Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Room 10.38, Worsley Building, Leeds LS2?9NL, UK.
Health Policy Plan. 2017 Oct 1;32(8):1111-1118. doi: 10.1093/heapol/czx049.
This article examines socioeconomic inequalities in maternal and child health care in Nigeria over an 18-year period. Studies demonstrate that maternal and child mortality is much higher amongst the poor in low-income countries, with access to health care concentrated among the wealthiest. Evidence suggests that in Nigeria inequalities in access to quality services continue to persist. We use data from two rounds of the Nigerian Demographic and Heath Survey (NDHS) conducted in 1990 and 2008 and measure inequalities in maternal and child health care variables across socioeconomic status using concentration curves and indices. Factors contributing to the inequalities are investigated using decomposition analysis. The results show that in 1990, maternal access to skilled assistance during delivery had the highest levels of inequalities. It reveals that child and maternal health inequalities appear to be determined by different factors and while inequalities in child care have declined, inequalities in maternal care have increased. We discuss the findings in relation to the much greater attention paid to child health programmes. The findings of this study call for specific maternal programmes targeting the poor, less educated and rural areas in Nigeria.
本文考察了尼日利亚母婴保健服务中存在的社会经济不平等问题，时间跨度为 18 年。研究表明，在低收入国家，贫困人群的母婴死亡率要高得多，而最富有的人却能够获得更多的医疗保健资源。有证据表明，在尼日利亚，获得优质服务的不平等现象仍然存在。我们利用了尼日利亚两次人口与健康调查（NDHS）的数据，调查分别于 1990 年和 2008 年进行，并使用集中曲线和指数来衡量母婴保健变量的社会经济地位不平等。我们使用分解分析来研究导致不平等的因素。结果表明，1990 年，产妇在分娩时获得熟练帮助的机会存在最高水平的不平等。结果显示，儿童和产妇健康不平等似乎由不同的因素决定，虽然儿童保健方面的不平等有所减少，但产妇保健方面的不平等却有所增加。我们根据对儿童健康计划给予了更多关注的情况讨论了这些发现。本研究的结果呼吁在尼日利亚制定针对贫困人口、受教育程度较低的人和农村地区的具体产妇方案。
