Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines.
BMC Public Health
; 16: 523, 2016 07 06.
Article
en En
| MEDLINE
| ID: mdl-27383189
ABSTRACT
BACKGROUND:
Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap.METHODS:
Using national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery.RESULTS:
The mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers' and her partners' education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers' religion and the subjective distance to the health facility were also noteworthy.CONCLUSIONS:
This study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
10_ODS3_salud_sexual_reprodutiva
/
11_ODS3_cobertura_universal
/
1_ASSA2030
/
2_ODS3
/
5_ODS3_mortalidade_materna
Problema de salud:
10_adolescent_pregnacy
/
10_safe_abortion_services
/
11_multisectoral_coordination
/
1_acesso_equitativo_servicos
/
1_desigualdade_iniquidade
/
2_cobertura_universal
/
2_salud_sexual_reprodutiva
/
5_maternal_care
Asunto principal:
Servicios de Salud del Niño
/
Parto Obstétrico
/
Disparidades en Atención de Salud
/
Servicios de Salud Materna
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Límite:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Middle aged
/
Pregnancy
País/Región como asunto:
Asia
Idioma:
En
Revista:
BMC Public Health
Asunto de la revista:
SAUDE PUBLICA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Australia