Assessing sub-regional wealth Inequalities in the ANCq - a content-qualified antenatal care (ANC) coverage indicator in Pakistan: evidence from the MICS surveys 2017-2020.

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Date
2024-08-23
Authors
Khan, Eefa S.
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Abstract

The rate of progress towards achieving the Sustainable Development Goals for maternal health in Pakistan has been exceedingly slow. Maternal health indicators are disappointingly some of the lowest, and inequalities in those indicators are some of the highest in the region, necessitating urgent and accelerated efforts to expand access to the most marginalized and disadvantaged groups. An analysis of wealth-based inequalities in the ANCq – a content-qualified antenatal indicator, with a particular focus on understanding these inequalities within and between provinces is presented. Considering Pakistan's 18th Constitutional Amendment and the devolution of healthcare, identifying these inequalities at the sub-provincial level is ever more crucial. Methods This study analyzed data from the 2017-20 Multiple Indicator Cluster Surveys (MICS) to examine the wealth-based inequalities in the components of the ANCq as well as the weighted mean of the ANCq using simple and complex measures of inequality in districts as well as tiers of districts within each province. Overall, the study supports the conclusion that stark inter-provincial and sub-provincial wealth-based disparities exist in the coverage of antenatal care and its components. Similar ANCq scores in the poorest wealth quintiles in both developed and less-developed districts suggest that health resource benefits are not only unevenly distributed, in some respects, they harm equity by widening gaps in coverage. Economically disadvantaged populations continue to face major barriers in accessing high-quality antenatal care even in areas with better health infrastructure, underscoring the need for comprehensive strategies to ensure equitable healthcare for all.

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Keywords
antenatal care, equity, wealth inequalities
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