Files and links (1)
CC BY V4.0, Open Access
Journal article
Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature
Maternal and Child Health Journal , Vol.29(6), pp.741-766
2025
Appears in Open Access via Read & Publish Agreements
Abstract
Background
Inequality in maternal healthcare service (MHS) utilization is a significant global health challenge in low- and middle-income countries (LMICs). Recently, the literature on MHS inequality in LMICs has expanded. We conducted a scoping review to synthesize existing evidence and identify knowledge gaps.
Methods
Following PRISMA-ScR guidelines, we systematically searched PubMed, Scopus, and CINAHL Ultimate in June 2023 for literature published since January 1, 2015. We included empirical studies using nationally representative data to measure inequality in at least one of five MHS indicators: antenatal care (ANC), skilled birth attendance (SBA), facility-based delivery (FBD), caesarean-section (C-section) delivery, and postnatal care (PNC). Our review encompassed 132 peer-reviewed articles on MHS inequality in LMICs.
Results
ANC, FBD, and SBA were more frequently analyzed indicators for inequality measurement compared to PNC and C-section delivery. None of the 132 studies assessed all five MHS indicators together. The concentration index was the most frequently used inequality measure across all MHS indicators. Included studies were predominantly focused on economic (wealth) and geographic (residence, region) inequalities, while sociocultural factors (e.g., religion, ethnicity) remain underexplored. Inequality was most pronounced in low-income (LICs) and lower-middle-income countries (LwMICs). The extant literature mainly concentrates on India and Ethiopia as research settings.
Conclusion
Our review highlights significant gaps in health inequality research, particularly in LICs and upper-middle-income countries (UMICs), with a heavy reliance on cross-sectional data, limited assessment of PNC and C-section delivery and lack of comprehensive analysis across all five common MHS indicators. Future research in LMICs should address the gaps identified in this review.
Details
- Title
- Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature
- Authors/Creators
- Farjana Misu (Author)Dominic Gasbarro (Author)Khurshid Alam (Author) - Murdoch University, Centre for Healthy Ageing
- Publication Details
- Maternal and Child Health Journal , Vol.29(6), pp.741-766
- Publisher
- Springer Nature
- Number of pages
- 26
- Identifiers
- 991005780531907891
- Copyright
- © 2025 Springer Science+Business Media, LLC, part of Springer Nature
- Murdoch Affiliation
- Centre for Healthy Ageing; Personalised Medicine Centre
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Metrics
489 File views/ downloads
19 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.156 Healthcare Policy
- 1.156.381 Maternal Health Equity
- Web Of Science research areas
- Public, Environmental & Occupational Health
- ESI research areas
- Social Sciences, general