Effectiveness of interventions on reducing inequities in maternal and child health in low-and middle-income settings

Article type
Authors
Målqvist M1, Trygg N2, Qian X3, Ng N4, Thomsen S2
1Uppsala University
2Karolinska Institutet
3Fudan University
4Umeå University
Abstract
Background: The deadline for achieving the Millennium Development Goals 4 and 5 is approaching, but the inequity between disadvantaged and other populations is a significant barrier for progress towards achieving these goals.

Objectives: This systematic review aims to collect evidence about the differential effects of interventions on different socioeconomic groups in order to identify interventions which were effective in reducing maternal or child health inequalities.

Methods: We searched the PubMed, EMBASE and other relevant databases. The reference lists of relevant reviews were also screened to find more relevant studies. We included experimental or observational studies that assessed the effects of interventions on maternal and child health, but only studies that report quantitative outcomes for groups with different socioeconomic characteristics were finally included for analysis.

Results: 17 articles about effectiveness of intervention on equity in maternal and child health were finally included. These studies covered five kinds of interventions: immunization campaign, nutrition supplement program, health care provision improvement interventions, combined nutrition and health care provision, and health insurance program. The outcome indicators covered all MDG 4 and three MDG 5 outcomes. Stronger or moderate evidence showed that all kinds of the included interventions may be more effective in improving maternal or child health for disadvantaged populations.

Conclusions: We noted these interventions which were effective in reducing inequity were all related to basic health care for pregnant women or children. These interventions were usually delivered by outreach methods, using human resources in local areas or provided at the community level nearest to residents.