| Inequalities in sub-Saharan African women’s and
girls’ health opportunities and outcomes: evidence
from the Demographic and Health Surveys |
| Authors: |
Clara Pons-Duran, Anna Lucas, Ambar Narayan, Andrew Dabalen, and Clara Menéndez |
| Source: |
Journal of Global Health, 9(1); DOI: 10.7189/jogh.09.010410 |
| Topic(s): |
Inequality
Women's health
Youth
|
| Country: |
Africa
Multiple African Countries
|
| Published: |
JUN 2019 |
| Abstract: |
Background Maternal and reproductive health services are far from
universalization and important gaps exist in their distribution across
groups of women in sub-Saharan Africa (SSA). The aim of this study
is to determine the magnitude of this unequal distribution of maternal
and reproductive health-related opportunities and outcomes and to
identify the major sources of inequality.
Methods Demographic and Health Surveys data were used to analyse
15 opportunities for women of reproductive age (15-49), pregnant
women and older adolescent girls (15-19), across 29 SSA countries.
The tool employed is the Human Opportunity Index (HOI), a composite
indicator that combines the availability of an opportunity (the
coverage rate) with a measure of how equitably it is distributed among
groups of women with different characteristics (or circumstances). Decompositions
are used to assess the contribution of each individual circumstance
to inequality.
Results The maternity care package of services is found to have lowest
average HOI (26%), while exclusive breastfeeding among children
aged 0-6 months has the highest HOI (77%). The other indicators show
low HOIs, sometimes lower than 50%, indicating low coverage and/or
high inequality. Wealth, education and area of residence are the main
contributors to inequality for women of reproductive age. Among adolescent
girls, marital status is the major contributor.
Conclusions Reproductive and maternal health opportunities for
women in SSA are scarce and far from reaching the global goals set by
the post 2015 agenda. Further progress in improving women’s and adolescents’
health and well-being can only be achieved by a strong expansion
of coverage to produce a more equitable and efficient distribution
of health care. Failure to do so will compromise the likelihood of
achieving the post-2015 Sustainable Development Goals (SDG). New
metrics such as the HOI allows better understanding of the nature of
challenges to achieving equity in perinatal and reproductive health, and
offers a tool for monitoring progress in implementing a strong equity
agenda as a part of the SDG initiative. |
| Web: |
http://www.jogh.org/documents/issue201901/jogh-09-010410.pdf |
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