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ORIGINAL ARTICLE
Open Access

Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries

Md. Mehedi Hasan, Ricardo J. Soares Magalhaes, Saifuddin Ahmed, Sayem Ahmed, Tuhin Biswas, Yaqoot Fatima, Md. Saimul Islam, Md. Shahadut Hossain and Abdullah A. Mamun
Global Health: Science and Practice December 2020, 8(4):654-665; https://doi.org/10.9745/GHSP-D-20-00097
Md. Mehedi Hasan
aInstitute for Social Science Research, The University of Queensland, Indooroopilly, Australia.
bThe Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Indooroopilly, Australia.
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  • For correspondence: m.m.hasan@uqconnect.edu.au
Ricardo J. Soares Magalhaes
cSpatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, Australia.
dChildren’s Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Australia.
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Saifuddin Ahmed
eDepartment of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
fBill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Sayem Ahmed
gHealth Economics and Policy Research Group, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
hDepartment of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
iHealth Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
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Tuhin Biswas
aInstitute for Social Science Research, The University of Queensland, Indooroopilly, Australia.
bThe Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Indooroopilly, Australia.
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Yaqoot Fatima
aInstitute for Social Science Research, The University of Queensland, Indooroopilly, Australia.
jCentre for Rural and Remote Health, James Cook University, Mount Isa, Australia.
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Md. Saimul Islam
kDepartment of Statistics, University of Rajshahi, Rajshahi, Bangladesh.
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Md. Shahadut Hossain
lDepartment of Statistics, College of Business & Economics, United Arab Emirates University, United Arab Emirates.
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Abdullah A. Mamun
aInstitute for Social Science Research, The University of Queensland, Indooroopilly, Australia.
bThe Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Indooroopilly, Australia.
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Key Findings

  • Progress in reproductive, maternal, newborn,and child health care service coverage is increasing but is uneven between countries and across subgroups (in terms of wealth, place of residence, education, age, and sex) within countries. These coverage gaps are projected to continue.

  • By 2030, none of the low- and middle-income countries would be able to achieve the target of universal coverage for oral rehydration therapy for diarrhea treatment or to seek care for acute respiratory infections. Only a few countries are likely to achieve universal coverage for demand for family planning satisfied with modern contraceptive methods, recommended visits for antenatal care, and skilled birth attendant for assistance during birth.

Key Implications

  • When designing appropriate interventions for increasing the coverage of reproductive, maternal, newborn, and child health care services, program managers should consider disadvantaged and marginalized populations.

  • Acceleration is needed in coordinated global efforts and government policies focusing on marginalized groups, administering cost-effective interventions, and implementing proactive follow-up for routinely scheduled health care services.

ABSTRACT

Introduction:

Improving reproductive, maternal, newborn, and child health (RMNCH) care services is imperative for reducing maternal and child mortality. Many low- and middle-income countries (LMICs) are striving to achieve RMNCH-related Sustainable Development Goals (SDGs). We monitored progress, made projections, and calculated the average annual rate of change needed to achieve universal (100%) access of RMNCH service indicators by 2030.

Methods:

We extracted Demographic and Health Survey (DHS) data of 75 LMICs to estimate the coverage of RMNCH indicators and composite coverage index (CCI) to measure health system strengths. Bayesian linear regression models were fitted to predict the coverage of indicators and the probability of achieving targets.

Results:

The projection analysis included 64 countries with available information for at least 2 DHS rounds. No countries are projected to reach universal CCI by 2030; only Brazil, Cambodia, Colombia, Honduras, Morocco, and Sierra Leone will have more than 90% CCI. None of the LMICs will achieve universal coverage of all RMNCH indicators by 2030, although some may achieve universal coverage for specific services. To meet targets for universal service access by 2030, most LMICs must attain a 2-fold increase in the coverage of indicators from 2019 to 2030. Coverage of RMNCH indicators, the probability of target attainments, and the required rate of increase vary significantly across the spectrum of sociodemographic disadvantages. Most countries with poor historical and current trends for RMNCH coverage are likely to experience a similar scenario in 2030. Countries with lower coverage had higher disparities across the subgroups of wealth, place of residence, and women’s/mother’s education and age; these disparities are projected to persist in 2030.

Conclusion:

None of the LMICs will meet the SDG RMNCH 2030 targets without scaling up essential RMNCH interventions, reducing gaps in coverage, and reaching marginalized and disadvantaged populations.

  • Received: March 1, 2020.
  • Accepted: August 26, 2020.
  • Published: December 23, 2020.
  • © Hasan et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-20-00097

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Global Health: Science and Practice: 8 (4)
Global Health: Science and Practice
Vol. 8, No. 4
December 23, 2020
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Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries
Md. Mehedi Hasan, Ricardo J. Soares Magalhaes, Saifuddin Ahmed, Sayem Ahmed, Tuhin Biswas, Yaqoot Fatima, Md. Saimul Islam, Md. Shahadut Hossain, Abdullah A. Mamun
Global Health: Science and Practice Dec 2020, 8 (4) 654-665; DOI: 10.9745/GHSP-D-20-00097

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Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries
Md. Mehedi Hasan, Ricardo J. Soares Magalhaes, Saifuddin Ahmed, Sayem Ahmed, Tuhin Biswas, Yaqoot Fatima, Md. Saimul Islam, Md. Shahadut Hossain, Abdullah A. Mamun
Global Health: Science and Practice Dec 2020, 8 (4) 654-665; DOI: 10.9745/GHSP-D-20-00097
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