NDLI: Disparities in use of skilled birth attendants and neonatal mortality rate in Guinea over two decades

Content Provider	Springer Nature : BioMed Central
Author	Zegeye, Betregiorgis Ahinkorah, Bright Opoku Ameyaw, Edward Kwabena Budu, Eugene Seidu, Abdul-Aziz Olorunsaiye, Comfort Z. Yaya, Sanni
Abstract	Background Maternal mortality remains high in sub-Saharan African countries, including Guinea. Skilled birth attendance (SBA) is one of the crucial interventions to avert preventable obstetric complications and related maternal deaths. However, within-country inequalities prevent a large proportion of women from receiving skilled birth attendance. Scarcity of evidence related to this exists in Guinea. Hence, this study investigated the magnitude and trends in socioeconomic and geographic-related inequalities in SBA in Guinea from 1999 to 2016 and neonatal mortality rate (NMR) between 1999 and 2012. Methods We derived data from three Guinea Demographic and Health Surveys (1999, 2005 and 2012) and one Guinea Multiple Indicator Cluster Survey (2016). For analysis, we used the 2019 updated WHO Health Equity Assessment Toolkit (HEAT). We analyzed inequalities in SBA and NMR using Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D) and Ratio (R). These summary measures were computed for four equity stratifiers: wealth, education, place of residence and subnational region. We computed 95% Uncertainty Intervals (UI) for each point estimate to show whether or not observed SBA inequalities and NMR are statistically significant and whether or not disparities changed significantly over time. Results A total of 14,402 for SBA and 39,348 participants for NMR were involved. Profound socioeconomic- and geographic-related inequalities in SBA were found favoring the rich (PAR = 33.27; 95% UI: 29.85–36.68), educated (PAR = 48.38; 95% UI: 46.49–50.28), urban residents (D = 47.03; 95% UI: 42.33–51.72) and regions such as Conakry (R = 3.16; 95% UI: 2.31–4.00). Moreover, wealth-driven (PAF = -21.4; 95% UI: −26.1, −16.7), education-related (PAR = -16.7; 95% UI: −19.2, −14.3), urban-rural (PAF = -11.3; 95% UI: −14.8, −7.9), subnational region (R = 2.0, 95% UI: 1.2, 2.9) and sex-based (D = 12.1, 95% UI; 3.2, 20.9) inequalities in NMR were observed between 1999 and 2012. Though the pattern of inequality in SBA varied based on summary measures, both socioeconomic and geographic-related inequalities decreased over time. Conclusions Disproportionate inequalities in SBA and NMR exist among disadvantaged women such as the poor, uneducated, rural residents, and women from regions like Mamou region. Hence, empowering women through education and economic resources, as well as prioritizing SBA for these disadvantaged groups could be key steps toward ensuring equitable SBA, reduction of NMR and advancing the health equity agenda of “no one left behind.”
Related Links	https://bmcpregnancychildbirth.biomedcentral.com/counter/pdf/10.1186/s12884-021-04370-8.pdf
Ending Page	13
Page Count	13
Starting Page	1
File Format	HTM / HTML
ISSN	14712393
DOI	10.1186/s12884-021-04370-8
Journal	BMC Pregnancy and Childbirth
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2022-01-21
Access Restriction	Open
Subject Keyword	Reproductive Medicine Maternal and Child Health Gynecology Skilled birth attendance neonatal mortality maternal health inequality Guinea DHS MICS Global health
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3.4/2023

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