Coverage of maternal and child healthcare services in Ethiopia: Measuring progress towards universal health coverage using the Demographic Health Surveys
- Publication Type:
- Thesis
- Issue Date:
- 2022
Open Access
Copyright Clearance Process
- Recently Added
- In Progress
- Open Access
This item is open access.
𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: In low and lower-middle-income countries, maternal and child health interventions have not been considered holistically. Evidence suggests that inequity in the coverage of services impedes progress in maternal and child health and conventional coverage measures do not account for quality. This research aimed to generate policy-relevant evidence by comprehensively assessing the coverage and inequalities in maternal, and child health interventions across the continuum of care in Ethiopia.
𝗠𝗲𝘁𝗵𝗼𝗱𝘀: This research comprises a systematic review and three cross-sectional analyses of the Ethiopia Demographic and Health Surveys. The first study identified the determinants of the continuum of care in maternal and child health using quantile regression. The second study assessed inequalities in maternal and child health coverage along the continuum of care and the major contributors to the inequality. The third study presented a systematic review of studies evaluating effective coverage of maternal and child health services. Finally, the fourth study assessed the effective coverage of newborn postnatal care in Ethiopia.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀: The results of the first study showed that the average composite coverage index was 39%. Postnatal care for newborns had the lowest coverage (12%). Further, individual, socioeconomic and reproductive factors influenced the continuum of care differently across levels of the composite coverage index. Findings from the second study revealed that the composite coverage index increased from 24% in 2000 to 42% in 2016. However, coverage was pro-rich, and the wealth quintile was the major contributor to the inequalities in all survey years.
The systematic review found (1) the effective coverage values were lower when the crude coverage estimates were adjusted to account for the quality of care; (2) quality assessments addressed structural, process and outcome domains individually or combined; (3) the wealthiest quintile had a higher effective coverage of services than the poorest quintile. The fourth study found that the crude coverage of newborn postnatal care was 13% in Ethiopia, but 9% when adjusted for quality. Further, a spatial variation across regions and a pro-rich inequality in high-quality newborn postnatal care were demonstrated.
𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻𝘀: Ethiopian women and children are not receiving the best possible health benefits, and government efforts to address inequity are insufficient, underscoring areas for improvement. Tailored interventions are required that address the determinants of the continuum of care. Furthermore, the findings suggest that national policy and programming efforts should prioritise accessibility and high-quality care, particularly for disadvantaged sub-groups and geographical locations that lag behind.
Please use this identifier to cite or link to this item: