Socioeconomic inequalities in access to maternal healthcare in South-Asian countries: A systematic review

Background: Despite numerous efforts, South Asia is the second most leading region for maternal mortality and morbidity. Although there have been notable advancements on this continent, progress in maternal healthcare access has been slow. Inequalities remain in different maternal health services across diverse population groups. The aim of this study is to better understand the socioeconomic inequalities in maternal healthcare access in South Asian countries. Methods: Two databases (MEDLINE and Google Scholar) were searched for identifying studies. Studies with data on socioeconomic factors, maternal healthcare, inequality, and South-Asian countries were included. Mixed method appraisal tool was used for quality assessment of the identified studies. Results: A total of 55 studies from India, Nepal, Bangladesh, Afghanistan and Pakistan were included in the final analysis. Overall, quantitative study showed that maternal healthcare access is linked to economic status, education, occupation, and women’s autonomy. Qualitative studies demonstrated poverty, lack of awareness of complication and service and inability in decision making on healthcare was the reason for not accessing maternal health care. Significant finding from this review includes effect of education mostly evident after secondary education and paternal occupation was significant rather than maternal occupation. Conclusion: Findings of this review indicates a large disparity in access to maternal health care services. Policymakers should create interventions and financial schemes that are tailored to the mothers from low socioeconomic background.