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Coverage and inequalities in maternal and child health interventions in Afghanistan

Overview of attention for article published in BMC Public Health, September 2016
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (69th percentile)
  • Good Attention Score compared to outputs of the same age and source (68th percentile)

Mentioned by

policy
1 policy source
twitter
2 tweeters

Citations

dimensions_citation
15 Dimensions

Readers on

mendeley
92 Mendeley
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Title
Coverage and inequalities in maternal and child health interventions in Afghanistan
Published in
BMC Public Health, September 2016
DOI 10.1186/s12889-016-3406-1
Pubmed ID
Authors

Nadia Akseer, Zaid Bhatti, Arjumand Rizvi, Ahmad S. Salehi, Taufiq Mashal, Zulfiqar A. Bhutta

Abstract

Afghanistan has made considerable gains in improving maternal and child health and survival since 2001. However, socioeconomic and regional inequities may pose a threat to reaching universal coverage of health interventions and further health progress. We explored coverage and socioeconomic inequalities in key life-saving reproductive, maternal, newborn and child health (RMNCH) interventions at the national level and by region in Afghanistan. We also assessed gains in child survival through scaling up effective community-based interventions across wealth groups. Using data from the Afghanistan Multiple Indicator Cluster Survey (MICS) 2010/11, we explored 11 interventions that spanned all stages of the continuum of care, including indicators of composite coverage. Asset-based wealth quintiles were constructed using standardised methods, and absolute inequalities were explored using wealth quintile (Q) gaps (Q5-Q1) and the slope index of inequality (SII), while relative inequalities were assessed with ratios (Q5/Q1) and the concentration index (CIX). The lives saved tool (LiST) modeling used to estimate neonatal and post-neonatal deaths averted from scaling up essential community-based interventions by 90 % coverage by 2025. Analyses considered the survey design characteristics and were conducted via STATA version 12.0 and SAS version 9.4. Our results underscore significant pro-rich socioeconomic absolute and relative inequalities, and mass population deprivation across most all RMNCH interventions studied. The most inequitable are antenatal care with a skilled attendant (ANCS), skilled birth attendance (SBA), and 4 or more antenatal care visits (ANC4) where the richest have between 3.0 and 5.6 times higher coverage relative to the poor, and Q5-Q1 gaps range from 32 % - 65 %. Treatment of sick children and breastfeeding interventions are the most equitably distributed. Across regions, inequalities were highest in the more urbanised East, West and Central regions of the country, while they were lowest in the South and Southeast. About 7700 newborns and 26,000 post-neonates could be saved by scaling up coverage of community outreach interventions to 90 %, with the most gains in the poorest quintiles. Afghanistan is a pervasively poor and conflict-prone nation that has only recently experienced a decade of relative stability. Though donor investments during this period have been plentiful and have contributed to rebuilding of health infrastructure in the country, glaring inequities remain. A resolution to scaling up health coverage in insecure and isolated regions, and improving accessibility for the poorest and marginalised populations, should be at the forefront of national policy and programming efforts.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 92 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 91 99%

Demographic breakdown

Readers by professional status Count As %
Unspecified 20 22%
Student > Master 20 22%
Student > Ph. D. Student 19 21%
Researcher 9 10%
Student > Doctoral Student 5 5%
Other 19 21%
Readers by discipline Count As %
Unspecified 23 25%
Medicine and Dentistry 21 23%
Nursing and Health Professions 19 21%
Social Sciences 14 15%
Biochemistry, Genetics and Molecular Biology 3 3%
Other 12 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2017.
All research outputs
#3,314,657
of 12,918,141 outputs
Outputs from BMC Public Health
#3,719
of 8,808 outputs
Outputs of similar age
#78,768
of 265,818 outputs
Outputs of similar age from BMC Public Health
#5
of 16 outputs
Altmetric has tracked 12,918,141 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 8,808 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.0. This one has gotten more attention than average, scoring higher than 56% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,818 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 16 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.