ArticleBMJ global health2025
Effective coverage for reproductive, maternal, neonatal and newborn health: an analysis of geographical and socioeconomic inequalities in 39 low- and middle-income countries.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Estimating the impact and cost-effectiveness of antenatal care approaches in 24 low- and middle-income countries: a modelling study.BMC global and public health · 2026Article
- [Joint trajectories and evolution patterns of direct and indirect maternal mortality across 204 countries from 2000 to 2021].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
- Article
- Zero-inflated negative binomial modelling of antenatal care utilization and it's predictors in Somaliland:Frontiers in global women's health · 2026Article
- Evaluating the implementation of intermittent versus continuous fetal heart rate monitoring on intrapartum care and early neonatal outcomes using causal mediational modeling.Frontiers in drug safety and regulation · 2026Article
- Artificial intelligence and the future of maternal and newborn health in low-income countries: advancing equity, early detection, and health system resilience.Frontiers in public health · 2026Review
- Global burden and trend of ischemic heart disease and its attributable risk factors among women of childbearing age from 1990 to 2021.Frontiers in cardiovascular medicine · 2026Article
- Effective coverage of maternal and newborn health services across the antepartum and peripartum continuum in primary health care in Ethiopia.Reproductive health · 2025Article
- Developing a framework for monitoring the stages towards achieving effective coverage and equity for maternal, newborn, child health and nutrition interventions.BMJ global health · 2025Article
- Incomplete antenatal care despite high coverage: geographic and sociocultural barriers in Lao PDR.Frontiers in public health · 2025Article
- Bottleneck Analysis of Maternal, Newborn and Child Health Services in Underserved Areas of Kwale County, Kenya.Health services insights · 2025Article
Corrections and comments
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Authors and funding
6 authors.
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Abstract
backgroundInadequate access to quality maternal and child health services leads to poor health outcomes for millions of women, particularly in low- and middle-income countries (LMICs). This study aims to explore the effective coverage of reproductive, maternal, neonatal and newborn health (RMNCH) services and examines socioeconomic and rural and urban disparities in 39 LMICs.
methodsUsing Demographic and Health Surveys (DHS) data, the research assesses RMNCH service quality by applying an effective coverage framework, which measures service contact, crude coverage, quality-adjusted coverage and user adherence-adjusted coverage. We applied weighted analyses to investigate the rural-urban differences in service coverage based on countries' Human Development Index (HDI) levels as well as crude coverage and socioeconomic levels.
findingsUrban areas generally exhibit better effective coverage across all RMNCH services compared with rural areas, with significant disparities in antenatal, childbirth and postnatal care. For instance, 85% (95% CI=85-86%) of urban women received skilled birth attendance compared with 64% (95% CI=64-65%) in rural areas. High-HDI countries show smaller rural-urban gaps in service coverage than low-HDI countries. Socioeconomic inequalities are more pronounced in rural areas, particularly in services that require higher quality and adherence to standards. Socioeconomic disparities are significant in LMICs with lower HDI and are more evident in harder-to-achieve quality indicators, such as user adherence to recommended practices or treatment. For example, in medium-HDI countries, the relative inequality index (RII) for antenatal care user adherence coverage is 3.6 (95% CI=3.4-3.8) in rural areas compared with 1.9 (95% CI=1.8-2.1) in urban areas.
interpretationThe research underscores the need for targeted interventions and policies to address these disparities. The evidence supports the need for a shift from focusing solely on access to care to improve the quality of care to address rural-urban and socioeconomic inequalities in RMNCH outcomes.
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