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Assessing inequality in reproductive, maternal and child health in Lao PDR

Assessing inequality in reproductive, maternal and child health in Lao PDR. 02 May 2014. Indicators . Antenatal care (at least one visit ) Careseeking for pneumonia DPT3 immunization Early initiation of breastfeeding Measles immunization

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Assessing inequality in reproductive, maternal and child health in Lao PDR

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  1. Assessing inequality in reproductive, maternal and child health in Lao PDR 02 May 2014

  2. Indicators • Antenatal care (at least one visit) • Careseeking for pneumonia • DPT3 immunization • Early initiation of breastfeeding • Measles immunization • Oral rehydration therapy for children with diarrhoea • Births attended by skilled health personnel • Stunting (height for age) in children under 5 years • Underweight (weight for age) in children under 5 years • Wasting (weight for height) in children under 5 years

  3. Dimensions of inequality • Wealth • Education • Sex • Area.

  4. Each indicator, three aspects will be assessed • The latest status (from MICS 2011) • The time trend (2006 to 2011) • Benchmarking against other countries in the Asia Pacific Region

  5. Example for HD*calc analysis of latest status - Slop index inequality(SII) and Relative concentration index(RCI)were selected for wealth stratifier - Range different(RD) and relative different(RR) were sected for education, sex and area.

  6. The latest status of inequality • In 2011, indicators showed less than 60% in coverage and only 3 of the 10 indicators showed higher than 50%(ANC1,DPTV and Carep). • Births attended by skilled health personnel showed greatest level of inequality across the 4 stratifiers (wealth-based, education based, sex based and area-based), And ANC1 is also showed high level of inequality as second

  7. Prioritizing the latest status of inequality and national coverage 3 (red) indicated urgent need for action, 2 (yellow) indicated that action is needed 1 (green) indicated that no action is needed. The most inequitable health services indicator across all equity stratifiers assessed was the presence of a skilled birth attendant

  8. Prioritizing the latest status of inequality and national coverage • Urgent need for action. • Births attended by skilled health personnel • Measles immunization • Need for action. • Antenatal care (at least one visit) • Stunting (height for age) in children under 5 years • Underweight (weight for age) in children under 5 years

  9. Trend of Inequality by Stratifiers • Most of indicators the trend of the inequality by stratifiers were no change or slight change and don’t show large gap of inequality over 5 years. ANC, DPTV and SBA showed highest inequality of absolute number. • The largest increase in coverage was seen in measles immunization by 20% from 2006 to2011. Care seeking for pneumonia and early initiation of breastfeeding show second and third respectively and the rest indicators were slightly changed.

  10. Example table for trend analyzed by HD*calcFor wealth-based

  11. Prioritizing the time trend of inequality and national coverage 3 (red) indicated urgent need for action, 2 (yellow) indicated that action is needed 1 (green) indicated that no action is needed.

  12. Examples on trend of inequity in health (1)

  13. Prioritizing the trend of inequality and national coverage • Need for action: • Antenatal care (at least one visit) • Careseeking for pneumonia • DPT3 immunization • Early initiation of breastfeeding • Oral rehydration therapy for children with diarrhoea • Stunting (height for age) in children under 5 years • Underweight (weight for age) in children under 5 years • Wasting (weight for height) in children under 5 years

  14. Benchmarking The red dot indicate the value of Lao PDR

  15. Example: Oral rehydration therapy for children with diarrhea

  16. Benchmarking 3 (red) indicated urgent need for action, 2 (yellow) indicated that action is needed 1 (green) indicated that no action is needed.

  17. conclusion • Births attended by skilled health personnel and Antenatal care (at least one visit) showed greatest level of inequality across the 4 stratifiers • Most of the indicator when compared to other countries in the Asia Pacific Region, Laos had the highest absolute wealth-based inequality in our assess inequitable health services indicator across all equity stratifiers with low coverage 8 0f 10 indicators.

  18. Conclusion • Urgent action should be taken for these indicators below: • Antenatal care ( at least one visit) • Births attended by skilled health personnel • Careseeking for pneumonia • DPT3 immunization • Early initiation of breastfeeding • Stunting (height for age) in children under 5 years • Underweight (weight for age) in children under 5 years

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