Lancet review examines equity in MNCH interventions

31 MARCH 2012 – The global health community must increase its efforts to ensure key maternal, newborn, and child health interventions are adequately reaching all social groups. In a study published in the Lancet — funded by PMNCH members The Bill & Melinda Gates Foundation and The World Bank, in conjunction with Norad (Norwegian Agency for Development Cooperation) — substantial variations in coverage levels were observed between interventions and countries. The study looked at data for 12 interventions from national surveys done in 54 Countdown countries between Jan 1, 2000, and Dec 31, 2008.

Key findings

  • Skilled birth attendant coverage was found to be the least equitable intervention; the most equitable intervention was found to be early initiation of breastfeeding.
  • Chad, Nigeria, Somalia, Ethiopia, Laos, and Niger were the most inequitable countries for the interventions examined, followed by Madagascar, Pakistan, and India; the most equitable countries were Uzbekistan and Kyrgyzstan.
  • Community-based interventions were more equally distributed than those delivered in health facilities.
  • For all interventions, variability in coverage between countries was larger for the poorest than for the richest individuals.