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1.
Trop Med Int Health ; 21(4): 486-503, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26892335

RESUMO

OBJECTIVE: The objective of this study was to assess the role of the private sector in low- and middle-income countries (LMICs). We used Demographic and Health Surveys for 57 countries (2000-2013) to evaluate the private sector's share in providing three reproductive and maternal/newborn health services (family planning, antenatal and delivery care), in total and by socio-economic position. METHODS: We used data from 865 547 women aged 15-49, representing a total of 3 billion people. We defined 'met and unmet need for services' and 'use of appropriate service types' clearly and developed explicit classifications of source and sector of provision. RESULTS: Across the four regions (sub-Saharan Africa, Middle East/Europe, Asia and Latin America), unmet need ranged from 28% to 61% for family planning, 8% to 22% for ANC and 21% to 51% for delivery care. The private-sector share among users of family planning services was 37-39% across regions (overall mean: 37%; median across countries: 41%). The private-sector market share among users of ANC was 13-61% across regions (overall mean: 44%; median across countries: 15%). The private-sector share among appropriate deliveries was 9-56% across regions (overall mean: 40%; median across countries: 14%). For all three healthcare services, women in the richest wealth quintile used private services more than the poorest. Wealth gaps in met need for services were smallest for family planning and largest for delivery care. CONCLUSIONS: The private sector serves substantial numbers of women in LMICs, particularly the richest. To achieve universal health coverage, including adequate quality care, it is imperative to understand this sector, starting with improved data collection on healthcare provision.


Assuntos
Parto Obstétrico , Países em Desenvolvimento , Serviços de Planejamento Familiar , Equidade em Saúde , Disparidades em Assistência à Saúde , Serviços de Saúde Materna , Setor Privado , Adolescente , Adulto , Anticoncepção , Estudos Transversais , Feminino , Saúde Global , Necessidades e Demandas de Serviços de Saúde , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Cuidado Pré-Natal , Setor Público , Fatores Socioeconômicos , Adulto Jovem
2.
Acta Obstet Gynecol Scand ; 81(4): 277-83, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11952455

RESUMO

This paper delineates important considerations for having a better understanding of quality in maternity care. High quality requires providing a minimum level of care to all pregnant women and their new born babies and a higher level of care to those who need it; obtaining the best possible medical outcome of mother and baby; providing care which satisfies users and providers; and maintaining sound managerial and financial performance. While all these aspects are important, prioritizing among interventions to improve them will be influenced by cultural values, expectations and available resources.


Assuntos
Serviços de Saúde da Criança/normas , Serviços de Saúde Materna/normas , Qualidade da Assistência à Saúde , Atenção à Saúde/normas , Países em Desenvolvimento , Feminino , Humanos , Recém-Nascido , Satisfação do Paciente , Gravidez
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