TY - JOUR
T1 - Unequal coverage of nutrition and health interventions for women and children in seven countries
AU - Nguyen, Phuong Hong
AU - Singh, Nishmeet
AU - Scott, Samuel
AU - Neupane, Sumanta
AU - Jangid, Manita
AU - Walia, Monika
AU - Murira, Zivai
AU - Bhutta, Zulfiqar A.
AU - Torlesse, Harriet
AU - Piwoz, Ellen
AU - Heidkamp, Rebecca
AU - Menon, Purnima
N1 - Publisher Copyright:
© 2022, World Health Organization. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - Objective To examine inequalities and opportunity gaps in co-coverage of health and nutrition interventions in seven countries. Methods We used data from the most recent (2015–2018) demographic and health surveys of mothers with children younger than 5 years in Afghanistan (n = 19 632), Bangladesh (n = 5051), India (n = 184 641), Maldives (n = 2368), Nepal (n = 3998), Pakistan (n = 8285) and Sri Lanka (n = 7138). We estimated co-coverage for a set of eight health and eight nutrition interventions and assessed within-country inequalities in co-coverage by wealth and geography. We examined opportunity gaps by comparing coverage of nutrition interventions with coverage of their corresponding health delivery platforms. Findings Only 15% of 231 113 mother–child pairs received all eight health interventions (weighted percentage). The percentage of mother–child pairs who received no nutrition interventions was highest in Pakistan (25%). Wealth gaps (richest versus poorest) for co-coverage of health interventions were largest for Pakistan (slope index of inequality: 62 percentage points) and Afghanistan (38 percentage points). Wealth gaps for co-coverage of nutrition interventions were highest in India (32 percentage points) and Bangladesh (20 percentage points). Coverage of nutrition interventions was lower than for associated health interventions, with opportunity gaps ranging from 4 to 54 percentage points. Conclusion Co-coverage of health and nutrition interventions is far from optimal and disproportionately affects poor households in south Asia. Policy and programming efforts should pay attention to closing coverage, equity and opportunity gaps, and improving nutrition delivery through health-care and other delivery platforms.
AB - Objective To examine inequalities and opportunity gaps in co-coverage of health and nutrition interventions in seven countries. Methods We used data from the most recent (2015–2018) demographic and health surveys of mothers with children younger than 5 years in Afghanistan (n = 19 632), Bangladesh (n = 5051), India (n = 184 641), Maldives (n = 2368), Nepal (n = 3998), Pakistan (n = 8285) and Sri Lanka (n = 7138). We estimated co-coverage for a set of eight health and eight nutrition interventions and assessed within-country inequalities in co-coverage by wealth and geography. We examined opportunity gaps by comparing coverage of nutrition interventions with coverage of their corresponding health delivery platforms. Findings Only 15% of 231 113 mother–child pairs received all eight health interventions (weighted percentage). The percentage of mother–child pairs who received no nutrition interventions was highest in Pakistan (25%). Wealth gaps (richest versus poorest) for co-coverage of health interventions were largest for Pakistan (slope index of inequality: 62 percentage points) and Afghanistan (38 percentage points). Wealth gaps for co-coverage of nutrition interventions were highest in India (32 percentage points) and Bangladesh (20 percentage points). Coverage of nutrition interventions was lower than for associated health interventions, with opportunity gaps ranging from 4 to 54 percentage points. Conclusion Co-coverage of health and nutrition interventions is far from optimal and disproportionately affects poor households in south Asia. Policy and programming efforts should pay attention to closing coverage, equity and opportunity gaps, and improving nutrition delivery through health-care and other delivery platforms.
UR - http://www.scopus.com/inward/record.url?scp=85123561283&partnerID=8YFLogxK
U2 - 10.2471/BLT.21.286650
DO - 10.2471/BLT.21.286650
M3 - Article
C2 - 35017754
AN - SCOPUS:85123561283
SN - 0042-9686
VL - 100
SP - 20
EP - 29
JO - Bulletin of the World Health Organization
JF - Bulletin of the World Health Organization
IS - 1
ER -