Progress in reducing inequalities in reproductive, maternal, newborn, and child health in Latin America and the Caribbean: An unfinished agenda

María Clara Restrepo-Méndez, Aluísio J D Barros, Jennifer Harris Requejo, Pablo Durán, Luis Andrés De Francisco Serpa, Giovanny V A França, Fernando C. Wehrmeister, Cesar G. Victora

Research output: Contribution to journalArticle

Abstract

Objective. To expand the "Countdown to 2015" analyses of health inequalities beyond the 75 countries being monitored worldwide to include all countries in Latin America and the Caribbean (LAC) that have adequate data available. Methods. Demographic and Health Surveys and Multiple Indicator Cluster Surveys were used to monitor progress in health intervention coverage and inequalities in 13 LAC countries, five of which are included in the Countdown (Bolivia, Brazil, Guatemala, Haiti, and Peru) and eight that are not (Belize, Colombia, Costa Rica, Dominican Republic, Guyana, Honduras, Nicaragua, and Suriname). The outcomes included neonatal and under-5 year mortality rates, child stunting preva-lence, and the composite coverage index-A weighted average of eight indicators of coverage in reproductive, maternal, newborn, and child health. The slope index of inequality and concentration index were used to assess absolute and relative inequalities. Results. The composite coverage index showed monotonic patterns over wealth quintiles, with lowest levels in the poorest quintile. Under-5 and neonatal mortality as well as stunting prevalence were highest among the poor. In most countries, intervention coverage increased, while under-5 mortality and stunting prevalence fell most rapidly among the poor, so that inequalities were reduced over time. However, Bolivia, Guatemala, Haiti, Nicaragua, and Peru still show marked inequalities. Brazil has practically eliminated inequalities in stunting. Conclusions. LAC countries presented substantial progress in terms of reducing inequalities in reproductive, maternal, newborn, and child health interventions, child mortality, and nutrition. However, the poorest 20% of the population in most countries is still lagging behind, and renewed actions are needed to improve equity.

Original languageEnglish (US)
Pages (from-to)9-16
Number of pages8
JournalRevista Panamericana de Salud Publica/Pan American Journal of Public Health
Volume38
Issue number1
StatePublished - Jul 1 2015
Externally publishedYes

Keywords

  • Caribbean Region
  • Health inequalities
  • Latin America
  • Maternal and child health
  • Millennium Development Goals
  • Socioeconomic factors

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Restrepo-Méndez, M. C., Barros, A. J. D., Requejo, J. H., Durán, P., De Francisco Serpa, L. A., França, G. V. A., Wehrmeister, F. C., & Victora, C. G. (2015). Progress in reducing inequalities in reproductive, maternal, newborn, and child health in Latin America and the Caribbean: An unfinished agenda. Revista Panamericana de Salud Publica/Pan American Journal of Public Health, 38(1), 9-16.