背景:在2006年至2017年期间,贝宁的产前护理(ANC)覆盖率下降,可能加剧不平等,并证实健康不平等监测的必要性。这项研究考察了贝宁非国大出勤的不平等,按妇女年龄分列,教育水平,经济地位,居住地,居住地区,以及它们随时间变化的程度。
方法:分析了三轮贝宁人口和健康调查(2006、2011-12和2017-18),以检查ANC覆盖率的不平等。采用探索性描述性方法进行分析。使用世界卫生组织的健康公平评估工具包(WHO的HEAT)在线平台计算了简单的[差异(D)和比率(R)]和复杂的[人口归因风险(PAR)和人口归因分数(PAF)]不平等度量。三项调查中的每一项措施都是单独计算的,并对他们的估计进行了比较。
结果:调查结果显示,在2006年至2017-18年间,至少四次ANC访问下降了8.4%。下降的发生与年龄无关,教育状况,经济地位,居住地,和区域。与区域相关的不平等最大,在2006年(D=54.6;R=2.6;PAF=47.8,PAR=29.0)和2017-18年(D=55.8;R=3.1;PAF=57.2,PAR=29.8)之间略有增加。教育(2006年:D=31.3,R=1.6,PAF=40.5,PAR=24.5;2017-18年:D=25.2,R=1.6,PAF=34.9,PAR=18.1)和城乡(2006年:D=16.8,R=1.3,PAF=17.8,PAR=10.8;2017-18年:D=11.2,R=1.2,PAF=13.1,2006年龄不平等非常小。
结论:ANC不平等在贝宁仍然根深蒂固。解决这些问题的不同程度需要全面的战略,包括供应和需求方面的干预措施,重点是接触最贫困家庭中未受教育的妇女以及居住在农村地区和阿塔科拉的妇女。
BACKGROUND: Between 2006 and 2017, antenatal care (ANC) coverage in Benin declined, potentially exacerbating inequalities and substantiating the need for health inequality monitoring. This study examines inequalities in ANC attendance in Benin, disaggregated by women\'s age, educational level, economic status, place of residence, region of residence, and the extent to which they have changed over time.
METHODS: Three rounds of the Benin Demographic and Health Surveys (2006, 2011-12, and 2017-18) were analyzed to examine inequalities in ANC coverage. An exploratory descriptive approach was adopted for the analysis. Simple [difference (D) and ratio (R)] and complex [population attributable risk (PAR) and population attributable fraction (PAF)] measures of inequalities were computed using the World Health Organization\'s Health Equity Assessment Toolkit (WHO\'s HEAT) online platform. The measures were computed separately for each of the three surveys, and their estimates were compared.
RESULTS: The findings revealed an 8.4% decline in at least four ANC visits between 2006 and 2017-18. The decline occurred irrespective of age, educational status, economic status, place of residence, and region. Region-related inequalities were the largest and increased slightly between 2006 (D = 54.6; R = 2.6; PAF = 47.8, PAR = 29.0) and 2017-18 (D = 55.8; R = 3.1; PAF = 57.2, PAR = 29.8). Education (2006: D = 31.3, R = 1.6, PAF = 40.5, PAR = 24.5; 2017-18: D = 25.2, R = 1.6, PAF = 34.9, PAR = 18.1) and rural-urban (2006: D = 16.8, R = 1.3, PAF = 17.8, PAR = 10.8; 2017-18: D = 11.2, R = 1.2, PAF = 13.1, PAR = 6.8) inequalities reduced while economic status inequalities did not improve (2006: D = 48, R = 2.2, PAF = 44.5, PAR = 26.9; 2017-18: D = 43.9, R = 2.4, PAF = 45.0, PAR = 23.4). Age inequalities were very minimal.
CONCLUSIONS: ANC inequalities remain deeply ingrained in Benin. Addressing their varying levels requires comprehensive strategies that encompass both supply-and demand-side interventions, focusing on reaching uneducated women in the poorest households and those residing in rural areas and Atacora.