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Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods

Author

Listed:
  • Anne Darline Youmbi

    (University of Yaoundé II-Soa)

  • Betrand Fesuh Nono

    (Ecole Polytechnique de Yaoundé)

  • Christian Zamo Akono

    (University of Yaoundé II-Soa
    University of Yaoundé II-Soa)

Abstract

In Cameroon, major inequalities exist in women’s access to antenatal care (ANC), yet underlying circumstance drivers remain understudied. Using recently available Demographic and Health Survey data, we conducted multilevel model and spatial analyses to identify circumstance factors driving ANC disparities across the country's diverse regions. Drawing on a novel integration of theoretical frameworks, we evaluated how circumstances like geographic, economic and educational barriers combined to shape inequities. Both Shapley and Fields decomposition techniques apportioned contributors to ongoing inequality. Results from our study provide the first direct comparison of these approaches in Cameroon, finding a strong positive correlation between methods. Our findings show that ANC utilization overall was suboptimal, varying substantially between urban and rural areas. Key circumstance factors which disproportionately constrained disadvantaged groups’ opportunities for care included household wealth, level of education of the woman and spouse, and place of residence. Policy-relevant insights emerge from disentangling multifaceted opportunity gaps. Targeted interventions should address modifiable barriers facing underserved populations to promote more equal maternal health nationwide. Our multidisciplinary analytical approach offers lessons for analysing complex health disparities in diverse low-resource settings. Graphical abstract

Suggested Citation

  • Anne Darline Youmbi & Betrand Fesuh Nono & Christian Zamo Akono, 2024. "Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods," Swiss Journal of Economics and Statistics, Springer;Swiss Society of Economics and Statistics, vol. 160(1), pages 1-17, December.
    • Handle: RePEc:spr:sjecst:v:160:y:2024:i:1:d:10.1186_s41937-024-00121-6
    DOI: 10.1186/s41937-024-00121-6
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    More about this item

    Keywords

    Access to ANC; Circumstances; Inequality of opportunity; Logistic mixed regression; Spatial analysis; Shapley and fields decompositions; Correlation; Cluster bootstrap;
    All these keywords.

    JEL classification:

    • C19 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Other
    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models
    • C55 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Large Data Sets: Modeling and Analysis
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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