scholarly journals Ethno-political favouritism in maternal health care service delivery: Micro-level evidence from sub-Saharan Africa, 1981–2014

2020 ◽  
Vol 23 (1) ◽  
pp. 3-27
Author(s):  
Ole Magnus Theisen ◽  
Håvard Strand ◽  
Gudrun Østby
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Political Status ◽  
Care Services ◽  
Maternal Health Care Services ◽  
Sub Saharan

It is commonly held that political leaders favour people of the same ethnic origin. We test this argument of ethno-political favouritism by studying variations in the usage of maternal health care services across groups in sub-Saharan Africa (SSA). More specifically, we link geo-referenced individual-level data from the Demographic and Health Surveys on 601,311 births by 399,908 mothers in 31 countries during the period 1981–2014 with data on the settlement of ethnic groups and their political status. Our results indicate that women benefit from the shift that brings co-ethnics into power, increasing the probability of receiving maternal health care services. The effect strengthens with increased competitiveness around elections. We advance the current literature in four important ways. Firstly, we undertake the first analysis that utilizes shifts in ethno-political status for the same individual, effectively eliminating competing time-invariant explanations to that of shifts in ethno-political status. Secondly, since SSA governments often incorporate multiple groups, we test the effect of patronage on being co-ethnic with cabinet members in general, and not only the president. Thirdly, health services constitute the public good most desired by citizens of SSA. Our measure captures a vital health service that is highly desired across groups. An increase in usage likely reflects genuine trickle-down effects of having co-ethnics in power, a crucial ingredient in building popular support for ethnic patrons. Fourthly, we show that electoral competition is an important conditioner of ethno-political favouritism.

DECOMPOSING THE SOCIOECONOMIC INEQUALITY IN UTILIZATION OF MATERNAL HEALTH CARE SERVICES IN SELECTED COUNTRIES OF SOUTH ASIA AND SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (6) ◽  
pp. 749-769 ◽  
Author(s):  
Srinivas Goli ◽  
Dipty Nawal ◽  
Anu Rammohan ◽  
T. V. Sekher ◽  
Deepshikha Singh
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Services ◽  
Socioeconomic Inequalities ◽  
Maternal Health Care ◽  
Health Care Use ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Care Services ◽  
Maternal Health Care Services

SummaryThe gap in access to maternal health care services is a challenge of an unequal world. In 2015, each day about 830 women died due to complications of pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented. This study quantified the contributions of the socioeconomic determinants of inequality to the utilization of maternal health care services in four countries in diverse geographical and cultural settings: Bangladesh, Ethiopia, Nepal and Zimbabwe. Data from the 2010–11 Demographic and Health Surveys of the four countries were used, and methods developed by Wagstaff and colleagues for decomposing socioeconomic inequalities in health were applied. The results showed that although the Concentration Index (CI) was negative for the selected indicators, meaning maternal health care was poorer among lower socioeconomic status groups, the level of CI varied across the different countries for the same outcome indicator: CI of −0.1147, −0.1146, −0.2859 and −0.0638 for <3 antenatal care visits; CI of −0.1338, −0.0925, −0.1960 and −0.2531 for non-institutional delivery; and CI of −0.1153, −0.0370, −0.1817 and −0.0577 for no postnatal care within 2 days of delivery for Bangladesh, Ethiopia, Nepal and Zimbabwe, respectively. The marginal effects suggested that the strength of the association between the outcome and explanatory factors varied across the different countries. Decomposition estimates revealed that the key contributing factors for socioeconomic inequalities in maternal health care varied across the selected countries. The findings are significant for a global understanding of the various determinants of maternal health care use in high-maternal-mortality settings in different geographical and socio-cultural contexts.

scholarly journals Utilization pattern and associated factors of maternal health care services in Haryana, India: a study based on district level household survey data

2018 ◽  
Vol 7 (3) ◽  
pp. 1154 ◽  
Author(s):  
Shinjini Ray ◽  
Pravat Bhandari ◽  
Jang Bahadur Prasad
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Institutional Delivery ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
District Level ◽  
Care Services ◽  
Maternal Health Care Services

Background: Maternal health was one of the most important millennium development goals (MDGs), India didn’t achieve by the year 2015. Since, India is a multicultural, social and multiregional country, where some of the regions have good social and demographic achievement while some are poor. Haryana is one of them, which has 146 maternal mortality ratio. The level of receiving antenatal care (ANC) in Haryana is quite low as compared to other states of India. Objective of present study was to Understand the extent of use of maternal health care services in Haryana as well as examining the role of antenatal care and other socio-economic factors on the utilization of maternal health services.Methods: Bivariate analysis, chi-square test, and binary logistic regression have been used based on district level household and facility survey-4 data.Results: The utilization of ANC (any and full), institutional delivery and post-delivery treatment seeking varies among women by literacy, age at first marriage, age at women and place of residence. Literate women are two times more likely to access ANC [odds ratio (OR)=1.97 (any ANC), 1.95 (full ANC), p<0.01] and 1.52 times more likely to prefer institutional delivery [OR=1.52, p<0.01].Conclusions: Empowering women through the encouragement of mother’s education should be one of the most fundamental strategies to promote maternal health care services and reduce inequalities.

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