@article{fdi:010079472,
  title = {{P}ro-equity legislation, health policy and utilisation of sexual and reproductive health services by vulnerable populations in sub-{S}aharan {A}frica : a systematic review},
  author = {{M}ac-{S}eing, {M}. and {Z}inszer, {K}. and {O}menka, {C}. {O}. and {B}eaudrap, {P}ierre de and {M}ehrabi, {F}. and {Z}arowsky, {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{T}wenty-five years ago, the {I}nternational {C}onference on {P}opulation and {D}evelopment highlighted the need to address sexual and reproductive health ({SRH}) rights on a global scale. {T}he sub-{S}aharan {A}frica region continues to have the highest levels of maternal mortality and {HIV}, primarily affecting the most vulnerable populations. {R}ecognising the critical role of policy in understanding health population, we conducted a systematic review of original primary research which examined the relationships between equity-focused legislation and policy and the utilisation of {SRH} services by vulnerable populations in sub-{S}aharan {A}frica. {W}e searched nine bibliographic databases for relevant articles published between 1994 and 2019. {T}hirty-two studies, conducted in 14 sub-{S}aharan {A}frican countries, met the inclusion criteria. {T}hey focused on maternal health service utilisation, either through specific fee reduction/removal policies, or through healthcare reforms and insurance schemes to increase {SRH} service utilisation. {F}indings across most of the studies showed that health-related legislation and policy promoted an increase in service utilisation, over time, especially for antenatal care, skilled birth attendance and facility-based delivery. {H}owever, social health inequalities persisted among subgroups of women. {N}either the reviewed studies nor the policies specifically addressed youth, people living with {HIV} and people with disabilities. {I}n the era of the sustainable development goals, addressing health inequities in the context of social determinants of health becomes unavoidable. {S}ystematic and rigorous quantitative and qualitative research, including longitudinal policy evaluation, is required to understand the complex relationships between policy addressing upstream social determinants of health and health service utilisation.},
  keywords = {determinants of health ; equity ; social justice ; maternal health ; policy ; politics ; reproductive health ; sub-{S}aharan {A}frica ; systematic review ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{G}lobal {H}ealth {P}romotion},
  volume = {27},
  numero = {4},
  pages = {97--106},
  ISSN = {1757-9759},
  year = {2020},
  DOI = {10.1177/1757975920941435},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079472},
}