National data on coverage levels often hide important disparities among population subgroups. Inequities in health have several dimensions, including socioeconomic position, gender, place of residence, and ethnic group. Mothers and children belonging to disadvantaged groups are less likely to receive essential preventive and curative interventions, and as a result show higher morbidity and mortality.
Improving equity will be essential for achieving the Sustainable Development Goals, as it has been for efforts to achieve the Millennium Development Goals (MDGs) by 2015. Countdown therefore aims not only to promote increased coverage levels for the population as a whole, but also to ensure that disadvantaged groups do not lag behind.
Countdown’s Equity Working Group carries out analyses of survey results from the priority Countdown countries, and provides breakdowns of key reproductive, maternal, newborn, and child health indicators according to the different dimensions of equity. Countdown equity analyses include systematic breakdowns of key coverage indicators by wealth quintiles, maternal education, sex of the child, urban/rural residence, and region of the country.
On this page, Countdown presents data and analysis relating to equity of coverage for interventions essential for reproductive, maternal, newborn, and child health. The Equity Working Group’s research is presented in detail in equity profiles prepared for individual Countdown countries, and is summarized in the Countdown Reports.
For more updated Equity Profiles, please click here.
Equity profiles
As a supplement to the Countdown Reports in 2015, 2014, 2012, and 2010, the Equity Working Group produced equity profiles containing extra information on selected maternal and child health indicators. In addition, the profiles present the Slope Index of Inequality and the Concentrator Index for each health indicator, as well as a variety of charts including the coverage gap by wealth quintile, coverage levels for selected interventions along the continuum of care, and the percentage of children aged 1-4 years according to the number of key child-survival interventions received, by wealth quintile. Each of these measures is described in detail in Annex E from the 2010 report.
Equity Country Profiles – October 2015 [PDF – 2.5 MB]
Equity Country Profiles – June 2014 [PDF – 1.44 MB]
Equity Country Profiles – June 2012 [PDF – 2.05 MB]
Equity Country Profiles – August 2010 [PDF – 2.75 MB]
Equity profiles for individual countries, along with full Countdown country profiles from 2015, 2014, 2012, 2010, 2008, and 2005, are available here.
In a capacity-building workshop conducted at the 2013 Women Deliver conference, Dr. Aluisio Barros presented a slide presentation offering a guide to understanding the detailed equity profile:
A detailed description of the coverage gap index can be found in the following technical notes:
Measuring equity in MNCH through the coverage gap index: technical notes (Annex E of 2008 Decade Report) [PDF – 176 KB]
The equity data used in Countdown’s 2013 and 2012 reports, profiles, and equity profiles are publicly available, and can be downloaded here. For more information about Countdown’s datasets, please contact the Countdown Secretariat at countdown@jhu.edu.
Equity research
Countdown’s equity research has been presented in more detail in the following articles published in The Lancet:
- Hosseinpoor AR, Bergen N, Barros A, Wong K, Boerma T, Victora C, Monitoring subnational regional inequalities in health: measurement approaches and challenges. International Journal for Equity in Health.2016, 15:18. DOI: 10.1186/s12939-016-0307-y.
PDF - Victora C, Barros A, et al, How changes in coverage affect equity in maternal and child health interventions in 35 Countdown to 2015 countries: an analysis of national surveys. Lancet 2012, 21 September 2012. DOI: 10.1016/S0140-6736(12)61427-5. PDF
- Barros A, Ronsmans C, Axelson H, et al., Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries. Lancet 2011. 379 (9822), 1225-1233. PDF
- Countdown 2008 Equity Analysis Group, Mind the gap: equity and trends in coverage of maternal, newborn and child health services in 54 Countdown countries. Lancet. 371 (9620): 1259-1267. PDF
In Countdown sessions at the 2013 Women Deliver conference, members of the Equity Working Group presented recent equity research:
Cesar Victora, Federal University of Pelotas, Brazil
Inequalities in RMNCH: Countdown findings 2012-2013
Cesar Victora, Federal University of Pelotas, Brazil
Trends in inequalities in caesarean sections
Aluisio Barros, Federal University of Pelotas, Brazil
Trends in equity for contraception, pregnancy and delivery care
Mickey Chopra, UNICEF (co-chair, Countdown to 2015)
Reaching the unreached: Is UHC enough?
Equity analyses are also conducted as part of Countdown-supported in-depth country case studies, which have been completed or are in process in Niger, Bangladesh, Peru, Tanzania, Ethiopia, Malawi, Afghanistan, Pakistan, China, and Kenya.