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Socio-Economic Gradients in Maternal and Child Health-Seeking Behaviours in Egypt: Systematic Literature Review and Evidence Synthesis

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  • Lenka Benova
  • Oona M R Campbell
  • George B Ploubidis

Abstract

Background: Health-seeking behaviour lies on the direct pathway between socio-economic position (SEP) and health outcomes. The objective of this systematic review is to identify and synthesise evidence of socio-economic gradients in health-seeking behaviours related to maternal and child health in Egypt. Methods: Four databases (Medline, Embase, Global Health and Web of Science) were searched in September 2013 for material published in English from 1992 to 2013 for a combination of terms describing health-seeking behaviours, indicators of socio-economic position and geographical limitation to Egypt. Findings of studies were described and synthesised in a narrative format as meta-analysis was not possible. Findings: Among the 786 references identified, 10 articles met the inclusion criteria. Six studies examined maternal and five studies child health-seeking behaviours (one study examined both). For maternal health, three dimensions of health-seeking behaviour (receipt of any care, type of care and intensity of care) were covered by studies of ante-natal and one dimension (type of care) by analyses of delivery care. For child health, two dimensions of preventive care (coverage of and intensity of immunisation) and three dimensions of curative care (receipt of any care, type and cost of care) were analysed. Conclusions: Based on two studies of time trends in nationally-representative surveys, socio-economic inequalities in seeking care for basic preventive and curative interventions in maternal and child health appear to have narrowed. Limited evidence of gradients in intensity of maternal preventive and provider selection in child curative care showed that inequalities may have widened. In studies of more geographically and socially homogeneous samples, fewer gradients were identified. Current body of evidence contains numerous limitations and gaps and is insufficient to draw a conclusive summary of such gradients. Improved understanding of SEP gradients is crucial in designing and prioritising interventions to equitably improve maternal and child health outcomes.

Suggested Citation

  • Lenka Benova & Oona M R Campbell & George B Ploubidis, 2014. "Socio-Economic Gradients in Maternal and Child Health-Seeking Behaviours in Egypt: Systematic Literature Review and Evidence Synthesis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-12, March.
    • Handle: RePEc:plo:pone00:0093032
    DOI: 10.1371/journal.pone.0093032
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    References listed on IDEAS

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    1. Winnie Yip & Peter Berman, 2001. "Targeted health insurance in a low income country and its impact on access and equity in access: Egypt's school health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 207-220, April.
    2. Palloni, Alberto & Milesi, Carolina & White, Robert G. & Turner, Alyn, 2009. "Early childhood health, reproduction of economic inequalities and the persistence of health and mortality differentials," Social Science & Medicine, Elsevier, vol. 68(9), pages 1574-1582, May.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    4. Till Stowasser & Florian Heiss & Daniel McFadden & Joachim Winter, 2011. ""Healthy, Wealthy and Wise?" Revisited: An Analysis of the Causal Pathways from Socioeconomic Status to Health," NBER Chapters, in: Investigations in the Economics of Aging, pages 267-317, National Bureau of Economic Research, Inc.
    5. Aluísio J D Barros & Cesar G Victora, 2013. "Measuring Coverage in MNCH: Determining and Interpreting Inequalities in Coverage of Maternal, Newborn, and Child Health Interventions," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-9, May.
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    Cited by:

    1. Ahmed Shoukry Rashad & Mesbah Fathy Sharaf, 2015. "Who Benefits from Public Healthcare Subsidies in Egypt?," Social Sciences, MDPI, vol. 4(4), pages 1-15, November.

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