Inequities in Use of Maternal Health Care Services among urban women in Nepal, 2001-2010

The health care services that a woman receives during pregnancy, delivery and postnatal period is crucial in terms of survival and well-being of both mother and child. Ideally, there should not be inequity in using maternal... [ view full abstract ]

The health care services that a woman receives during pregnancy, delivery and postnatal period is crucial in terms of survival and well-being of both mother and child. Ideally, there should not be inequity in using maternal health care services among urban women of different socio-economic groups.

The study aims to examine the trends and inequities in use of maternal health care services among urban poorest and urban richest women aged 15-49 years in Nepal between 2001 and 2010. The study is based on wealth quintile analysis, of the women’s individual datasets from Nepal Demographic and Health Survey 2006 and 2011, using SPSS 16 version on weighted case.

Inequity in use of antenatal care by skilled birth attendants, 4+antenatal care, delivery by skilled birth attendants and postnatal care was significant among urban richest and urban poorest women, however, it is reducing over time. Between 2001-2005 and 2006-2010, the rich: poor ratio reduced from 1.6 to 1.3 for antenatal care by skilled birth attendants. The rich: poor ratio reduced by half from 5.2 to 2.3 for 4+antenatal care, from 3.9 to 2.0 for delivery by skilled birth attendants and from 2.8 to 1.4 for postnatal Care. In terms of rich: poor differences, there was significant equity gain for antenatal care by skilled birth attendants, delivery by skilled birth attendants and postnatal care but not for 4+ antenatal care. There is significant increment in using antenatal and postnatal care by urban poorest women thereby reducing inequities in between 2006-2010.

The equity is improving in maternal health among urban women in Nepal. The study recommends (i) use of dis-aggregated urban data for planning and monitoring of inequity in use of maternal health care through routine health information system and (ii) strengthening pro-poor interventions focusing on urban context.

Keywords: Inequity, Maternal Health Care, Urban Women