EQUITY AS CENTRAL TO PROGRESS Reaching the unreached.

Transcription

1 EQUITY AS CENTRAL TO PROGRESS Reaching the unreached 1

2 My personal trajectory 2007 BSc (Nutrition) 2010 MSc (Epidemiology) Ongoing PhD (Epidemiology) joined the ICEH data analyses and drafting technical reports and scientific papers 2

3 Equity Working Group Cesar Victora (co-chair) Ties Boerma (co-chair) Aluisio Barros Carine Ronsmans Wendy Graham Betty Kirkwood Edilberto Loaiza Zulfiqar Bhutta Kate Kerber Ahmad Hosseinpoor Alexander Manu Xing Lin Feng 3

4 International Center for Equity in Health Mission: monitor equity in reproductive, maternal, newborn and child health and nutrition in low and middle-income countries Main activities Reanalyses of 234 national surveys (so far) Standardized indicators and stratifiers Disaggregation by wealth, sex, urban/rural, etc Preparation of reports and scientific papers 4

5 Contributions 5

6 The 2014 CD Report Fulfilling the Health Agenda for Women and Children 6

7 Equity Performance of 11 Countdown countries with available data on 8 interventions along the continuum of care using the Composite Coverage score, by wealth quintile, In virtually every CD country, coverage of 8 preventive and curative interventions is higher among the richest than among the poor 7

8 Coverage inequality Composite Coverage Index score, by wealth quintile, various years Rapid progress in reducing coverage inequality is possible in the Countdown countries, but some countries are still lagging behind 8

9 Co-coverage Share of mothers and children in the poorest 20% of the population who received none, one or two of eight essential preventive interventions, (%) In some countries more than half the mothers and children in the poorest 20% of the population have received two or fewer essential interventions 9

10 Co-coverage Analyses of mothers and children who failed to receive a single intervention is essential for identifying and targeting those who are being left behind 10

11 CD Country Profile 2014 How equitable is coverage? Are certain interventions particularly inaccessible for the poorest segment of the population? Why? 11

12 Equity box The narrow bars show Malawi s relatively equitable coverage found for many coverage indicators 12

13 Equity box The wide bars show Nigeria s highly inequitable coverage found for many coverage indicators 13

14 Equity Profiles Web materials 1 Table 18 indicators 3 aggregated indicators 4 graphs Co-coverage <3 interventions 6+ interventions Composite coverage score 14

15 Equity Profiles Trends in coverage of key interventions are presented if two surveys were available, with a minimum interval of five years 15

16 Equity profiles Co coverage of key health interventions Proportion of children in each wealth quintile that received a given number of interventions Composite coverage of selected interventions and corresponding coverage gap Most often we see an increasing trend towards the richest 16

17 LAC Profiles Commissioned by the Partnership for Maternal, Newborn and Child Health Findings: Several countries managed to reduce the gap between rich and poor Nevertheless, the poor and rural populations are way behind in most countries Date of most recent data on LAC CD countries 17

18 Scientific publications

19 Messages Coverage for nearly all interventions is much higher for the wealthy than for the poor across CD countries There are also important inequalities associated with urban/rural residence, maternal education, region of the country and, in some countries, sex of the child Interventions that require functioning health services and/or require out of pocket payment tend to be the most inequitable Equity analyses are essential for monitoring progress and planning health programs 19

20 Thank you! Giovanny V A França [email protected] 20