Inter-district and Wealth-related Inequalities in Maternal and Child Health Service Coverage and Child Mortality within Addis Ababa City

This study aims to investigate temporal trends and geographic differences in maternal, newborn, and child health service utilization between Addis Ababa ’s poorest and richest districts and households. A World Bank district-based poverty index was used to classify districts into the top 60% (non-poor) and bottom 40% (poor), and wealth index data from the Ethiopian Demographic and Health Survey (EDHS) was used to classify households into the top 60 % (non-poor) and bottom 40% (poor). Essential maternal, newborn, and child health service coverage was estimated from routine health facility data for 2019–2021, and five rounds of the EDHS (2000–2019) were used to estimate child mortality. The results showed that service coverage was substantia lly higher in the top 60% than in the bottom 40% of districts. Coverage of four antenatal care visits, skill birth attendance, and postnatal care all exceeded 90% in the non-poor districts but only ranged from 54 to 67% in the poor districts. Inter-district inequalities were less pronounced for chil dhood vaccinations, with over 90% coverage levels across all districts. Inter-district inequalities in mortality rates were considerable. The neonatal mortality rate was nearly twice as high in the bottom 40% of households' as in the top 60% of households. Similarly, the under-5 mortality rate was t hree times higher in the bottom 40% compared to the top 60% of households. The substantial inequalities in MNCH service utilization and child m...
Source: Journal of Urban Health - Category: Health Management Source Type: research