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Background: Monitoring the progress in reproductive, maternal, newborn, and child health (RMNCH) using the composite coverage index (CCI) is crucial to evaluate the advancement of low-income and middle-income countries (LMICs) towards the attainment of Sustainable Development Goal target 3. We present current benchmarking for 70 LMICs, forecasting to 2030, and an analysis of inequities within and across countries. Methods: In this cross-sectional secondary data analysis, we extracted 291 data points from the WHO Equity Monitor, and Demographic and Health Survey Statcompiler for 70 LMICs. We selected countries on the basis of whether they belonged to LMICs, had complete information about the predictors between 2000 and 2030, and had at least one data point related to CCI. CCI was calculated on the basis of eight types of RMNCH interventions in four domains, comprising family planning, antenatal care, immunisations, and management of childhood illnesses. This study examined CCI as the main outcome variable. Bayesian hierarchical models were used to estimate trends and projections of the CCI at regional and national levels, as well as the area of residence, educational level, and wealth quintile. Findings: Despite progress, only 18 countries are projected to reach the 80% CCI target by 2030. Regionally, CCI is projected to increase in all regions of Asia (in southern Asia from 51·8% in 2000 to 89·2% in 2030, in southeastern Asia from 58·8% to 84·4%, in central Asia from 70·3% to 87·0%, in eastern Asia from 76·8% to 82·1%, and in western Asia from 56·5% to 72·1%), Africa (in sub-Saharan Africa from 46·3% in 2000 to 72·2% in 2030 and in northern Africa from 55·0% to 81·7%), and Latin America and the Caribbean (from 67·0% in 2000 to 83·4% in 2030). By contrast, southern Europe is predicted to experience a decline in CCI over the same period (70·1% in 2000 to 55·2% in 2030). Across LMICs, CCIs are higher in urban areas, in populations in which women have higher education levels, and in populations with a high income. Interpretation: Governments of countries where the universal target of 80% CCI has not yet been reached must develop evidence-based policies aimed at enhancing RMNCH coverage. Additionally, they should focus on reducing the extent of existing inequalities within their populations to drive progress in RMNCH. Funding: Hitotsubashi University and Japan Society for the Promotion of Science. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Abstract

Bayes Theorem, Child, Child Health, Cross-Sectional Studies, Developing Countries, Family, Female, Humans, Infant, Newborn, Pregnancy, Africa south of the Sahara, article, Asia, Caribbean, central Asia, child, child health, childhood, demography, educational status, family planning, female, government, health survey, highest income group, human, human experiment, immunization, Japan, lowest income group, middle income country, newborn, outcome variable, prenatal care, secondary data analysis, South and Central America, South Asia, Southeast Asia, Southern Europe, tertiary education, trend study, urban area, western Asia, Bayes theorem, cross-sectional study, developed country, family, pregnancy

Significance Statement:

Reproductive, maternal, newborn, and child health intervention coverage in 70 low-income and middle-income countries, 2000–30: trends, projections, and inequities

Rahman M.M., Rouyard T., Khan S.T., Nakamura R., Islam M.R., Hossain M.S., Akter S., Lohan M., Ali M., Sato M.

This research provides a comprehensive analysis of reproductive, maternal, newborn, and child health (RMNCH) intervention coverage in 70 low-income and middle-income countries. The findings indicate only a few countries are on track to meet the 80% composite coverage index (CCI) target by 2030. Significant regional differences and disparities based on urban-rural divide, education, and income levels suggest the need for tailored policies to improve RMNCH coverage and address existing inequalities​​.

The Lancet Global Health

2023

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