Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil
| العنوان: | Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil |
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| المؤلفون: | Iná S. Santos, Cesar G. Victora, Alicia Matijasevich, Mariângela F Silveira, Ajd Barros, Fernando C. Barros |
| المصدر: | Health Policy and Planning. 25:253-261 |
| بيانات النشر: | Oxford University Press (OUP), 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Black People, Prenatal care, Family income, White People, Cohort Studies, Nursing, Pregnancy, Universal Health Insurance, Health care, Humans, Medicine, Healthcare Disparities, Quality of Health Care, Insurance, Health, Public Sector, Health economics, business.industry, Health Policy, Public sector, Attendance, Prenatal Care, Original Articles, Patient Acceptance of Health Care, Private sector, Socioeconomic Factors, Income, Female, Private Sector, business, Brazil, Demography, Cohort study |
| الوصف: | 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. |
| تدمد: | 1460-2237 0268-1080 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::701df2f7ace20e49f05fad9ccf5a5113 https://doi.org/10.1093/heapol/czp065 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....701df2f7ace20e49f05fad9ccf5a5113 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602237 02681080 |
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