Edson Serván-Mori1, Ileana Heredia-Pi1, Diego Cerecero García1, Gustavo Nigenda2, Sandra G Sosa-Rubí1, Jacqueline A Seiglie3, Rafael Lozano4. 1. Center for Health System Research, National Institute of Public Health, Avenida Universidad #655, 62100, Cuernavaca, Morelos, Mexico. 2. National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico. 3. Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America (USA). 4. Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
Abstract
OBJECTIVE: To describe the temporal and geographical patterns of the continuum of maternal health care in Mexico, as well as the sociodemographic characteristics that affect the likelihood of receiving this care. METHODS: We conducted a pooled cross-sectional analysis using the 1997, 2009, 2014 and 2018 waves of the National Survey of Demographic Dynamics, collating sociodemographic and obstetric characteristics of 93 745 women aged 12-54 years at last delivery. We defined eight variables along the antenatal-postnatal continuum, both independently and conditionally. We used a pooled fixed-effects multivariable logistic model to determine the likelihood of receiving the continuum of care for various properties. We also mapped the quintiles of adjusted state-level absolute change in continuum of care coverage during 1994-2018. FINDINGS: We observed large absolute increases in the proportion of women receiving timely antenatal and postnatal care (from 48.9% to 88.2% and from 39.1% to 68.7%, respectively). In our conditional analysis, we found that the proportion of women receiving adequate antenatal care doubled over this period. We showed that having social security and a higher level of education is positively associated with receiving the continuum of care. We observed the largest relative increases in continuum of care coverage in Chiapas (181.5%) and Durango (160.6%), assigned human development index categories of low and medium, respectively. CONCLUSION: Despite significant progress in coverage of the continuum of maternal health care, disparities remain. While ensuring progress towards achievement of the health-related sustainable development goal, government intervention must also target underserved populations. (c) 2021 The authors; licensee World Health Organization.
OBJECTIVE: To describe the temporal and geographical patterns of the continuum of maternal health care in Mexico, as well as the sociodemographic characteristics that affect the likelihood of receiving this care. METHODS: We conducted a pooled cross-sectional analysis using the 1997, 2009, 2014 and 2018 waves of the National Survey of Demographic Dynamics, collating sociodemographic and obstetric characteristics of 93 745 women aged 12-54 years at last delivery. We defined eight variables along the antenatal-postnatal continuum, both independently and conditionally. We used a pooled fixed-effects multivariable logistic model to determine the likelihood of receiving the continuum of care for various properties. We also mapped the quintiles of adjusted state-level absolute change in continuum of care coverage during 1994-2018. FINDINGS: We observed large absolute increases in the proportion of women receiving timely antenatal and postnatal care (from 48.9% to 88.2% and from 39.1% to 68.7%, respectively). In our conditional analysis, we found that the proportion of women receiving adequate antenatal care doubled over this period. We showed that having social security and a higher level of education is positively associated with receiving the continuum of care. We observed the largest relative increases in continuum of care coverage in Chiapas (181.5%) and Durango (160.6%), assigned human development index categories of low and medium, respectively. CONCLUSION: Despite significant progress in coverage of the continuum of maternal health care, disparities remain. While ensuring progress towards achievement of the health-related sustainable development goal, government intervention must also target underserved populations. (c) 2021 The authors; licensee World Health Organization.
Authors: Gerard H A Visser; Diogo Ayres-de-Campos; Eytan R Barnea; Luc de Bernis; Gian Carlo Di Renzo; Maria Fernanda Escobar Vidarte; Isabel Lloyd; Anwar H Nassar; Wanda Nicholson; P K Shah; William Stones; Luming Sun; Gerhard B Theron; Salimah Walani Journal: Lancet Date: 2018-10-13 Impact factor: 79.321
Authors: Midiam Ibáñez-Cuevas; Ileana B Heredia-Pi; Sergio Meneses-Navarro; Blanca Pelcastre-Villafuerte; Miguel A González-Block Journal: Int J Equity Health Date: 2015-12-23
Authors: Agbessi Amouzou; Hannah Hogan Leslie; Malathi Ram; Monica Fox; Safia S Jiwani; Jennifer Requejo; Tanya Marchant; Melinda Kay Munos; Lara M E Vaz; William Weiss; Chika Hayashi; Ties Boerma Journal: BMJ Glob Health Date: 2019-06-24
Authors: Edson Serván-Mori; Diego Cerecero-García; Ileana B Heredia-Pi; Carlos Pineda-Antúnez; Sandra G Sosa-Rubí; Gustavo Nigenda Journal: J Glob Health Date: 2019-12 Impact factor: 4.413