Journal Article

Equity in newborn care, evidence from national surveys in low- and middle-income countries

Mallick, Lindsay, Peven, Kimberly, Taylor, Cath, Purssell, Edward, Bick, Debra, Day, Louise T., Kadzem, Lionel

2021

Overview

Background High coverage of care is essential to improving newborn survival; however, gaps exist in access to timely and appropriate newborn care between and within countries. In high mortality burden settings, health inequities due to social and economic factors may also impact on newborn outcomes. This study aimed to examine equity in co-coverage of newborn care interventions in low- and low middle-income countries in sub-Saharan Africa and South Asia. Methods We analysed secondary data from recent Demographic and Health Surveys in 16 countries. We created a co-coverage index of five newborn care interventions. We examined differences in coverage and co-coverage of newborn care interventions by country, place of birth, and wealth quintile. Using multilevel logistic regression, we examined the association between high co-coverage of newborn care (4 or 5 interventions) and social determinants of health. Results Coverage and co-coverage of newborn care showed large between- and within-country gaps for home and facility births, with important inequities based on individual, family, contextual, and structural factors. Wealth-based inequities were smaller amongst facility births compared to non-facility births. Conclusion This analysis underlines the importance of facility birth for improved and more equitable newborn care. Shifting births to facilities, improving facility-based care, and community-based or pro-poor interventions are important to mitigate wealth-based inequities in newborn care, particularly in countries with large differences between the poorest and richest families and in countries with very low coverage of care.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Africa South of the Sahara / Age / Asia / Birth / Births / Breastfeeding & lactation / Care and treatment / Childbirth & labor / Decision making / Demographic aspects / Developing Countries / Economic factors / Empowerment / Equality and Human Rights / Fairness / Families & family life / Female / Health care disparities / Health Care Surveys / Health disparities / Health equity / Health facilities / Health Policy / Health Promotion and Disease Prevention / Health services / Health Services Research / Health surveys / Healthcare Disparities - statistics & numerical data / Home births / Humans / Impact analysis / Income / Inequality / Infant / Infant Care / Infant, Newborn / Infants / International aspects / Intervention / Low income groups / Maternal & child health / Medicine / Medicine & Public Health / Newborn / Newborn babies / Polls & surveys / Population / Postnatal care / Postpartum period / Principal components analysis / Public Health / Quality of care / Social determinants of health / Social exclusion / Social factors / Social Justice / Social Policy / Socioeconomic Factors / Variables / Wealth / Womens health / Young Adult