TY - JOUR
T1 - Measuring equity in utilization of emergency obstetric care at Wolisso Hospital in Oromiya, Ethiopia
T2 - A cross sectional study
AU - Wilunda, Calistus
AU - Putoto, Giovanni
AU - Manenti, Fabio
AU - Castiglioni, Maria
AU - Azzimonti, Gaetano
AU - Edessa, Wagari
AU - Atzori, Andrea
AU - Merialdi, Mario
AU - Betrán, Ana Pilar
AU - Vogel, Joshua
AU - Criel, Bart
PY - 2013/5/1
Y1 - 2013/5/1
N2 - Introduction. Improving equity in access to services for the treatment of complications that arise during pregnancy and childbirth, namely Emergency Obstetric Care (EmOC), is fundamental if maternal and neonatal mortality are to be reduced. Consequently, there is a growing need to monitor equity in access to EmOC. The objective of this study was to develop a simple questionnaire to measure equity in utilization of EmOC at Wolisso Hospital, Ethiopia and compare the wealth status of EmOC users with women in the general population. Methods. Women in the Ethiopia 2005 Demographic and Health Survey (DHS) constituted our reference population. We cross-tabulated DHS wealth variables against wealth quintiles. Five variables that differentiated well across quintiles were selected to create a questionnaire that was administered to women at discharge from the maternity from January to August 2010. This was used to identify inequities in utilization of EmOC by comparison with the reference population. Results: 760 women were surveyed. An a posteriori comparison of these 2010 data to the 2011 DHS dataset, indicated that women using EmOC were wealthier and more likely to be urban dwellers. On a scale from 0 (poorest) to 15 (wealthiest), 31% of women in the 2011 DHS sample scored less than 1 compared with 0.7% in the study population. 70% of women accessing EmOC belonged to the richest quintile with only 4% belonging to the poorest two quintiles. Transportation costs seem to play an important role. Conclusions: We found inequity in utilization of EmOC in favour of the wealthiest. Assessing and monitoring equitable utilization of maternity services is feasible using this simple tool.
AB - Introduction. Improving equity in access to services for the treatment of complications that arise during pregnancy and childbirth, namely Emergency Obstetric Care (EmOC), is fundamental if maternal and neonatal mortality are to be reduced. Consequently, there is a growing need to monitor equity in access to EmOC. The objective of this study was to develop a simple questionnaire to measure equity in utilization of EmOC at Wolisso Hospital, Ethiopia and compare the wealth status of EmOC users with women in the general population. Methods. Women in the Ethiopia 2005 Demographic and Health Survey (DHS) constituted our reference population. We cross-tabulated DHS wealth variables against wealth quintiles. Five variables that differentiated well across quintiles were selected to create a questionnaire that was administered to women at discharge from the maternity from January to August 2010. This was used to identify inequities in utilization of EmOC by comparison with the reference population. Results: 760 women were surveyed. An a posteriori comparison of these 2010 data to the 2011 DHS dataset, indicated that women using EmOC were wealthier and more likely to be urban dwellers. On a scale from 0 (poorest) to 15 (wealthiest), 31% of women in the 2011 DHS sample scored less than 1 compared with 0.7% in the study population. 70% of women accessing EmOC belonged to the richest quintile with only 4% belonging to the poorest two quintiles. Transportation costs seem to play an important role. Conclusions: We found inequity in utilization of EmOC in favour of the wealthiest. Assessing and monitoring equitable utilization of maternity services is feasible using this simple tool.
KW - Access
KW - Emergency obstetrics care
KW - Maternal health
KW - Socio-economic status
UR - http://www.scopus.com/inward/record.url?scp=84876708944&partnerID=8YFLogxK
U2 - 10.1186/1475-9276-12-27
DO - 10.1186/1475-9276-12-27
M3 - Article
C2 - 23607604
AN - SCOPUS:84876708944
SN - 1475-9276
VL - 12
JO - International Journal for Equity in Health
JF - International Journal for Equity in Health
IS - 1
M1 - 27
ER -