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Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008

OBJECTIVE: To assess changes in the inequalities associated with maternal healthcare use according to economic status in the Philippines. DESIGN: An analysis of four population-based data sets that were conducted between 1993 and 2008. SETTING: Philippines. PARTICIPANTS: Women aged 15–49 years who h...

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Autores principales: Molina, Honey Faith, Nakamura, Keiko, Kizuki, Masashi, Seino, Kaoruko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686232/
https://www.ncbi.nlm.nih.gov/pubmed/23794551
http://dx.doi.org/10.1136/bmjopen-2012-002507
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author Molina, Honey Faith
Nakamura, Keiko
Kizuki, Masashi
Seino, Kaoruko
author_facet Molina, Honey Faith
Nakamura, Keiko
Kizuki, Masashi
Seino, Kaoruko
author_sort Molina, Honey Faith
collection PubMed
description OBJECTIVE: To assess changes in the inequalities associated with maternal healthcare use according to economic status in the Philippines. DESIGN: An analysis of four population-based data sets that were conducted between 1993 and 2008. SETTING: Philippines. PARTICIPANTS: Women aged 15–49 years who had a live-birth within 1 year in 1993 (n=1707), 1998 (n=1513), 2003 (n=1325) and 2008 (n=1209). OUTCOMES: At least four visits of antenatal care, skilled birth attendance and delivery in a medical facility. RESULTS: The adjusted OR for antenatal-care use when comparing the highest wealth-index quintile with the lowest quintile declined from 1993 to 2008: 3.43 (95% CI 2.22 to 5.28) to 2.87 (95% CI 1.31 to 6.29). On the other hand, the adjusted OR for the other two outcome indicators by the wealth index widened from 1993 to 2008: 9.92 (95% CI 5.98 to 16.43) to 15.53 (95% CI 6.90 to 34.94) for skilled birth attendance and 7.74 (95% CI 4.22 to 14.21) to 16.00 (95% CI 7.99 to 32.02) for delivery in a medical facility. The concentration indices for maternal health utilisation in 1993 and 2008 were 0.19 and 0.09 for antenatal care; 0.26 and 0.24 for skilled birth attendance and 0.41 and 0.35 for delivery in a medical facility. CONCLUSIONS: Over a 16-year period, gradients in antenatal-care use decreased and the high level of inequalities in skilled birth attendance and delivery in a medical facility persisted. The results showed a disproportionate use of institutional care at birth among disadvantaged Filipino women.
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spelling pubmed-36862322013-06-20 Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008 Molina, Honey Faith Nakamura, Keiko Kizuki, Masashi Seino, Kaoruko BMJ Open Public Health OBJECTIVE: To assess changes in the inequalities associated with maternal healthcare use according to economic status in the Philippines. DESIGN: An analysis of four population-based data sets that were conducted between 1993 and 2008. SETTING: Philippines. PARTICIPANTS: Women aged 15–49 years who had a live-birth within 1 year in 1993 (n=1707), 1998 (n=1513), 2003 (n=1325) and 2008 (n=1209). OUTCOMES: At least four visits of antenatal care, skilled birth attendance and delivery in a medical facility. RESULTS: The adjusted OR for antenatal-care use when comparing the highest wealth-index quintile with the lowest quintile declined from 1993 to 2008: 3.43 (95% CI 2.22 to 5.28) to 2.87 (95% CI 1.31 to 6.29). On the other hand, the adjusted OR for the other two outcome indicators by the wealth index widened from 1993 to 2008: 9.92 (95% CI 5.98 to 16.43) to 15.53 (95% CI 6.90 to 34.94) for skilled birth attendance and 7.74 (95% CI 4.22 to 14.21) to 16.00 (95% CI 7.99 to 32.02) for delivery in a medical facility. The concentration indices for maternal health utilisation in 1993 and 2008 were 0.19 and 0.09 for antenatal care; 0.26 and 0.24 for skilled birth attendance and 0.41 and 0.35 for delivery in a medical facility. CONCLUSIONS: Over a 16-year period, gradients in antenatal-care use decreased and the high level of inequalities in skilled birth attendance and delivery in a medical facility persisted. The results showed a disproportionate use of institutional care at birth among disadvantaged Filipino women. BMJ Publishing Group 2013-06-12 /pmc/articles/PMC3686232/ /pubmed/23794551 http://dx.doi.org/10.1136/bmjopen-2012-002507 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode
spellingShingle Public Health
Molina, Honey Faith
Nakamura, Keiko
Kizuki, Masashi
Seino, Kaoruko
Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008
title Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008
title_full Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008
title_fullStr Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008
title_full_unstemmed Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008
title_short Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008
title_sort reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the philippines from 1993 to 2008
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686232/
https://www.ncbi.nlm.nih.gov/pubmed/23794551
http://dx.doi.org/10.1136/bmjopen-2012-002507
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