@article{fdi:010064137,
  title = {{I}nequalities in maternal health care utilization in sub-{S}aharan {A}frican countries : a multiyear and multi-country analysis},
  author = {{A}lam, {N}. and {H}ajizadeh, {M}. and {D}umont, {A}lexandre and {F}ournier, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{T}o assess social inequalities in the use of antenatal care ({ANC}), facility based delivery ({FBD}), and modern contraception ({MC}) in two contrasting groups of countries in sub-{S}aharan {A}frica divided based on their progress towards maternal mortality reduction. {S}ix countries were included in this study. {T}hree countries ({E}thiopia, {M}adagascar, and {U}ganda) had <350 {MMR} in 2010 with >4.5% average annual reduction rate while another three ({C}ameroon, {Z}ambia, and {Z}imbabwe) had >550 {MMR} in 2010 with only <1.5% average annual reduction rate. {A}ll of these countries had at least three rounds of {D}emographic and {H}ealth {S}urveys ({DHS}) before 2012. {W}e measured rate ratios and differences, as well as relative and absolute concentration indices in order to examine within-country geographical and wealth-based inequalities in the utilization of {ANC}, {FBD}, and {MC}. {I}n the countries which have made sufficient progress (i.e. {E}thiopia, {M}adagascar, and {U}ganda), {ANC} use increased by 8.7, 9.3 and 5.7 percent, respectively, while the utilization of {FBD} increased by 4.7, 0.7 and 20.2 percent, respectively, over the last decade. {B}y contrast, utilization of these services either plateaued or decreased in countries which did not make progress towards reducing maternal mortality, with the exception of {C}ameroon. {U}tilization of {MC} increased in all six countries but remained very low, with a high of 40.5% in {Z}imbabwe and low of 16.1% in {C}ameroon as of 2011. {I}n general, relative measures of inequalities were found to have declined overtime in countries making progress towards reducing maternal mortality. {I}n countries with insufficient progress towards maternal mortality reduction, these indicators remained stagnant or increased. {A}bsolute measures for geographical and wealth-based inequalities remained high invariably in all six countries. {T}he increasing trend in the utilization of maternal care services was found to concur with a steady decline in maternal mortality. {R}elative inequality declined overtime in countries which made progress towards reducing maternal mortality.},
  keywords = {{ETHIOPIE} ; {MADAGASCAR} ; {OUGANDA} ; {CAMEROUN} ; {ZAMBIE} ; {ZIMBABWE}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {10},
  numero = {4},
  pages = {e0120922 [16 p.]},
  ISSN = {1932-6203},
  year = {2015},
  DOI = {10.1371/journal.pone.0120922},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064137},
}