AI Article Synopsis
- The study analyzes trends in facility-based delivery care and cesareans in Morocco from 1987 to 2012, focusing especially on how these trends have impacted poorer populations.
- Results indicate a significant rise in use of facility deliveries and cesareans, particularly among the poorest, with faster growth rates compared to wealthier groups, but no notable acceleration related to specific policy events.
- The positive trend in delivery care is attributed to a combination of demand and supply strategies, including investments in healthcare personnel and provision of free delivery services, though inequalities still persist.
Article Abstract
Objectives: To examine trends in the utilisation of facility-based delivery care and caesareans in Morocco between 1987 and 2012, particularly among the poor, and to assess whether uptake increased at the time of introduction of policies or programmes aimed at improving access to intrapartum care.
Methods: Using data from nationally representative household surveys and routine statistics, our analysis focused on whether women delivered within a facility, and whether the delivery was by caesarean; analyses were stratified by relative wealth quintile and public/private sector where possible. A segmented Poisson regression model was used to assess whether trends changed at key events.
Results: Uptake of facility-based deliveries and caesareans in Morocco has risen considerably over the past two decades, particularly among the poor. The rate of increase in facility deliveries was much faster in the poorest quintile (annual increase RR: 1.09; 95% CI: 1.07-1.11) than the richest quintile (annual increase RR: 1.01; 95% CI: 1.02-1.02). A similar pattern was observed for caesareans (annual increase among poorest RR: 1.13; 95% CI: 1.07-1.19 vs. annual increase among richest RR: 1.08; 95% CI: 1.06-1.10). We found no significant acceleration in trend coinciding with any of the events investigated.
Conclusions: Morocco's success in improving uptake of facility deliveries and caesareans is likely to be the result of the synergistic effects of comprehensive demand and supply-side strategies, including a major investment in human resources and free delivery care. Equity still needs to be improved; however, the overall trend is positive.
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| http://dx.doi.org/10.1111/tmi.12466 | DOI Listing |
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