Jonah Coretta M P
DST-NRF Centre of Excellence in Food Security, University of the Western Cape, South Africa.
J Public Health Afr. 2020 Mar 20;10(2):1118. doi: 10.4081/jphia.2019.1118. eCollection 2019 Dec 31.
The gap in maternal health outcomes, access and utilization between the haves and have-nots continues to be a challenge globally despite improvements over the past decade. Though Ghana has experienced steady gains in maternal health access and utilization over the years, maternal outcomes, on the other hand, remain poor. In this regard, it is essential to know how various groups in the population achieved improvements and whether some women continue to be disproportionately disadvantaged. The paper performs an analysis of cross-sectional data from the 2017 Ghana maternal health survey to examine the existence of the inverse care law in maternal health services in Ghana. Using descriptive techniques and multivariate logistic regression models the study reveals a pro-rich and pro-urban gradient in the use of hospital facilities for delivery and antenatal care attendance - also, regions known for their high levels of poverty feature significantly lower rates of hospital deliveries. The paper concludes by stressing that unless policies are changed to accommodate these groups, overall gains in maternal health will continue to be incremental.
尽管在过去十年中有所改善，但全球范围内富人与穷人在孕产妇健康结果、获得和利用方面的差距仍然是一个挑战。尽管加纳多年来在孕产妇健康的获得和利用方面取得了稳步进展，但孕产妇健康结果却仍然很差。在这方面，了解人群中的不同群体是如何取得改善的，以及是否有一些妇女仍然处于不成比例的不利地位至关重要。本文对2017年加纳孕产妇健康调查的横断面数据进行了分析，以检验加纳孕产妇保健服务中反向照护法则的存在情况。通过描述性技术和多变量逻辑回归模型，该研究揭示了在使用医院设施进行分娩和产前检查方面存在有利于富人和城市居民的梯度——此外，以高贫困水平闻名的地区，医院分娩率显著较低。本文最后强调，除非改变政策以适应这些群体，否则孕产妇健康方面的总体进展将继续是渐进式的。
