Cargando…

The equity impact of a universal child health promotion programme

BACKGROUND: Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after deliver...

Descripción completa

Detalles Bibliográficos
Autores principales: Pulkki-Brännström, Anni-Maria, Lindkvist, Marie, Eurenius, Eva, Häggström, Jenny, Ivarsson, Anneli, Sampaio, Filipa, Feldman, Inna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337232/
https://www.ncbi.nlm.nih.gov/pubmed/32303594
http://dx.doi.org/10.1136/jech-2019-213503
_version_ 1783554470029819904
author Pulkki-Brännström, Anni-Maria
Lindkvist, Marie
Eurenius, Eva
Häggström, Jenny
Ivarsson, Anneli
Sampaio, Filipa
Feldman, Inna
author_facet Pulkki-Brännström, Anni-Maria
Lindkvist, Marie
Eurenius, Eva
Häggström, Jenny
Ivarsson, Anneli
Sampaio, Filipa
Feldman, Inna
author_sort Pulkki-Brännström, Anni-Maria
collection PubMed
description BACKGROUND: Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery. METHODS: Using the mother’s place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents’ earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach. RESULTS: Income-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers’ healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time. CONCLUSION: In northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers’ healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time.
format Online
Article
Text
id pubmed-7337232
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-73372322020-07-14 The equity impact of a universal child health promotion programme Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna J Epidemiol Community Health Evidence-Based Public Health Policy and Practice BACKGROUND: Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery. METHODS: Using the mother’s place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents’ earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach. RESULTS: Income-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers’ healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time. CONCLUSION: In northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers’ healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time. BMJ Publishing Group 2020-06 2020-06-10 /pmc/articles/PMC7337232/ /pubmed/32303594 http://dx.doi.org/10.1136/jech-2019-213503 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Evidence-Based Public Health Policy and Practice
Pulkki-Brännström, Anni-Maria
Lindkvist, Marie
Eurenius, Eva
Häggström, Jenny
Ivarsson, Anneli
Sampaio, Filipa
Feldman, Inna
The equity impact of a universal child health promotion programme
title The equity impact of a universal child health promotion programme
title_full The equity impact of a universal child health promotion programme
title_fullStr The equity impact of a universal child health promotion programme
title_full_unstemmed The equity impact of a universal child health promotion programme
title_short The equity impact of a universal child health promotion programme
title_sort equity impact of a universal child health promotion programme
topic Evidence-Based Public Health Policy and Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337232/
https://www.ncbi.nlm.nih.gov/pubmed/32303594
http://dx.doi.org/10.1136/jech-2019-213503
work_keys_str_mv AT pulkkibrannstromannimaria theequityimpactofauniversalchildhealthpromotionprogramme
AT lindkvistmarie theequityimpactofauniversalchildhealthpromotionprogramme
AT eureniuseva theequityimpactofauniversalchildhealthpromotionprogramme
AT haggstromjenny theequityimpactofauniversalchildhealthpromotionprogramme
AT ivarssonanneli theequityimpactofauniversalchildhealthpromotionprogramme
AT sampaiofilipa theequityimpactofauniversalchildhealthpromotionprogramme
AT feldmaninna theequityimpactofauniversalchildhealthpromotionprogramme
AT pulkkibrannstromannimaria equityimpactofauniversalchildhealthpromotionprogramme
AT lindkvistmarie equityimpactofauniversalchildhealthpromotionprogramme
AT eureniuseva equityimpactofauniversalchildhealthpromotionprogramme
AT haggstromjenny equityimpactofauniversalchildhealthpromotionprogramme
AT ivarssonanneli equityimpactofauniversalchildhealthpromotionprogramme
AT sampaiofilipa equityimpactofauniversalchildhealthpromotionprogramme
AT feldmaninna equityimpactofauniversalchildhealthpromotionprogramme