Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil.

Abstract:

BACKGROUND:Socio-economic inequalities in maternal and child health are ubiquitous, but limited information is available on how much the quality of care varies according to wealth or ethnicity in low- and middle-income countries. Also, little information exists on quality differences between public and private providers. METHODS:Quality of care for women giving birth in 2004 in Pelotas, Brazil, was assessed by measuring how many of 11 procedures recommended by the Ministry of Health were performed. Information on family income, self-assessed skin colour, parity and type of provider were collected. RESULTS:Antenatal care was used by 98% of the 4244 women studied (mean number of visits 8.3), but the number of consultations was higher among better-off and white women, who were also more likely to start antenatal care in the first trimester. The quality of antenatal care score ranged from 0 to 11, with an overall mean of 8.3 (SD 1.7). Mean scores were 8.9 (SD 1.5) in the wealthiest and 7.9 (SD 1.8) in the poorest quintiles (P < 0.001), 8.4 (SD 1.6) in white and 8.1 (SD 1.9) in black women (P < 0.001). Adjusted analyses showed that these differences seemed to be due to attendance patterns rather than discrimination. Mean quality scores were higher in the private 9.3 (SD 1.3) than in the public sector 8.1 (SD 1.6) (P < 0.001); these differences were not explained by maternal characteristics or by attendance patterns. CONCLUSIONS:Special efforts must be made to improve quality of care in the public sector. Poor and black women should be actively encouraged to start antenatal care early in pregnancy so that they can fully benefit from it. There is a need for regular monitoring of antenatal attendances and quality of care with an equity lens, in order to assess how different social groups are benefiting from progress in health care.

journal_name

Health Policy Plan

authors

Victora CG,Matijasevich A,Silveira M,Santos I,Barros AJ,Barros FC

doi

10.1093/heapol/czp065

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

253-61

issue

4

eissn

0268-1080

issn

1460-2237

pii

czp065

journal_volume

25

pub_type

杂志文章
  • Dual practice of public hospital physicians in Vietnam.

    abstract::Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physician...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czy075

    authors: Do N,Do YK

    更新日期:2018-10-01 00:00:00

  • Public and private hospitals in Bangladesh: service quality and predictors of hospital choice.

    abstract::This study compares the quality of services provided by public and private hospitals in Bangladesh. The premise of the paper was that the quality of hospital services would be contingent on the incentive structure under which these institutions operate. Since private hospitals are not subsidized and depend on income f...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/15.1.95

    authors: Andaleeb SS

    更新日期:2000-03-01 00:00:00

  • Exploring referral systems for injured patients in low-income countries: a case study from Cambodia.

    abstract::Injury is a growing public health concern worldwide. Since severe injuries require urgent treatment, involving smooth, timely patient referral between facilities, strengthening of the referral system would reduce injury mortality. Smooth referral consists of identification of severe cases, organization of transportati...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp063

    authors: Nakahara S,Saint S,Sann S,Ichikawa M,Kimura A,Eng L,Yoshida K

    更新日期:2010-07-01 00:00:00

  • The quality of risk factor screening during antenatal consultations in Niger.

    abstract::A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health prog...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/15.1.11

    authors: Prual A,Toure A,Huguet D,Laurent Y

    更新日期:2000-03-01 00:00:00

  • Acceptability of conditions in a community-led cash transfer programme for orphaned and vulnerable children in Zimbabwe.

    abstract::Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash tran...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czt060

    authors: Skovdal M,Robertson L,Mushati P,Dumba L,Sherr L,Nyamukapa C,Gregson S

    更新日期:2014-10-01 00:00:00

  • Transcalar networks for policy transfer and implementation: the case of global health policies for malaria and HIV/AIDS in Cameroon.

    abstract::This paper explores the nature and type of policy transfer promoted by global health partnerships to facilitate access to medication in Cameroon and the associated implementation challenges. Using concepts from policy transfer, multi-level governance and the politics of scale, the paper conceptualizes the social space...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czq018

    authors: Ngoasong MZ

    更新日期:2011-01-01 00:00:00

  • Rehabilitating health services in Cambodia: the challenge of coordination in chronic political emergencies.

    abstract::The end of the Cold War brought with it opportunities to resolve a number of conflicts around the world, including those in Angola, Cambodia, El Salvador and Mozambique. International political efforts to negotiate peace in these countries were accompanied by significant aid programmes ostensibly designed to redress t...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/14.3.229

    authors: Lanjouw S,Macrae J,Zwi AB

    更新日期:1999-09-01 00:00:00

  • Treatment as insurance: HIV antiretroviral therapy offers financial risk protection in Malawi.

    abstract::Many countries have expanded insurance programmes in an effort to achieve universal health coverage (UHC). We assess a complementary path toward financial risk protection: increased access to technologies that improve health and reduce the risk of large health expenditures. Malawi has provided free HIV treatment since...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa023

    authors: Dickerson S,Baranov V,Bor J,Barofsky J

    更新日期:2020-07-01 00:00:00

  • Health and economic benefits of scaling up a home-based neonatal care package in rural India: a modelling analysis.

    abstract::Approximately 900 000 newborn children die every year in India, accounting for 28% of neonatal deaths globally. In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. We estimate the disease and economic burden that could be averted by scaling...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv113

    authors: Nandi A,Colson AR,Verma A,Megiddo I,Ashok A,Laxminarayan R

    更新日期:2016-06-01 00:00:00

  • Pneumonia's second wind? A case study of the global health network for childhood pneumonia.

    abstract::Advocacy, policy, research and intervention efforts against childhood pneumonia have lagged behind other health issues, including malaria, measles and tuberculosis. Accelerating progress on the issue began in 2008, following decades of efforts by individuals and organizations to address the leading cause of childhood ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv070

    authors: Berlan D

    更新日期:2016-04-01 00:00:00

  • Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme.

    abstract::Neonatal deaths account for about half of all deaths among children under 5 years of age in Bangladesh, making prevention a major priority. This paper reports on a study of neonatal deaths in 12 areas of Bangladesh served by a large NGO programme, which had high coverage of reproductive health outreach services and re...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czl024

    authors: Mercer A,Haseen F,Huq NL,Uddin N,Hossain Khan M,Larson CP

    更新日期:2006-11-01 00:00:00

  • Opening the debate on DALYs (disability-adjusted life years).

    abstract::The 1993 World Development Report is proving to be an influential document for the development of the health sector policies in developing countries. One important aspect of the Report concerns its proposals for Disability Adjusted Life Years as a measure of health change and hence effectiveness of interventions. This...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/11.2.179

    authors: Barker C,Green A

    更新日期:1996-06-01 00:00:00

  • Measuring family planning quality and its link with contraceptive use in public facilities in Burkina Faso, Ethiopia, Kenya and Uganda.

    abstract::The individual impacts of several components of family planning service quality on contraceptive use have been studied, but the influence of a composite measure synthesizing these components has not been often investigated. We (1) develop a composite score for family planning service quality based on health facility d...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czy058

    authors: Fruhauf T,Zimmerman L,Kibira SPS,Makumbi F,Gichangi P,Shiferaw S,Seme A,Guiella G,Tsui A

    更新日期:2018-09-01 00:00:00

  • The cost-effectiveness of introducing hepatitis B vaccine into infant immunization services in Mozambique.

    abstract:OBJECTIVE:To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001. METHODS:A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi006

    authors: Griffiths UK,Hutton G,Das Dores Pascoal E

    更新日期:2005-01-01 00:00:00

  • The elasticity of demand for health care in Burkina Faso: differences across age and income groups.

    abstract::Like many other developing countries, Burkina Faso has been exploring how community resources can be tapped to co-finance health services. Although revenue generation is important for the viability of health services, effects on utilization and on equity of access to health care must also be considered. The authors pr...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/9.2.185

    authors: Sauerborn R,Nougtara A,Latimer E

    更新日期:1994-06-01 00:00:00

  • Financing mental health services in low- and middle-income countries.

    abstract::Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries und...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czl004

    authors: Dixon A,McDaid D,Knapp M,Curran C

    更新日期:2006-05-01 00:00:00

  • Income elasticity of health expenditures in Iran.

    abstract::Because of its policy implications, the income elasticity of health care expenditures is a subject of much debate. Governments may have an interest in subsidizing the care of those with low income. Using more than two decades of data from the Iran Household Expenditure and Income Survey, this article investigates the ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs106

    authors: Zare H,Trujillo AJ,Leidman E,Buttorff C

    更新日期:2013-09-01 00:00:00

  • Why should the poor insure? Theories of decision-making in the context of health insurance.

    abstract::Increasingly, low- and middle-income countries are looking to community-based health insurance (CBHI) as a means of ensuring access to health care for the poor. However, little evidence exists about the determining factors that affect poor individuals' insurance decisions. This article reviews the economic and social ...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czh050

    authors: Schneider P

    更新日期:2004-11-01 00:00:00

  • Impact of integrated healthcare: Taiwan's Family Doctor Plan.

    abstract::Integration of health services has been pursued worldwide. Diversity in integration approaches and in the contexts in which integrated programmes operate, however, hinders comparative analysis of care integration in both high-income countries (HICs) and low- and middle-income countries (LMICs). This study evaluates an...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czz111

    authors: Liang LL

    更新日期:2019-11-01 00:00:00

  • Improving access for the poorest to public sector health services: insights from Kirivong Operational Health District in Cambodia.

    abstract::This article presents research findings into the effectiveness of an innovative equity fund approach to improving access to public sector health services for the poor in Kirivong Operational Health District in Cambodia. The operational health district is the lowest organizational level in the Cambodian health system, ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czj001

    authors: Jacobs B,Price N

    更新日期:2006-01-01 00:00:00

  • Sector-wide approaches (SWAps) in health: what have we learned?

    abstract::Sector-wide approaches (SWAps) in health were developed in the early 1990s in response to widespread dissatisfaction with fragmented donor-sponsored projects and prescriptive adjustment lending. SWAps were intended to provide a more coherent way to articulate and manage government-led sectoral policies and expenditure...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs128

    authors: Peters DH,Paina L,Schleimann F

    更新日期:2013-12-01 00:00:00

  • Long-term care systems as social security: the case of Chile.

    abstract::Similar to many other countries, Chile is facing the challenges of rapid ageing and the increase in long-term care (LTC) needs for this population. Implementation of LTC systems has been the response to these challenges in other countries, however, Chile still lacks a strategy for addressing LTC needs. This article ad...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czy083

    authors: Villalobos Dintrans P

    更新日期:2018-11-01 00:00:00

  • Cost of school-based drug treatment in Tanzania. The Partnership for Child Development.

    abstract::It has been argued that targeting delivery of anthelmintics to school-children by taking advantage of the existing education infrastructure and administrative system can be one of the most cost-effective approaches in minimizing the intensity of infections with both schistosomiasis and major intestinal nematodes in ma...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/13.4.384

    authors:

    更新日期:1998-12-01 00:00:00

  • National and sub-national analysis of the health benefits and cost-effectiveness of strategies to reduce maternal mortality in Afghanistan.

    abstract:BACKGROUND:Afghanistan has one of the highest rates of maternal mortality in the world. We assess the health outcomes and cost-effectiveness of strategies to improve the safety of pregnancy and childbirth in Afghanistan. METHODS:Using national and sub-national data, we adapted a previously validated model that simulat...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs026

    authors: Carvalho N,Salehi AS,Goldie SJ

    更新日期:2013-01-01 00:00:00

  • The evolution, etiology and eventualities of the global health security regime.

    abstract:BACKGROUND:Attention to global health security governance is more important now than ever before. Scientists predict that a possible influenza pandemic could affect 1.5 billion people, cause up to 150 million deaths and leave US$3 trillion in economic damages. A public health emergency in one country is now only hours ...

    journal_title:Health policy and planning

    pub_type: 历史文章,杂志文章

    doi:10.1093/heapol/czq037

    authors: Hoffman SJ

    更新日期:2010-11-01 00:00:00

  • Career intentions of medical students in the setting of Nepal's rapidly expanding private medical education system.

    abstract::The number of medical students trained in Nepal each year has increased nearly fifty-fold in the last 15 years, primarily through the creation of private medical schools. It is unknown where this expanding cohort of new physicians will ultimately practice. We distributed an anonymous survey to students in their last 2...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr052

    authors: Huntington I,Shrestha S,Reich NG,Hagopian A

    更新日期:2012-08-01 00:00:00

  • Costing essential services package provided by a non-governmental organization network in Bangladesh.

    abstract::The health profile of Bangladesh has improved remarkably, yet gaps in delivering quality health care remain. In response to the need for evidence to quantify resources for providing health services in Bangladesh, this study estimates unit costs of providing the essential services package (ESP) in the not-for-profit se...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx105

    authors: Zeng W,Halasa YA,Cros M,Akhter H,Nandakumar AK,Shepard DS

    更新日期:2017-12-01 00:00:00

  • Increasing contraceptive use in rural Pakistan: an evaluation of the Lady Health Worker Programme.

    abstract::Past efforts to promote family planning in Pakistan have been disappointing, but between 1990-91 and 2000-01 contraceptive use has more than doubled. This rise has coincided with a concerted effort on the part of the Pakistani government to increase access to contraceptive services, particularly in rural areas. The La...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi014

    authors: Douthwaite M,Ward P

    更新日期:2005-03-01 00:00:00

  • Ability to pay for health care: concepts and evidence.

    abstract::In many developing countries people are expected to contribute to the cost of health care from their own pockets. As a result, people's ability to pay (ATP) for health care, or the affordability of health care, has become a critical policy issue in developing countries, and a particularly urgent issue where households...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/11.3.219

    authors: Russell S

    更新日期:1996-09-01 00:00:00

  • Provider payment in community-based health insurance schemes in developing countries: a systematic review.

    abstract:OBJECTIVES:Community-based health insurance (CBI) is a common mechanism to generate financial resources for health care in developing countries. We review for the first time provider payment methods used in CBI in developing countries and their impact on CBI performance. METHODS:We conducted a systematic review of the...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czs034

    authors: Robyn PJ,Sauerborn R,Bärnighausen T

    更新日期:2013-03-01 00:00:00