Urban Inequalities in antenatal care and facility birth for 33 countries: Evolution over time

With the urban population increasing in both number and percentage, urban health inequalities has been rising up the research agenda. A crucial aspect of health, both for the MDGs and the post-2015 agenda, is maternal health. This paper looks at inequalities in the percentage receiving sufficient antenatal care and children born within a facility and assesses how these have changed over time. Countries which have been most successful in reducing inequalities while increasing the proportion of mothers with these services will be studied, and countries which have not succeeded in this way will also be assessed.
Using 125 Demographic and Health Surveys from 33 countries, new measures of wealth were constructed using Principal Components Analysis, applying only to urban residents, based on the assets that the household owns. Wealth was used both as a continuous measure (factor score) and in quintiles. The difference and ratio between richest and poorest quintiles was calculated, while concentration indices calculated.
Results indicated that countries were diverse in the evolution of inequality with some successfully reducing it and others showing an increase over time. Policies to improve maternal health should tackle inequalities, while still increasing the overall level of service use in the whole population.