scholarly journals Inequity in health care utilization for common childhood illnesses in India: measurement and decomposition analysis using the India demographic and health survey 2015–16

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tulasi Malini Maharatha ◽  
Umakant Dash
Keyword(s):  
Health Care ◽  
Child Health ◽  
Medical Treatment ◽  
Health Survey ◽  
Concentration Index ◽  
Decomposition Analysis ◽  
Demographic And Health Survey ◽  
Horizontal Inequity ◽  
Indian States ◽  
Childhood Illnesses

Abstract Background Though child mortality has dropped remarkably, it is considerably high in South Asia. Across the globe, 5.2 million children under 5 years of age died in 2019, and India accounts for a significant portion of these deaths. Common childhood illnesses are the leading cause of these deaths. Seeking care from formal providers can reduce these avoidable deaths. Inequity is a crucial blockage in optimum utilization of medical treatment for children. Hence, the present study analyzes the inequalities and horizontal inequities in utilizing the medical treatment for diarrhea, fever, acute respiratory infection (ARI), and any of these common childhood illnesses in India and across the Indian states. The study also attempts to locate significant contributors to these inequalities. Methods The study used 0 to 59 months children’s data sourced from the Demographic and Health Survey, India (2015–16). Concentration Index (CI) and Erreygers Corrected Concentration Index (EI) were used to measure the inequalities. The Horizontal Inequity Index (HII) was deployed to estimate inequity. The decomposition method introduced by Erreygers was applied to determine the significant contributors of inequalities. Results The EI in medical treatment-seeking for common childhood illnesses was 0.16, while the HII was 0.15. The highest inequality was perceived in the utilization of medical treatment for ARI (0.17). The primary contributing factors of these inequalities were continuum of maternal care (18.7%), media exposure (12%), affordability (9.3%), place of residence (9.1%), mother’s education (8.5%), and state groups (8.8%). The North-Eastern states showed the highest level of inequality across the Indian states. Conclusion The study reveals that the horizontal inequity in medical treatment utilization for children in India is pro-rich. The findings of the study suggest that attuning the efforts of existing maternal and child health programs into one seamless chain of care can bring the inequalities down and improve the utilization of child health care services. The spread of health education through different media sources, reaching out to rural and remote places with adequate health personnel, and easing out the financial hardship in accessing medical treatment could be the cornerstone in accelerating the utilization level amongst the impoverished children.

scholarly journals Trends and determinants of an acceptable antenatal care coverage in Ethiopia, evidence from 2005-2016 Ethiopian demographic and health survey; Multivariate decomposition analysis

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Tilahun Yemanu Birhan ◽  
Wullo Sisay Seretew
Keyword(s):  
Health Care ◽  
Educational Attainment ◽  
Antenatal Care ◽  
Health Survey ◽  
Decomposition Analysis ◽  
Health Care Facilities ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Antenatal Care Visit ◽  
Care Visit

Abstract Background an acceptable antenatal care (ANC4+) is defined as attending at least four antenatal care visit, received at least one dose of tetanus toxoid (TT) injections and consumed 100 iron-folic acids (IFA) tablets/syrup during the last pregnancy. Since maternal health care service utilization continues to be an essential indicator for monitoring the improvements of maternal and child health outcomes. This study aimed to analyze the trends and determinants that contributed to the change in an acceptable antenatal care visit over the last 10 years in Ethiopia. Methods Nationally representative repeated cross-sectional survey was conducted using 2005, 2011, and 2016 Ethiopian Demographic and Health Survey datasets. The data were weighted and analyzed by STATA 14.1 software. Multivariate decomposition regression analysis was used to identify factors that contribute for the change in an acceptable antenatal care visit. A p-value < 0.05 was taken to declare statistically significant predictors to acceptable antenatal care visit. Results among the reproductive age women the rate of an acceptable antenatal care visits was increased from 16% in 2005 to 35% in 2016 in Ethiopia. In the multivariate decomposition analysis, about 29% of the increase in acceptable antenatal care visit was due to a difference in composition of women (endowments) across the surveys. Residence, religion, husband educational attainment, and wealth status was the main source of compositional change factors for the improvements of an acceptable antenatal care visit. Almost two-thirds of an overall change in acceptable antenatal care visit was due to the difference in coefficients/ change in behavior of the population. Religion, educational attainment (both women and husband), and residence are significantly contributed to the change in full antenatal care visit in Ethiopia over the last decades. Conclusion Besides the relevance of receiving an acceptable antenatal care visit for pregnant women and their babies, an acceptable antenatal care visit was slightly increased over time in Ethiopia. Women’s characteristics and behavior change were significantly associated with the change in acceptable antenatal care visits. Public interventions needed to improve acceptable antenatal care coverage, women’s education, and further advancing of health care facilities in rural communities should be done to maintain the further improvements acceptable antenatal care visits.

Adaptive Multi-Services System for Maternal and Child Health Care on Mobile Application (AM-Care)

2012 ◽  
pp. 263-280
Author(s):  
Walisa Romsaiyud ◽  
Wichian Premchaiswadi
Keyword(s):  
Health Care ◽  
Child Health ◽  
Medical Treatment ◽  
Maternal And Child Health ◽  
Health Care Services ◽  
Health Management ◽  
Web Based ◽  
Fully Integrated ◽  
Care Services ◽  
And Child Health

Addressing efforts towards the improvement of maternal and child health management can often prove to be problematic in context to successfully obtaining healthcare and medical treatment information from health care professionals. In this regard, the authors propose an adaptive multi-service system that contains fully integrated health care services, medical treatment services, and maternal and child health management. The system utilized both web-based and mobile technology for implementing the application. A practical framework for generating individual maternal and child health care is also presented from data repositories and fully integrated functional health care services to support an improved quality of life for both mother and children. The application, namely AM-Care, consists of the three main components, i.e., Control Centre Component, Web-based Components, and Mobile Components. Also, AM-Care has the important add-on features such as emergency services and warning services.

Equity in coverage of maternal and newborn care in India: evidence from a nationally representative survey

2020 ◽  
Vol 35 (5) ◽  
pp. 616-623 ◽  
Author(s):  
Yuvaraj Krishnamoorthy ◽  
Marie Gilbert Majella ◽  
Sathish Rajaa
Keyword(s):  
Child Health ◽  
Health Survey ◽  
Maternal And Child Health ◽  
Rural Areas ◽  
Concentration Index ◽  
Newborn Care ◽  
Child Health Services ◽  
Theil Index ◽  
Geographical Regions ◽  
And Child Health

Abstract Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in antenatal care (ANC), intranatal care and postnatal care (PNC) coverage for mothers and newborns in India. We have analysed the NFHS-4 data gathered from the Demographic Health Survey programme. Stratification and clustering in the sample design were accounted for using ‘svyset’ command. Point estimates were reported as proportions with 95% confidence interval. The concentration curve and index were used to represent the socio-economic inequities. Theil index was computed to report inequities across geographical regions and place of residence. In total, 190 797 women who had at least one live birth in the preceding 5 years were included. About 52.1% of women had at least four ANC visits and 81.4% had institutional delivery. About 25.2% and 27.1% of the newborn received PNC within 24 and 48 h of delivery. The proportion of women who received PNC within 24 and 48 h after the delivery was 63.4% and 65.2%, respectively. Maximum inequity was observed for ANC (concentration index—0.195) followed by receipt of PNC by mothers within 24 and 48 h (concentration index—0.106 and 0.103). Women from the rural areas had a disproportionately high proportion of home deliveries (Theil index—3813.6). The findings from this study inform the policymakers and planners about the socio-economic inequity existing across various maternal and child health indicators. This will help them in making informed decisions and strengthen the maternal and child health programme in our country.

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