Gradients in Wealth Quintile and Access to Maternal Care Services: Reanalysis of Data from the Philippines National Demographic and Health Survey 2013

Carl Abelardo T. Antonio

Department of Health Policy and Administration,
College of Public Health, University of the Philippines Manila

Objective. To quantify the magnitude of difference in access to selected maternal care services among Filipino women who belong to different income groups.

Methods. Point and interval estimates of the inter-quintile difference in access to a selected maternal care services (family planning; antenatal care; facility-based delivery; skilled birth attendance; and postnatal care) were constructed using weighed coverage data from the Philippines National Demographic and Household Survey 2013.

Results. There is a generally increasing trend in the inter-quintile differences in coverage from the lowest to the highest income quintile group (Q1-Q4 > Q1-Q3 > Q1-Q5 > Q1-Q2 > Q2-Q5 > Q2-Q4 > Q3-Q5 > Q3-Q4 > Q2-Q4 > Q4-Q5). Differences in maternal care access between wealth groups ranged from less than 1% for antenatal care (DQ2-Q3 -0.4% [95% CI -1.9% to 1.1%]) to as much as 60% for facility-based delivery (DQ1-Q5 -58.4% [95% CI -61.2% to -55.6%]). Such differences persist even between the two highest quintiles (facility based delivery DQ4-Q5 -9.7% [95% CI -12.5% to -6.9%]).

Conclusion. Gradients in access to selected maternal care services exist among Filipino women who belong to different wealth quintiles. The call for stakeholders, therefore, is to intensify efforts to narrow such gaps because, within and across communities, we affirm that no women "should die in the course of the normal process of reproduction" and no families must suffer the devastating consequences of such occurrence.

Key Words: healthcare disparities, maternal health services, Philippines