Equality in maternal child health services utilisation in mauritania

Resumen

The objective of this study is to analyse the scope of equity in the Mauritanian health system in the use of maternal health care services and to identify the factors that contribute to its improvement measuring the level of horizontal inequity in the distribution of maternal and child health care services. Moreover, the study aims to analyze financial protection against catastrophic health expenditures and impoverishment in Mauritania. Methodology. The variables of maternal and child health services utilization are five: contraceptive use, antenatal visits, skilled birth attendants, postnatal visits and children fully vaccinated. Equity measures are calculated through concentration curves, concentration indices, and incidence analysis of benefit incidence of public expenditure. Horizontal inequity is measured through inequality in the utilization of maternal health care in relation to socio-economic characteristics, mainly income. To this end, the standardization of the different needs between the poor and the rich is carried out. The analysis is based on Multiple Indicator Cluster Surveys 2015, which is a representative national survey of households, women, and children; and National health accounts (NHA 2008 and 2015). The analysis of catastrophic health care payments follows the approach by O’Donnell et al. (2008) which defines health spending as “catastrophic” if it exceeds some fraction or threshold of total expenditure, or of total non-food expenditure, in a given period. We defined expenditure as being catastrophic if a household’s financial contributions to the health system exceed a threshold of 40% of non-food spending. A regression analysis was conducted to explore variables associated with catastrophic health expenditure. Data comes from Permanent Household Living Conditions Survey 2014. Results. The finding reveals that the progress in equity on maternal and child health service utilization has been mixed. utilization has been mixed. First, the study reveals that concentration index for contraceptive use has a positive value in 2007, 2011 and in 2015 indica