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Trends of socioeconomic inequality in using maternal health care services in Lao Peoples Democratic Republic from year 2000 to 2012

Cited 3 time in Web of Science Cited 9 time in Scopus
Issue Date
2018-07-13
Publisher
BioMed Central
Citation
BMC Public Health, 18(1):875
Keywords
TrendsInequalitySocioeconomic factorsMaternal health servicesLao People’s Democratic Republic
Abstract
Background
Socioeconomic inequalities in access to maternal health care have received more attention as it challenges the sustainability of the ongoing achievement in reducing maternal mortality. By promoting access to maternal health care as one of the core targets of the Health Sector Reform, Lao Peoples Democratic Republic has reduced maternal mortality dramatically over the last decade. In spite of this improvement, little has been known about the secular trends in disparities of service utilization across different socioeconomic subgroups.

Methods
Two waves of the Multiple Indicator Cluster Survey in the years 2000 and 2012 were pooled for the analysis. We used logistic regression to estimate the likelihood of using antenatal care (ANC) and delivery services with skilled birth attendants (SBA) across different socioeconomic subgroups. Difference-in-difference method was applied to examine the inequality trends across the years by analyzing the interaction terms of the survey years and socioeconomic factors (education, wealth, ethnicity, and residential areas).


Results
Urban-rural disparity was improved over time while there were no educational disparity changes. Rural residential areas showed significant changes than urban areas over time [OR = 2.40; 95% CI: 1.52–3.77 for ANC and OR = 2.16; 95% CI: 1.36–3.42 for SBA]. However, there were aggravations in the disparities between major and minor ethnic group as well as worsening disparities between the rich and poor: i.e. Ethnic minority showed significant aggravation over time [OR = 0.62; 95% CI: 0.44–0.89 for ANC and OR = 0.65; 95% CI: 0.44–0.97 for SBA].

Conclusions
Efforts to increase maternal health service utilization in poor and minority ethnic groups should be emphasized to reduce social inequalities, thus encompassing multiple-sector interventions rather than focusing only on health sector related interventions.
ISSN
1471-2458
Language
English
URI
https://hdl.handle.net/10371/143516
DOI
https://doi.org/10.1186/s12889-018-5811-0
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College of Medicine/School of Medicine (의과대학/대학원)JW LEE Center for Global Medicine (이종욱글로벌의학센터)Journal Papers (저널논문_이종욱글로벌의학센터)
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