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Co‐coverage of reproductive, maternal, newborn and child health interventions shows wide inequalities and is associated with child nutritional outcomes in Ethiopia (2005–2019)
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Co‐coverage of reproductive, maternal, newborn and child health interventions shows wide inequalities and is associated with child nutritional outcomes in Ethiopia (2005–2019)
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Co‐coverage of reproductive, maternal, newborn and child health interventions shows wide inequalities and is associated with child nutritional outcomes in Ethiopia (2005–2019)
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Journal Article
Co‐coverage of reproductive, maternal, newborn and child health interventions shows wide inequalities and is associated with child nutritional outcomes in Ethiopia (2005–2019)
2024
Overview
The health system is the primary vehicle for the delivery of nutrition‐specific interventions that aim to reduce maternal and child malnutrition. The integration of nutrition interventions into existing health interventions is promising, but to ensure that no one is left behind requires that access to essential health services is equitably distributed. This study aims to assess trends and socioeconomic inequalities in coverage of reproductive, maternal, newborn and child health (RMNCH) and assess its association with child nutritional outcomes in Ethiopia. Using the Ethiopian Demographic and Health Survey (2005, 2011, 2016, and 2019), we estimated the coverage of RMNCH interventions in Ethiopia using the co‐coverage index, which is a count of the number of interventions accessed. We assessed the trend and inequalities in co‐coverage and evaluated its association with child nutritional outcomes like stunting, wasting, and minimum dietary diversity (MDD). The national co‐coverage index has shown a significant increase over the 2005–2019 period. However, all of the RMNCH interventions constituting the co‐coverage index showed a pro‐rich and pro‐urban distribution (p < 0.05). The highest inequality, based on the slope index of inequality (SII), was observed for skilled assistance during delivery (SII: 80.4%), followed by access to an improved source of drinking water (SII: 62.6%), and antenatal care visits (SII: 55.5%). The low coverage in RMNCH and the observed inequality were associated with stunting, wasting, and MDD. Reducing socioeconomic inequality in RMNCH is key to achieve the health, nutrition and equity‐related goals of the Sustainable Development Goals. Trend in co‐coverage of reproductive, maternal, newborn and child health interventions in Ethiopia (2005–2019). Key messages Significant increases in the coverage of reproductive, maternal, newborn and child health (RMNCH) interventions were observed between 2005 and 2019. Inequalities in RMNCH interventions were stark and showed pro‐rich and pro‐urban distribution. Improved co‐coverage of RMNCH interventions is associated with reduced odds of stunting and wasting, and increases in dietary diversity among children 6–23 months of age. Analyses stratified by rural/urban residence and wealth quintile showed that the association between co‐coverage and dietary diversity was stronger for urban and the wealthiest quintile.
