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Individual and contextual factors associated with maternal and child health essential health services indicators : a multilevel analysis of universal health coverage in 58 low & middle-income countries

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Anjorin, Seun S., Ayorinde, Abimbola A., Oyebode, Oyinlola and Uthman, Olalekan A. (2022) Individual and contextual factors associated with maternal and child health essential health services indicators : a multilevel analysis of universal health coverage in 58 low & middle-income countries. International Journal of Health Policy and Management, 11 (10). pp. 2062-2071. doi:10.34172/ijhpm.2021.121 ISSN 2322-5939.

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Official URL: https://doi.org/10.34172/ijhpm.2021.121

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Abstract

Background: Universal health coverage (UHC) is part of the global health agenda to tackle the lack of access to essential health services (EHS). This study developed and tested models to examine the individual, neighbourhood and country-level determinants associated with access to coverage of EHS under the UHC agenda in low- and middle-income countries (LMICs). Methods: We used datasets from the Demographic and Health Surveys of 58 LMICs. Suboptimal and optimal access to EHS were computed using nine indicators. Descriptive and multilevel multinomial regression analyses were performed using R & STATA. Result: The prevalence of suboptimal and optimal access to EHS varies across the countries, the former ranging from 5.55% to 100%, and the latter ranging from 0% to 90.36% both in Honduras and Colombia, respectively. In the fully adjusted model, children of mothers with lower educational attainment (RRR 2.11, 95% credible interval [CrI] 1.92 to 2.32) and those from poor households (RRR 1.79, 95%CrI 1.61 to 2.00) were more likely to have suboptimal access to EHS. Also, those with health insurance (RRR 0.72, 95% CrI 0.59 to 0.85) and access to media (RRR 0.59, 95% CrI 0.51 to 0.67) were at lesser risk of having suboptimal EHS. Similar trends, although in the opposite direction, were observed in the analysis involving optimal access. The intra-neighbourhood and intra-country correlation coefficients were estimated using the intercept component variance; 57.50%% and 27.70% of variances in suboptimal access to EHS are attributable to the neighbourhood and country-level factors. Conclusion: Neighbourhood-level poverty, illiteracy, and rurality modify access to EHS coverage in LMICs. Interventions aimed at achieving the 2030 UHC goals should consider integrating socioeconomic and living conditions of people.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Medical policy, Medical care, Public health, Child health services, Maternal health services
Journal or Publication Title: International Journal of Health Policy and Management
Publisher: Kerman University of Medical Sciences
ISSN: 2322-5939
Official Date: October 2022
Dates:
DateEvent
October 2022Published
1 September 2021Available
30 August 2021Accepted
Volume: 11
Number: 10
Page Range: pp. 2062-2071
DOI: 10.34172/ijhpm.2021.121
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 9 November 2022
Date of first compliant Open Access: 9 November 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
Applied Research Collaboration (ARC) West Midlands[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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