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      Socioeconomic inequalities in post-natal health checks for the newborn in Vietnam

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          Abstract

          Background

          The newborn and child death associated with inadequate post-natal health checks continued to be a significant issue across the world. This study aimed to assess the socioeconomic inequalities in post-natal health checks for the newborn in Vietnam in 2014.

          Methods

          We used the secondary data from the Multiple Indicator Cluster Survey in 2014. We included women aged 15–49 years who had a live birth within two years of the time of the interview. We estimated the concentration index to measure socioeconomic inequalities post-natal health checks for the newborn. We conducted multiple logistic regression analysis to identify factors associated with post-natal health checks for the newborn.

          Results

          Overall, the proportion of post-natal health checks for the newborn in Vietnam was 89.1%. The concentration index of post-natal health checks for the newborn was positive at 0.06. It indicated that the newborns in the rich households were more likely to get post-natal health checks as compared to in the poor households. The common factors significantly associated with the higher percentage of post-natal health checks for the newborn were women belonging to the Kinh and Hoa ethnic, higher education, and wealthier groups.

          Conclusion

          Socioeconomic inequalities in post-natal health checks for the newborn in Vietnam were not strong, but it still existed. Thus, we recommended that policy efforts to increase access to post-natal health services for poor women. In addition, there is a need to improve access to post-natal health services for women belonging to minor ethnic group and low education.

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          Most cited references14

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          Inequities in postnatal care in low- and middle-income countries: a systematic review and meta-analysis

          Abstract Objective To assess the socioeconomic, geographical and demographic inequities in the use of postnatal health-care services in low- and middle-income countries. Methods We searched Medline, Embase and Cochrane Central databases and grey literature for experimental, quasi-experimental and observational studies that had been conducted in low- and middle-income countries. We summarized the relevant studies qualitatively and performed meta-analyses of the use of postnatal care services according to selected indicators of socioeconomic status and residence in an urban or rural setting. Findings A total of 36 studies were included in the narrative synthesis and 10 of them were used for the meta-analyses. Compared with women in the lowest quintile of socioeconomic status, the pooled odds ratios for use of postnatal care by women in the second, third, fourth and fifth quintiles were: 1.14 (95% confidence interval, CI : 0.96–1.34), 1.32 (95% CI: 1.12–1.55), 1.60 (95% CI: 1.30–1.98) and 2.27 (95% CI: 1.75–2.93) respectively. Compared to women living in rural settings, the pooled odds ratio for the use of postnatal care by women living in urban settings was 1.36 (95% CI: 1.01–1.81). A qualitative assessment of the relevant published data also indicated that use of postnatal care services increased with increasing level of education. Conclusion In low- and middle-income countries, use of postnatal care services remains highly inequitable and varies markedly with socioeconomic status and between urban and rural residents.
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            Factors associated with non-utilisation of postnatal care services in Indonesia.

            Postnatal care helps prevent neonatal deaths. This study aims to examine factors associated with non-utilisation of postnatal care in Indonesia. A cross-sectional analytic study was conducted using data from the 2002-3 Indonesia Demographic and Health Survey (IDHS), which used multistage cluster random sampling. Contingency table and logistic regression analyses were used to determine the factors associated with non-utilisation of postnatal care services. The population attribution risk percentage (PAR%) for non-utilisation of postnatal care services was also calculated. Data were available for 15,553 singleton live-born infants. The prevalence of non-attendance at postnatal care services was consistently higher in rural areas than in urban areas. Maternal factors associated with lack of postnatal care included low household wealth index, low education levels, lack of knowledge of pregnancy-related complications or where distance from health services was a problem. Infants of high birth rank and those reported to be smaller than average were less likely to receive postnatal care. Other indicators of access to healthcare services which were associated with non-utilisation of postnatal care services included few antenatal care checks, use of untrained birth attendants and births outside healthcare facilities. Public health interventions to increase the utilisation of postnatal care services should target women who are poor, less educated, from rural areas and who use untrained birth attendants. Strategies to improve the availability and accessibility of antenatal care services and skilled birth attendance including focused financial support and health promotion programmes, particularly in the rural areas, should increase utilisation of postnatal care services in Indonesia.
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              Socio-Economic Inequalities in the Use of Postnatal Care in India

              Objectives First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. Methods and Findings Rich–poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007–08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. Conclusions PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy interventions.
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                Author and article information

                Contributors
                +84 904220301 , lamgmhs75@gmail.com
                +84 985259999 , bsanhbnhn@yahoo.com
                +84 989661093 , thuha.ivf@gmail.com
                +84 985219988 , drvinh1277@gmail.com
                +84 912259288 , vumaianh123@yahoo.com
                +84 912100500 , vuduykien@gmail.com , vuduykien@oncare.vn
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                16 August 2019
                16 August 2019
                2019
                : 18
                : 128
                Affiliations
                [1 ]ISNI 0000 0004 0642 8489, GRID grid.56046.31, Hanoi Medical University, ; No1. Ton That Tung Street, Hanoi, Vietnam
                [2 ]Hanoi Obstetrics and Gynecology Hospital, No. 929 La Thanh Street, Ba Dinh District, Hanoi, Vietnam
                [3 ]ISNI 0000 0004 0637 2083, GRID grid.267852.c, Vietnam National University, ; No 144 Xuan Thuy Street, Cau Giay District, Hanoi, Vietnam
                [4 ]ISNI 0000 0004 0642 7152, GRID grid.492361.b, Health Strategy and Policy Institute, ; A36 Lane, Ho Tung Mau St, Cau Giay District, Hanoi, Vietnam
                [5 ]OnCare Medical Technology Company Limited, No. 77/508 Lang Street, Hanoi, Vietnam
                Author information
                http://orcid.org/0000-0003-3563-7688
                http://orcid.org/0000-0002-4333-8912
                Article
                1029
                10.1186/s12939-019-1029-8
                6697903
                30606218
                6515d0e0-2d09-42d5-afe3-d488ce19ebf1
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 May 2019
                : 6 August 2019
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Health & Social care
                post-natal,health checks,newborn,inequalities,concentration index,vietnam
                Health & Social care
                post-natal, health checks, newborn, inequalities, concentration index, vietnam

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