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Effectiveness of Health Sector Reforms in Reducing Disparities in Utilization of Skilled Birth Attendants in Tanzania.

Kengia, J. T., Igarashi, I. and Kawabuchi, K. (2013) Effectiveness of Health Sector Reforms in Reducing Disparities in Utilization of Skilled Birth Attendants in Tanzania. The Tohoku journal of experimental medicine, 230 (4). pp. 241-53. ISSN 1349-3329

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Abstract

Improving maternal health is a Millennium Development Goal adopted at the 2000 Millennium Summit of the United Nations. As part of the improving maternal health in Tanzania, it has been recommended that skilled birth attendants be present at all births to help reduce the high maternal mortality ratio. However, utilization of these attendants varies across socio-economic groups. The government of Tanzania has repeatedly attempted to carry out health sector reforms (HSRs) to alleviate disparities in health service utilization. In particular, around 1999, HSRs were incorporated into two approaches, including Decentralization by Devolution and Sector Wide Approach. This study aims to clarify the unresolved questions with little published evidence on the effect of HSRs on reducing disparities in utilization of skilled birth attendants across socio-economic groups over time. We used four cross-sectional datasets from the Tanzania Demographic and Health Survey: 1992, 1996, 1999, and 2004/05. Subjects included 14,752 women of reproductive age (15-49 years) and data on the most recent birth in the 5 years before each survey. Logistic regression analysis was performed with the dependent variable of whether respondents utilized skilled birth attendants or not, and with the main independent variables of time and socio-economic group. Results showed that the disparity in utilization of skilled birth attendants was significantly decreased from 1999 to 2004/05. These findings suggest that the two strategies, Decentralization by Devolution and Sector Wide Approach, in the process of HSRs are effective in reducing the disparities in utilization of skilled birth attendants among socio-economic groups.

Item Type: Article
Keywords: Decentralization by Devolution, health sector reform, poor women, Sector Wide Approach, utilization of skilled birth attendants
Subjects: Maternal & Neonatal Health > Maternal Mortality & Morbidity
Divisions: Other
Depositing User: Mr Joseph Madata
Date Deposited: 12 Mar 2015 06:37
Last Modified: 12 Mar 2015 06:37
URI: http://ihi.eprints.org/id/eprint/2577

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