. Secondly, the CI was decomposed to estimate the contribution of various factors to inequality in these outcomes. RESULTS: The CCs show that utilization of at least four ANC visits and DTA were concentrated among women from wealthier households. However, the trends show the levels of inequality decreased in 2014. The CI of at least four ANC visits was 0.30 in 2003 and 0.18 in 2014. Similarly, the CIs for DTA was 0.60 in 2003 and 0.42 in 2014. The decomposition results show that access to National Health Insurance Scheme (NHIS) and women's education levels were the most important contributors to the reduction in inequality in maternal health care utilization. CONCLUSIONS: The findings highlight the importance of the NHIS and formal education in bridging the socioeconomic gap in maternal health care utilization.	en_US
dc.relation.ispartof	International journal for equity in health	en_US
dc.relation.isbasedon	10.1186/s12939-019-1043-x	en_US
dc.subject.classification	Public Health	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Prenatal Care	en_US
dc.subject.mesh	Demography	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Socioeconomic Factors	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Maternal Health Services	en_US
dc.subject.mesh	Patient Acceptance of Health Care	en_US
dc.subject.mesh	Ghana	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	Maternal Health	en_US
dc.subject.mesh	Universal Health Insurance	en_US
dc.title	Socioeconomic inequalities in maternal health care utilization in Ghana	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	18	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1608 Sociology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/DVC (International)
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	18	en_US

Abstract:

BACKGROUND: Improving maternal and child health remains a public health priority in Ghana. Despite efforts made towards universal coverage, there are still challenges with access to and utilization of maternal health care. This study examined socioeconomic inequalities in maternal health care utilization related to pregnancy and identified factors that account for these inequalities. METHODS: We used data from three rounds of the Ghana Demographic and Health Surveys (2003, 2008 and 2014). Two health care utilization measures were used; (i) four or more antenatal care (ANC) visits and (ii) delivery by trained attendants (DTA). We first constructed the concentration curve (CC) and estimated concentration indices (CI) to examine the trend in inequality. Secondly, the CI was decomposed to estimate the contribution of various factors to inequality in these outcomes. RESULTS: The CCs show that utilization of at least four ANC visits and DTA were concentrated among women from wealthier households. However, the trends show the levels of inequality decreased in 2014. The CI of at least four ANC visits was 0.30 in 2003 and 0.18 in 2014. Similarly, the CIs for DTA was 0.60 in 2003 and 0.42 in 2014. The decomposition results show that access to National Health Insurance Scheme (NHIS) and women's education levels were the most important contributors to the reduction in inequality in maternal health care utilization. CONCLUSIONS: The findings highlight the importance of the NHIS and formal education in bridging the socioeconomic gap in maternal health care utilization.

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http://hdl.handle.net/10453/138571