Measuring and analysing social efficiency in the production of maternal health services in Mexico, 2008–15

2020 ◽  
Vol 35 (8) ◽  
pp. 889-899
Author(s):  
Fato Fene ◽  
Edson Serván-Mori ◽  
Miguel Ángel Mendoza ◽  
Carlos Chivardi ◽  
Hortensia Reyes-Morales ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Fixed Effects ◽  
Structural Characteristics ◽  
Decomposition Analysis ◽  
Maternal Health Services ◽  
Social Efficiency ◽  
Spatial Autoregressive ◽  
Concentration Patterns

Abstract ‘Social efficiency’ (SE) denotes the capacity of health systems to ensure equitable access to quality health services at no financial risk to users. Mexico and other low- and middle-income countries have rarely studied the performance of their health systems from an SE perspective. We propose a metric for assessing SE in the production of maternal health services in the public sector among populations without social security, analysing contextual correlates of the demand for these services. Analysis was based on administrative data collected from the 243 health jurisdictions (HJs) in Mexico for the period 2008–15. We defined production inputs as the availability of physical and human resources and social product as the unweighted sum of social sub-products, including an equitable distribution of maternal health resources, the provision of quality maternal health care and financial protection for users. We described the SE scores, the main contextual characteristics as well as those related to the demand for maternal health services. We then performed a variance decomposition analysis of the SE score by component and estimated the SE territorial concentration patterns. Finally, we identified the structural characteristics modelling SE by means of a spatial autoregressive panel data model with fixed effects by year. The SE score rose from 57.7% in 2008 to 71.9% in 2015 (P < 0.01), with its quality component accounting for the largest proportion of variance (30%). SE peaked in HJs with low social marginalization and rurality, and with service demand characterized by low parity and older populations. Different SE levels demonstrated territorial concentration patterns. Analysing SE as a metric for health system performance offers elements that contribute to the achievement of UHC as well as to the design and implementation of effective maternal health interventions intended particularly for the most socially vulnerable sectors of the population.

Maternal health services in China’s western rural areas: uptake and correlates

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Chengfang Liu ◽  
Linxiu Zhang ◽  
Yaojiang Shi ◽  
Huan ZHOU ◽  
Alexis Medina ◽  
...  
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Uptake Rate ◽  
Rural Areas ◽  
Design Methodology ◽  
Maternal Health Services ◽  
Western China ◽  
Public Health Systems

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.

Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review

2012 ◽  
Vol 20 (39) ◽  
pp. 50-61 ◽  
Author(s):  
Maurice Bucagu ◽  
Jean M. Kagubare ◽  
Paulin Basinga ◽  
Fidèle Ngabo ◽  
Barbara K Timmons ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Maternal Health Services ◽  
Health Systems Strengthening

Health systems factors influencing maternal health services: a four-country comparison

Health Policy ◽  
2005 ◽  
Vol 73 (2) ◽  
pp. 127-138 ◽  
Author(s):  
Justin Oliver Parkhurst ◽  
Loveday Penn-Kekana ◽  
Duane Blaauw ◽  
Dina Balabanova ◽  
Kirill Danishevski ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Maternal Health Services ◽  
Factors Influencing ◽  
Country Comparison

scholarly journals Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature

2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Maternal Health Services ◽  
Policy Formulation ◽  
Social Accountability ◽  
The Social ◽  
The Government ◽  
The Impact

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.

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