Inequity in the Utilization of Maternal-Health Care Services in South Asia
(2014) Inequity in the Utilization of Maternal-Health Care Services in South Asia, no. 57.
Background: Millennium Development Goal (MDG) 5 is focused on achieving universal access to reproductive health care and maternal mortality. Extensive efforts have been made to achieve MDG 5 in all South Asian countries and in some countries much progress has been achieved. Progress has been uneven and inequitable within and with country however, many women still lack access to maternal health services. Objective: This study aims to review disparities in use of maternal health services and "Three delays framework" is used to categorize and explain determinants of inequity in use of SBAs and institutional delivery in Nepal, India and Sri Lanka. Methods: This is a desk study and conducted using narrative synthesis (a mixed method approach). Literature search was conducted from a relevant database including: Scopus, ProQuest and PubMed. The search was performed using developed list of search terms to find out published papers from Nepal, India and Sri Lanka: maternal health services, Findings: The evidence from these studies showed wide variation in use of maternal health services exist both between and within respective countries. This differences are due to lack of awareness among women regarding the importance of maternal health care, distance, lack of transportation, cost of transportation and cost of delivery at hospitals. Conclusion: This study has shown high variations in the use of maternal health care services among Nepal, India and Sri Lanka along socio-economic through SBAs at delivery and institutional delivery. Nepal and India has comparatively lower access and higher inequalities in use of maternal health services than Sri Lanka. Policies and programs targeting maternal health interventions need to consider equity with efficiency in utilization of maternal health services and appropriate strategies need to be implemented between and within respective countries to reduce the inequalities in the use of maternal health services. Keywords: Maternal health services, inequalities, disparities, Skilled birth attendants, Institutional delivery, South Asia, Nepal, India, Sri Lanka.