Trends in inequality in maternal and child health and health care in Uganda
Abstract
Background Uganda has made great strides in improving maternal and child health. However, little is known
about how this improvement has been distributed across diferent socioeconomic categories, and how the
health inequalities have changed over time. This study analyses data from Demographic and Health Surveys (DHS)
conducted in 2006, 2011, and 2016 in Uganda, to assess trends in inequality for a variety of mother and child health
and health care indicators.
Methods The indicators studied are acknowledged as critical for monitoring and evaluating maternal and child
health status. These include infant and child mortality, underweight status, stunting, and prevalence of diarrhea.
Antenatal care, skilled birth attendance, delivery in health facilities, contraception prevalence, full immunization
coverage, and medical treatment for child diarrhea and Acute Respiratory tract infections (ARI) are all health care
indicators. Two metrics of inequity were used: the quintile ratio, which evaluates discrepancies between the
wealthiest and poorest quintiles, and the concentration index, which utilizes data from all fve quintiles.
Results The study found extraordinary, universal improvement in population averages in most of the indices, ranging
from the poorest to the wealthiest groups, between rural and urban areas. However, signifcant socioeconomic
and rural-urban disparities persist. Under-fve mortality, malnutrition in children (Stunting and Underweight), the
prevalence of anaemia, mothers with low Body Mass Index (BMI), and the prevalence of ARI were found to have
worsening inequities. Healthcare utilization measures such as skilled birth attendants, facility delivery, contraceptive
prevalence rate, child immunization, and Insecticide Treated Mosquito Net (ITN) usage were found to be signifcantly
lowering disparity levels towards a perfect equity stance. Three healthcare utilization indicators, namely medical
treatment for diarrhea, medical treatment for ARI, and medical treatment for fever, demonstrated a perfect equitable
situation.
Conclusion Increased use of health services among the poor and rural populations leads to improved health status
and, as a result, the elimination of disparities between the poor and the wealthy, rural and urban people.
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