Trends and Inequalities in Access to Reproductive Health Services in Developing Countries: Which Services Are Reaching the Poor?

Emmanuela E. Gakidou, Harvard University
Cecilia Vidal, Harvard University
Margaret Hogan
Angelica Sousa, World Health Organization (WHO)
Brian Chin, Harvard University

This paper presents an analysis of time trends in average levels and inequalities in the provision of antenatal care and skilled birth attendance, using 61 surveys conducted in 18 Demographic and Health Surveys since 1985. The three main questions explored in the analysis are: (1)What are the trends in average levels and, more importantly, inequalities in delivering antenatal care and skilled birth attendance to women in low income countries over the past two decades? (2)Why are some countries more efficient than others at delivering maternal health interventions to poor populations? (3)Which countries have been more effective at reducing urban-rural inequalities in reproductive health services? A detailed analysis of similarities and differences of socioeconomic gradients of maternal health interventions both within and between countries is presented. This is an important step in considering how economic status may interact with other factors, such as geography, to affect maternal health and pregnancy outcomes.