RESUMEN
OBJECTIVE: To describe the behavior and social inequalities in prioritized indicators of Sustainable Development Goal 3 (ODS-3) among subpopulations and departments of Bolivia. METHODS: An analysis of the behavior of selected ODS-3 indicators over time was conducted. In addition, a study of social inequalities in these indicators was carried out for selected equity stratifiers. Simple measures (absolute gap and relative gap) and complex measures (slope inequality index and concentration index) were obtained to explore the magnitude of social inequalities. RESULTS: The ODS-3 indicators that have increased significantly at the national and departmental levels are the prevalence of four prenatal controls and the prevalence of births attended by qualified health personnel. Social inequalities in these indicators have decreased significantly over time. The prevalence of adolescent pregnancy and its social inequalities have remained unchanged, although with low inequalities. The prevalence of modern contraceptive methods use has decreased slightly, although social inequality has declined more rapidly. The maternal mortality rate has decreased nationally and in most departments, but social inequality on this indicator still needs to be addressed. CONCLUSIONS: National averages hide differences between subpopulations and departments in Bolivia. The findings show that the behavior and social inequality of some ODS-3 indicators have improved, but regarding other indicators interventions by different stakeholders must be strengthened to reduce social inequalities in health.
RESUMEN
[RESUMEN]. Objetivo. Describir el comportamiento y las desigualdades sociales en indicadores priorizados del Objetivo de Desarrollo Sostenible 3 (ODS-3) entre subpoblaciones y departamentos de Bolivia. Métodos. Se realizó un análisis del comportamiento de indicadores seleccionados del ODS-3 en el tiempo. Además, se llevó a cabo un estudio de desigualdades sociales en estos indicadores para estratificadores de equidad seleccionados. Se obtuvieron las medidas simples (brecha absoluta y brecha relativa) y las medidas complejas (índice de desigualdad de la pendiente e índice de concentración) para explorar la magnitud de las desigualdades sociales. Resultados. Los indicadores del ODS-3 que han tenido un aumento importante a nivel nacional y departamental son la prevalencia de cuatro controles prenatales y la prevalencia de parto atendido por personal de salud calificado. Las desigualdades sociales en estos indicadores han disminuido de manera significativa en el tiempo. La prevalencia de embarazo en adolescentes y sus desigualdades sociales se han mantenido sin mayores cambios, aunque con desigualdades bajas. La prevalencia de uso de métodos anticonceptivos modernos ha disminuido en forma leve, aunque la desigualdad social ha tenido una disminución más rápida. La razón de muerte materna ha disminuido a nivel nacional y en la mayoría de los departamentos, pero aún se requiere atacar la desigualdad social en este indicador. Conclusiones. Los promedios nacionales ocultan diferencias entre las subpoblaciones y los departamentos de Bolivia. Los hallazgos muestran que se ha mejorado en el comportamiento y desigualdad social de algunos indicadores del ODS-3, pero que en otros se deben fortalecer las intervenciones por diferentes actores para disminuir las desigualdades sociales en salud.
[ABSTRACT]. Objective. To describe the behavior and social inequalities in prioritized indicators of Sustainable Development Goal 3 (ODS-3) among subpopulations and departments of Bolivia. Methods. An analysis of the behavior of selected ODS-3 indicators over time was conducted. In addition, a study of social inequalities in these indicators was carried out for selected equity stratifiers. Simple measures (absolute gap and relative gap) and complex measures (slope inequality index and concentration index) were obtained to explore the magnitude of social inequalities. Results. The ODS-3 indicators that have increased significantly at the national and departmental levels are the prevalence of four prenatal controls and the prevalence of births attended by qualified health personnel. Social inequalities in these indicators have decreased significantly over time. The prevalence of adolescent pregnancy and its social inequalities have remained unchanged, although with low inequalities. The prevalence of modern contraceptive methods use has decreased slightly, although social inequality has declined more rapidly. The maternal mortality rate has decreased nationally and in most departments, but social inequality on this indicator still needs to be addressed. Conclusions. National averages hide differences between subpopulations and departments in Bolivia. The findings show that the behavior and social inequality of some ODS-3 indicators have improved, but regarding other indicators interventions by different stakeholders must be strengthened to reduce social inequalities in health.