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Growing inequities in maternal health in South Africa: a comparison of serial national households surveys

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dc.date.accessioned 2021-10-17T13:23:06Z
dc.date.available 2021-10-17T13:23:06Z
dc.date.issued 2017-03-28 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/10826
dc.description.abstract Rates of maternal mortality and morbidity vary markedly, both between and within countries. Documenting these variations, in a very unequal society like South Africa, provides useful information to direct initiatives to improve services. The study describes inequalities over time in access to maternal health services in South Africa, and identifies differences in maternal health outcomes between population groups and across geographical areas. Data were analysed from serial population-level household surveys that applied multistage-stratified sampling. Access to maternal health services and health outcomes in 2008 (n = 1121) were compared with those in 2012 (n = 1648). Differences between socio-economic quartiles were quantified using the relative (RII) and slope (SII) index of inequality, based on survey weights. High levels of inequalities were noted in most measures of service access in both 2008 and 2012. Inequalities between socio-economic quartiles worsened over time in antenatal clinic attendance, with overall coverage falling from 97.0 to 90.2 %. Nationally, skilled birth attendance remained about 95 %, with persistent high inequalities (SII = 0.11, RII = 1.12 in 2012). In 2012, having a doctor present at childbirth was higher than in 2008 (34.4 % versus 27.8 %), but inequalities worsened. Countrywide, levels of planned pregnancy declined from 44.6 % in 2008 to 34.7 % in 2012. The RII and SII rose over this period and in 2012, only 22.4 % of the poorest quartile had a planned pregnancy. HIV testing increased substantially by 2012, though remains low in groups with a high HIV prevalence, such as women in rural formal areas, and from Gauteng and Mpumalanga provinces. Marked deficiencies in service access were noted in the Eastern Cape ad North West provinces. Though some population-level improvements occurred in access to services, inequalities generally worsened. Low levels of planned pregnancy, antenatal clinic access and having a doctor present at childbirth among poor women are of most concern. Policy makers should carefully balance efforts to increase service access nationally, against the need for programs targeting under-served populations. en
dc.format.medium Print en
dc.publisher BMC en
dc.subject MATERNAL HEALTH en
dc.subject HOUSEHOLD SURVEYS en
dc.subject INEQUALITY en
dc.title Growing inequities in maternal health in South Africa: a comparison of serial national households surveys en
dc.type Journal Article en
dc.ProjectNumber N/A en
dc.Volume 16(1) en
dc.BudgetYear 2016/17 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle BMC Pregnancy and Childbirth en
dc.ArchiveNumber 9679 en
dc.URL http://ktree.hsrc.ac.za/doc_read_all.php?docid=17953 en
dc.PageNumber Online en
dc.outputnumber 8570 en
dc.bibliographictitle Wabiri, N., Chersich, M., Shisana, O., Blaauw, D., Rees, H. & Dwane, N. (2016) Growing inequities in maternal health in South Africa: a comparison of serial national households surveys. <i>BMC Pregnancy and Childbirth</i>. 16:Online. http://hdl.handle.net/20.500.11910/10826 en
dc.publicationyear 2016 en
dc.contributor.author1 Wabiri, N. en
dc.contributor.author2 Chersich, M. en
dc.contributor.author3 Shisana, O. en
dc.contributor.author4 Blaauw, D. en
dc.contributor.author5 Rees, H. en
dc.contributor.author6 Dwane, N. en


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