scholarly journals Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oduse Samuel ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Maternal Health ◽  
Rural Areas ◽  
Health Care Services ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Maternal Healthcare ◽  
Care Services ◽  
Urban Rural ◽  
Sub Saharan ◽  
Urban And Rural Areas

Abstract Background There has been a substantial improvement in reducing maternal mortality in the Sub-Saharan African region. The vast rural-urban gap in maternal health outcomes, however, is obscured by this average achievement. This study attempts to measure the contribution of identified risk factors to describe the average rural-urban difference in the use of antenatal care, health facilities for delivery, and health professional assistance at delivery. Method To achieve this objective, we used descriptive analysis and Fairlie non-linear decomposition method to quantify covariates’ contribution in explaining the urban–rural difference in maternal healthcare services utilisation. Result The study’s finding shows much difference between urban and rural areas in the use of maternal healthcare services. Socio-economic factors such as household wealth index, exposure to media, and educational level of women and their husbands/partners contributed the most in explaining the gap between urban and rural areas in healthcare services utilisation. Conclusions Interventions to bridge the gap between urban and rural areas in maternal healthcare services utilisation in Sub-Saharan Africa should be centred towards socio-economic empowerment. Government can enforce targeted awareness campaigns to encourage women in rural communities in Sub-Sharan Africa to take the opportunity and use the available maternal health care services to be at par with their counterparts in urban areas.

scholarly journals An analysis of the learning performance gap between urban and rural areas in sub-Saharan Africa

2021 ◽  
Vol 41 (2) ◽  
pp. 1-17
Author(s):  
Sugata Sumida ◽  
Keisuke Kawata
Keyword(s):  
Rural Areas ◽  
Family Characteristics ◽  
Sub Saharan Africa ◽  
School Characteristics ◽  
Persistent Problem ◽  
Learning Gap ◽  
Urban Rural ◽  
Sub Saharan ◽  
Urban And Rural Areas ◽  
Over Time

The learning gap between urban and rural areas is a persistent problem in many sub-Saharan African countries. Previous studies have found that the urban-rural learning gap is attributed to the fact that student characteristics and school resources are different in urban and rural areas. Our study updates this finding by using the latest dataset and further examines the changes in the attributed sources over time. Using 15 educational systems in sub-Saharan Africa, we examined 4 potential sources of the gap: student, family, teacher, and school characteristics. Our results reveal that the urban-rural learning gap in recent years is attributed mostly to differences in school and family characteristics. We also found that the attribution remains the same over time from 2004 to 2011 and that the attribution to family characteristics’ differences became slightly greater than the one to school characteristics’ differences.

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.

Do urban areas still have advantages over rural areas in antenatal care discontinuity in Sub-Saharan Africa?

2021 ◽  
Vol 9 (2) ◽  
pp. 27-35
Author(s):  
Franklin Bouba Djourdebbé ◽  
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Sub Saharan Africa ◽  
Health Policies ◽  
Antenatal Visit ◽  
Urban Rural ◽  
Health Survey Data ◽  
Sub Saharan

In sub-Saharan Africa, among the small proportion of women who had at least one antenatal visit, many of them no longer return to ensure continuity of antenatal care. This antenatal care discontinuity is a matter of serious concern for maternal health. Using Demographic and Health Survey data collected between 2000 and 2016 in 26 sub-Saharan countries, this study aims to analyse urban/rural differences in antenatal care discontinuity. Although in the majority of countries, urban areas have considerable advantages in terms of antenatal care continuity, there are countries where urban/rural differences are not significant, as well as atypical countries (Rwanda, Gambia and Zambia) where antenatal care discontinuity is higher in urban areas compared to rural areas. This study is a contribution to tackle the complex disparities in the discontinuity of care during pregnancy in maternal health policies in sub-Saharan Africa. Keywords: Maternal health, antenatal care, urban, rural, sub-Saharan Africa.

scholarly journals Male partners’ views of involvement in maternal healthcare services at Makhado Municipality clinics, Limpopo Province, South Africa

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Kenneth Nesane ◽  
Sonto M. Maputle ◽  
Hilda Shilubane
Keyword(s):  
Maternal Health ◽  
Health Care Services ◽  
Healthcare Services ◽  
Sampling Procedure ◽  
Limpopo Province ◽  
Major Theme ◽  
Male Partners ◽  
Maternal Healthcare ◽  
Individual Interviews ◽  
Care Services

Background: Male partners have a strong influence on pregnant partners’ health and their access to care. Their involvement is critical in the delivery and uptake of maternal healthcare services and improving maternal and child health outcomes.Aim: The study sought to determine male partners’ views on their involvement in maternal healthcare services.Setting: The Makhado Municipality’s Kutama, Madombidzha and Vleifontein clinics.Methods: A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. The population comprised 15 men whose partners had been pregnant within the last 2 years. A non-probability, purposive sampling procedure was used. Data were collected via in-depth individual interviews using a voice recorder and an interview schedule guide. Tesch’s open coding method was used to analyse data.Results: The findings revealed one major theme, namely that maternal health issues are viewed as a woman’sdomain; and three sub-themes: culture and participation in childbirth, male partners’ employment status, and male partners’ unwillingness to participate in maternal health issues.Conclusions: The involvement of male partners in maternal healthcare services, and further research in promoting this activity, should be proposed to policymakers.Keywords: Views, partners, involvement, maternal health care services, antenatal care, labour and postnatal care.

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 Geographical and socioeconomic inequalities in the utilization of maternal healthcare services in Nigeria: 2003–2017

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chijioke Okoli ◽  
Mohammad Hajizadeh ◽  
Mohammad Mafizur Rahman ◽  
Rasheda Khanam
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Healthcare Services ◽  
Socioeconomic Inequalities ◽  
Low Income Countries ◽  
Theil Index ◽  
Maternal Healthcare ◽  
North East ◽  
Birth Attendance ◽  
Urban And Rural Areas

Abstract Background Maternal mortality has remained a challenge in many low-income countries, especially in Africa and in Nigeria in particular. This study examines the geographical and socioeconomic inequalities in maternal healthcare utilization in Nigeria over the period between 2003 and 2017. Methods The study used four rounds of Nigeria Demographic Health Surveys (DHS, 2003, 2008, 2013, and 2018) for women aged 15–49 years old. The rate ratios and differences (RR and RD) were used to measure differences between urban and rural areas in terms of the utilization of the three maternal healthcare services including antenatal care (ANC), facility-based delivery (FBD), and skilled-birth attendance (SBA). The Theil index (T), between-group variance (BGV) were used to measure relative and absolute inequalities in the utilization of maternal healthcare across the six geopolitical zones in Nigeria. The relative and absolute concentration index (RC and AC) were used to measure education-and wealth-related inequalities in the utilization of maternal healthcare services. Results The RD shows that the gap in the utilization of FBD between urban and rural areas significantly increased by 0.3% per year over the study period. The Theil index suggests a decline in relative inequalities in ANC and FBD across the six geopolitical zones by 7, and 1.8% per year, respectively. The BGV results do not suggest any changes in absolute inequalities in ANC, FBD, and SBA utilization across the geopolitical zones over time. The results of the RC and the AC suggest a persistently higher concentration of maternal healthcare use among well-educated and wealthier mothers in Nigeria over the study period. Conclusion We found that the utilization of maternal healthcare is lower among poorer and less-educated women, as well as those living in rural areas and North West and North East geopolitical zones. Thus, the focus should be on implementing strategies that increase the uptake of maternal healthcare services among these groups.

Second-hand clothing encounters in Zambia: global discourses, Western commodities, and local histories

Africa ◽  
1999 ◽  
Vol 69 (3) ◽  
pp. 343-365 ◽  
Author(s):  
Karen Tranberg Hansen
Keyword(s):  
Rural Areas ◽  
Rapid Expansion ◽  
Sub Saharan Africa ◽  
African Countries ◽  
The West ◽  
Post Colonial ◽  
Sub Saharan ◽  
And Gender ◽  
Urban And Rural Areas ◽  
The Third World

AbstractThe rapid expansion in commercial exports of second-hand clothing from the West to the Third World and the increase in second-hand clothing consumption in many African countries raise challenging questions about the effects of globalisation and the meanings of the West and the local that consumers attribute to objects at different points of their journey across global space. This article draws on extensive research into the sourcing of second-hand clothing in the West, and its wholesaling, retailing, distribution and consumption in Zambia. Discussing how people in Zambia are deahng with the West's unwanted clothing, the article argues that a cultural economy is at work in local appropriations of this particular commodity that is opening space for local agency in clothing consumption. Clothing has a powerful hold on people's imagination because the self and society articulate through the dressed body. To provide background for this argument, the article briefly sketches recent trends in the global second-hand clothing trade that place the countries of sub-Saharan Africa as the world's largest importing region. There follows a discussion of Zambians' preoccupation with clothing, both new and second-hand, historically and at the present time. It demonstrates that the meanings consumers in Zambia attribute to second-hand clothing are neither uniform nor static but shift across class and gender lines, and between urban and rural areas. Above all, they depend on the cultural politics of their time. In dealing with clothing, people in Zambia are making sense of post-colonial society and their own place within it and in the world at large.

Sign in / Sign up

Export Citation Format

Share Document