Equity Analysis Of Free Maternal And Child Health Services In Delta State, Nigeria
Christie Akpoigho Enuku, RN, RM, MSc. MHPM, Ph.D
Department of Nursing Science. University of Benin, Benin City, Nigeria
Obinna E Onwujekwe MBBS, M.Sc., Ph.D
Department of Health Administration and Management, College of Medicine, University of Nigeria Enugu-campus, Enugu, Nigeria
Keywords: Equity, Educational status, Geographical area, Maternal and Child health, Socio economic status
Abstract
Inequity in access to health care is one of the leading cause of maternal and child mortality in Delta State. In order to reduce maternal and child mortality, the Delta State Government established the Free Maternal and Child Health Programmes (FMCHP) in 2007 and 2010 respectively. This paper provides new knowledge on how equitable the FMCHP in Delta state are among women from different socio-economic status (SES), educational background and between rural and urban areas. The population for the study were women of reproductive age (15-49 years) who had given birth in the last one year in two senatorial districts of Delta State. Data was collected from a random sample of 368 women using a pre-tested interviewer-administered questionnaire. Univariate, bivariate and multivariate analyses were used in data analysis. Inequities in utilization of free maternal and child health programmes were also measured using concentration curve and concentration index. The findings show that majority 199(54.1%) of them have secondary education, followed by tertiary education 106(28.8%). Majority of respondents are between age 21 to 30years 217(59.0%). 20% of respondents belong to the poorest, poor and least poor socio economic status(SES) group and 19.8% belong to average poor and rich SES group. From the concentration index, there was equity between different SES (0.014) and educational (0.027) backgrounds as indicated in concentration curves. However, the concentration index between the geographical areas (-0.0200) indicates inequity in access in favour of urban dwellers. It was concluded that FMCHP was found to be equitable across different SES groups and educational levels. However, there was inequity between urban and rural areas in favour of urban dwellers, mainly due to distances between rural dwellers and the hospitals located in the outskirts of town. Hence, it is recommended that regular transportation along the routes where there are hospitals should be provided