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The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011

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  • Makate, Marshall
  • Makate, Clifton

Abstract

Inequalities in maternal healthcare are pervasive in the developing world, a fact that has led to questions about the extent of these inequalities across socioeconomic groups. Yet, despite a growing literature on maternal health across Sub-Saharan African countries, relatively little is known about the evolution of these inequalities over time for specific countries. This study sought to examine and document the trends in the inequalities in prenatal care use, professional delivery assistance, and the receipt of information on pregnancy complications in Zimbabwe. We assess the extent to which the observed inequalities have been pro-poor or pro-rich. The empirical analysis uses data from four rounds of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 1994, 1999, 2005/06 and 2010/11. Three binary indicators were used as measures of maternal health care utilization; (1) the receipt of four or more antenatal care visits, (2) the use of professional delivery assistance, and (3) the receipt of information regarding pregnancy complications for the most recent pregnancy. We measure and explain inequalities in maternal health care use using Erreyger’s corrected concentration index. A decomposition analysis was conducted to determine the contributions of each determining factor to the measured inequalities. We found a significant and persistently pro-rich distribution of inequalities in professional delivery assistance and knowledge regarding pregnancy complications was observed between 1994 and 2010/11. Also, inequalities in prenatal care use were pro-rich in 1994, 2005/06 and 2010/11 periods and pro-poor in 1999. Furthermore, we stratified the results by rural or urban status. The results reveal a rising trend in observed inequalities in maternal health care use over time. Our findings suggest that addressing inequalities in maternal healthcare utilization requires coordinated public health policies targeting the more poor and vulnerable segments of the population in Zimbabwe.

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  • Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 72718, University Library of Munich, Germany, revised 24 Jul 2016.
    • Handle: RePEc:pra:mprapa:72718
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    Cited by:

    1. Makate, Marshall & Makate, Clifton, 2016. "Demand for prenatal care and its impact on neonatal, infant and child mortality in Zimbabwe: Evidence from the Demographic and Health Surveys," MPRA Paper 72805, University Library of Munich, Germany, revised 31 Jul 2016.
    2. Chipo Mutyambizi & Frederik Booysen & Andrew Stokes & Milena Pavlova & Wim Groot, 2019. "Lifestyle and socio-economic inequalities in diabetes prevalence in South Africa: A decomposition analysis," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-21, January.
    3. Conrad Murendo & Gamuchirai Murenje & Pepukai Prince Chivenge & Rumbidzai Mtetwa, 2021. "Financial Inclusion, Nutrition and Socio‐Economic Status Among Rural Households in Guruve and Mount Darwin Districts, Zimbabwe," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(1), pages 86-108, January.
    4. Dhammika Deepani Siriwardhana & Arunasalam Pathmeswaran & Ananda Rajitha Wickremasinghe, 2019. "Socioeconomic inequality and determinants of postnatal home visits made by public health midwives: An analysis of the Sri Lanka Demographic and Health Survey," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-15, April.

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    More about this item

    Keywords

    Socioeconomic-related inequality; maternal healthcare utilization; Erreygers concentration index; Zimbabwe;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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