Trends of socioeconomic inequality in using maternal health care services in Lao People’s Democratic Republic from year 2000 to 2012

作者：Ngan Do, Huong Thi Giang Tran, Alay Phonvisay, Juhwan Oh · 发表于：BMC Public Health · 年份：2018 · DOI：10.1186/s12889-018-5811-0 · 被引用次数：18 · 研究领域：Global Maternal and Child Health、Healthcare Systems and Reforms、Child Nutrition and Water Access

BACKGROUND: Socioeconomic inequalities in access to maternal health care have received more attention as it challenges the sustainability of the ongoing achievement in reducing maternal mortality. By promoting access to maternal health care as one of the core targets of the Health Sector Reform, Lao People's Democratic Republic has reduced maternal mortality dramatically over the last decade. In spite of this improvement, little has been known about the secular trends in disparities of service utilization across different socioeconomic subgroups. METHODS: Two waves of the Multiple Indicator Cluster Survey in the years 2000 and 2012 were pooled for the analysis. We used logistic regression to estimate the likelihood of using antenatal care (ANC) and delivery services with skilled birth attendants (SBA) across different socioeconomic subgroups. Difference-in-difference method was applied to examine the inequality trends across the years by analyzing the interaction terms of the survey years and socioeconomic factors (education, wealth, ethnicity, and residential areas). RESULTS: Urban-rural disparity was improved over time while there were no educational disparity changes. Rural residential areas showed significant changes than urban areas over time [OR = 2.40; 95% CI: 1.52-3.77 for ANC and OR = 2.16; 95% CI: 1.36-3.42 for SBA]. However, there were aggravations in the disparities between major and minor ethnic group as well as worsening disparities between the rich and poor: i....