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首页> 外文期刊>Global health research and policy. >The evolution of socioeconomic status-related inequalities in maternal health care utilization: evidence from Zimbabwe, 1994–2011
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The evolution of socioeconomic status-related inequalities in maternal health care utilization: evidence from Zimbabwe, 1994–2011

机译：孕产妇保健利用中与社会经济状况有关的不平等现象的演变：来自津巴布韦的证据，1994-2011年

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BackgroundInequalities in maternal health care are pervasive in the developing world, a fact that has led to questions about the extent of these disparities across socioeconomic groups. Despite a growing literature on maternal health across Sub-Saharan African countries, relatively little is known about the evolution of these inequalities over time for specific countries. This study sought to quantify and explain the observed differences in prenatal care use and professional delivery assistance in Zimbabwe. MethodsThe empirical analysis uses four rounds of the nationwide Zimbabwe Demographic and Health Survey administered in 1994, 1999, 2005/06 and 2010/11. Two binary indicators were used as measures of maternal health care utilization; (1) the receipt of four or more antenatal care visits and (2) receiving professional delivery assistance for the most recent pregnancy. We measure inequalities in maternal health care use using the Erreygers corrected concentration index. A decomposition analysis was conducted to determine the underlying drivers of the measured disparities. ResultsThe computed concentration indices for professional delivery assistance and prenatal care reveal a mostly pro-rich distribution of inequalities between 1994 and 2011. Particularly, the concentration index [95% confidence interval] for the receipt of prenatal care was 0.111 [0.056, 0.171] in 2005/06 and 0.094 [0.057, 0.138] in 2010/11. For professional delivery assistance, the concentration index stood at 0.286 [0.244, 0.329] in 2005/06 and 0.324 [0.283, 0.366] in 2010/11. The pro-rich inequality was also increasing in both rural and urban areas over time. The decomposition exercise revealed that wealth, education, religion and information access were the underlying drivers of the observed inequalities in maternal health care. ConclusionsIn Zimbabwe, socioeconomic disparities in maternal health care use are mostly pro-rich and have widened over time regardless of the location of residence. Overall, we established that inequalities in wealth and education are amongst the top drivers of the observed disparities in maternal health care. These findings suggest that addressing inequalities in maternal health care utilization requires coordinated public policies targeting the more poor and vulnerable segments of the population in Zimbabwe.
机译：背景孕产妇保健中的不平等现象在发展中国家普遍存在，这一事实引起了人们对社会经济群体之间这些差距的严重性的质疑。尽管关于撒哈拉以南非洲国家孕产妇保健的文献越来越多，但对于特定国家随着时间的推移，这些不平等现象的演变知之甚少。这项研究试图量化和解释津巴布韦在产前保健使用和专业分娩协助方面观察到的差异。方法：实证分析使用了1994年，1999年，2005/06年和2010/11年进行的四轮全国津巴布韦人口与健康调查。两项二元指标被用作衡量孕产妇保健利用的指标; （1）接受四次或更多次产前检查，以及（2）接受最近一次妊娠的专业分娩援助。我们使用Erreygers校正后的集中指数来衡量孕产妇保健使用中的不平等。进行了分解分析以确定所测量差异的潜在驱动因素。结果计算得出的专业分娩协助和产前护理的集中指数显示，1994年至2011年之间的不平等现象主要是富人分布。特别是，接受产前护理的集中指数[95％置信区间]为0.111 [0.056，0.171] 2005/06和2010/11的0.094 [0.057，0.138]。对于专业交付援助，2005/06年度的集中指数为0.286 [0.244，0.329]，2010/11年度的集中指数为0.324 [0.283，0.366]。随着时间的推移，在农村和城市地区，亲富人的不平等现象也在加剧。分解工作表明，财富，教育，宗教和信息获取是导致孕产妇保健不平等现象的根本原因。结论在津巴布韦，孕产妇保健使用方面的社会经济差异大多是富裕的，并且无论居住地点如何都随着时间的推移而扩大。总体而言，我们确定，财富和教育不平等是导致孕产妇保健差异的主要因素。这些发现表明，要解决孕产妇保健利用方面的不平等现象，就需要针对津巴布韦较贫穷和较脆弱人群的协调一致的公共政策。

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