Browsing by Subject "Healthcare Disparities"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Open Access
    Growing inequities in maternal health in South Africa: a comparison of serial national household surveys
    (2016) Wabiri, Njeri; Chersich, Matthew; Shisana, Olive; Blaauw, Duane; Rees, Helen; Dwane, Ntabozuko
    Abstract Background Rates of maternal mortality and morbidity vary markedly, both between and within countries. Documenting these variations, in a very unequal society like South Africa, provides useful information to direct initiatives to improve services. The study describes inequalities over time in access to maternal health services in South Africa, and identifies differences in maternal health outcomes between population groups and across geographical areas. Methods Data were analysed from serial population-level household surveys that applied multistage-stratified sampling. Access to maternal health services and health outcomes in 2008 (n = 1121) were compared with those in 2012 (n = 1648). Differences between socio-economic quartiles were quantified using the relative (RII) and slope (SII) index of inequality, based on survey weights. Results High levels of inequalities were noted in most measures of service access in both 2008 and 2012. Inequalities between socio-economic quartiles worsened over time in antenatal clinic attendance, with overall coverage falling from 97.0 to 90.2 %. Nationally, skilled birth attendance remained about 95 %, with persistent high inequalities (SII = 0.11, RII = 1.12 in 2012). In 2012, having a doctor present at childbirth was higher than in 2008 (34.4 % versus 27.8 %), but inequalities worsened. Countrywide, levels of planned pregnancy declined from 44.6 % in 2008 to 34.7 % in 2012. The RII and SII rose over this period and in 2012, only 22.4 % of the poorest quartile had a planned pregnancy. HIV testing increased substantially by 2012, though remains low in groups with a high HIV prevalence, such as women in rural formal areas, and from Gauteng and Mpumalanga provinces. Marked deficiencies in service access were noted in the Eastern Cape ad North West provinces. Conclusions Though some population-level improvements occurred in access to services, inequalities generally worsened. Low levels of planned pregnancy, antenatal clinic access and having a doctor present at childbirth among poor women are of most concern. Policy makers should carefully balance efforts to increase service access nationally, against the need for programs targeting underserved populations.
  • No Thumbnail Available
    Item
    Open Access
    Prevalence of babies born with neural tube defects and geospatial mapping of therapeutic services: a systematic review
    (2025) Zolo Ossou, Andre Yvan; Maswime, Salome; Isiagi, Moses
    Introduction: Neural tube defects (NTDs) are an important global health concern with high morbidity and mortality. Enhancing access to healthcare for children born with NTDs is crucial for improving health systems and service delivery. Methods: We conducted a systematic review to assess the global prevalence of NTDs and the accessibility of healthcare services. Our search spanned databases like PubMed, EMBASE, and Scopus, focusing on NTD prevalence, healthcare service mapping, and access barriers. We followed a standardized data extraction process, and the study is registered with PROSPERO (CRD42023425843). Results: From 3 067 records, 65 studies met our inclusion criteria, mainly focusing on newborns. The study durations range from six months to 40 years. The NTD prevalence was between 0.4 and 215.13 per 10 000 births, with Spina Bifida, Anencephaly, and Encephalocele being the most common. The African Region was the WHO region with the highest prevalence while the Western Pacific Region had the lowest prevalence. One study used geospatial mapping to identify healthcare access barriers. Conclusion: Our study revealed wide disparities in the prevalence rates of neural tube defects with the African region having the highest prevalence. Geospatial mapping was not used to assess access to healthcare services for children born with NTDs in almost all the studies. This underscores the global challenge of access to surgical care for children born with NTDs and the need for strengthening healthcare services in settings with high prevalences.