Reproductive, maternal, newborn, and child health intervention coverage in 70 low-income and middle-income countries, 2000-30: trends, projections, and inequities.

Autor:	Rahman MM; Research Centre for Health Policy and Economics, Hitotsubashi University, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan. Electronic address: mizanur.rahman@r.hit-u.ac.jp., Rouyard T; Research Centre for Health Policy and Economics, Hitotsubashi University, Tokyo, Japan., Khan ST; Global Public Health Research Foundation, Dhaka, Bangladesh., Nakamura R; Research Centre for Health Policy and Economics, Hitotsubashi University, Tokyo, Japan; Graduate School of Economics, Hitotsubashi University, Tokyo, Japan., Islam MR; Research Centre for Health Policy and Economics, Hitotsubashi University, Tokyo, Japan., Hossain MS; Global Public Health Research Foundation, Dhaka, Bangladesh., Akter S; Research Centre for Health Policy and Economics, Hitotsubashi University, Tokyo, Japan., Lohan M; School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK., Ali M; Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland., Sato M; Research Centre for Health Policy and Economics, Hitotsubashi University, Tokyo, Japan; Graduate School of Economics, Hitotsubashi University, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	The Lancet. Global health [Lancet Glob Health] 2023 Oct; Vol. 11 (10), pp. e1531-e1543. Date of Electronic Publication: 2023 Sep 04.
DOI:	10.1016/S2214-109X(23)00358-3
Abstrakt:	Background: Monitoring the progress in reproductive, maternal, newborn, and child health (RMNCH) using the composite coverage index (CCI) is crucial to evaluate the advancement of low-income and middle-income countries (LMICs) towards the attainment of Sustainable Development Goal target 3. We present current benchmarking for 70 LMICs, forecasting to 2030, and an analysis of inequities within and across countries. Methods: In this cross-sectional secondary data analysis, we extracted 291 data points from the WHO Equity Monitor, and Demographic and Health Survey Statcompiler for 70 LMICs. We selected countries on the basis of whether they belonged to LMICs, had complete information about the predictors between 2000 and 2030, and had at least one data point related to CCI. CCI was calculated on the basis of eight types of RMNCH interventions in four domains, comprising family planning, antenatal care, immunisations, and management of childhood illnesses. This study examined CCI as the main outcome variable. Bayesian hierarchical models were used to estimate trends and projections of the CCI at regional and national levels, as well as the area of residence, educational level, and wealth quintile. Findings: Despite progress, only 18 countries are projected to reach the 80% CCI target by 2030. Regionally, CCI is projected to increase in all regions of Asia (in southern Asia from 51·8% in 2000 to 89·2% in 2030; in southeastern Asia from 58·8% to 84·4%; in central Asia from 70·3% to 87·0%; in eastern Asia from 76·8% to 82·1%; and in western Asia from 56·5% to 72·1%), Africa (in sub-Saharan Africa from 46·3% in 2000 to 72·2% in 2030 and in northern Africa from 55·0% to 81·7%), and Latin America and the Caribbean (from 67·0% in 2000 to 83·4% in 2030). By contrast, southern Europe is predicted to experience a decline in CCI over the same period (70·1% in 2000 to 55·2% in 2030). Across LMICs, CCIs are higher in urban areas, in populations in which women have higher education levels, and in populations with a high income. Interpretation: Governments of countries where the universal target of 80% CCI has not yet been reached must develop evidence-based policies aimed at enhancing RMNCH coverage. Additionally, they should focus on reducing the extent of existing inequalities within their populations to drive progress in RMNCH. Funding: Hitotsubashi University and Japan Society for the Promotion of Science. Competing Interests: Declaration of interests We declare no competing interests. (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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