PT  - JOURNAL ARTICLE
AU  - Hasan, Md. Mehedi
AU  - Magalhaes, Ricardo J. Soares
AU  - Ahmed, Saifuddin
AU  - Ahmed, Sayem
AU  - Biswas, Tuhin
AU  - Fatima, Yaqoot
AU  - Islam, Md. Saimul
AU  - Hossain, Md. Shahadut
AU  - Mamun, Abdullah A.
TI  - Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries
AID  - 10.9745/GHSP-D-20-00097
DP  - 2020 Dec 23
TA  - Global Health: Science and Practice
PG  - 654--665
VI  - 8
IP  - 4
4099  - http://www.ghspjournal.org/content/8/4/654.short
4100  - http://www.ghspjournal.org/content/8/4/654.full
SO  - GLOB HEALTH SCI PRACT2020 Dec 23; 8
AB  - Key FindingsProgress 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 ImplicationsWhen 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.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.