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

Peven, K., Mallick, L., Taylor, C., Bick, D., Day, L. T., Kadzem, L. and Purssell, E. ORCID: 0000-0003-3748-0864 (2021). Equity in newborn care, evidence from national surveys in low- and middle-income countries. International Journal for Equity in Health, 20(1), p. 132. doi: 10.1186/s12939-021-01452-z

Abstract

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.

Publication Type: Article
Additional Information: © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data
Publisher Keywords: Infant, Newborn, Health equity, Socioeconomic factors, Postnatal care
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments: School of Health Sciences > Nursing
Funders: This study was supported by funds from the King’s College London Centre for Doctoral Studies.
Date available in CRO: 13 Jul 2021 07:20
Date deposited: 13 July 2021
Date of acceptance: 17 April 2021
Date of first online publication: 5 June 2021
URI: https://openaccess.city.ac.uk/id/eprint/26383
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