POPULATION COVERAGE OF MATERNAL, NEWBORN AND CHILD HEALTH INTERVENTIONS: THE IMPACT OF DONOR FINANCING, COVERAGE CHANGE METRICS AND PREDICTORS OF MATERNAL HEALTH SERVICE UTILIZATION
Nwaohiri, Anuli N.
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Background Donor financing in conjunction with national policies works through the existing health system to impact the uptake of MNCH interventions. However within countries, other key factors such as individual and household behaviors, the political economy, and the macroeconomic environment also influence the uptake of interventions. Demonstrating the relationship between increased financing and increased coverage can provide a platform for policymakers and other stakeholders to refine and appropriately target their health programs. Methods This complex relationship between financing and coverage was analyzed using: 1) A multi-country analysis examining the impact of official development assistance on the change in coverage levels of MNCH interventions; 2) To further contextualize the results of the multi-country analysis, a systematic review was performed to identify the different metrics used in computing coverage change; and 3) Individual-level factors related to utilization of maternal health services was examined among women of varying socioeconomic status in Nigeria. Results The multi-country analysis examining the impact of official development assistance (ODA) on coverage levels of MNCH interventions positive associations. The systematic review found that the method of computing change is important in coverage change estimates; and this can impact findings and future research directions. Furthermore, the trend of coverage rates within a country and the baseline rate is also important. Lastly, predictors of maternal health service utilization among Nigerian women were maternal education and employment. Conclusion This analysis has shown that ODA to maternal and child health can be effective in increasing the coverage rates of MNCH interventions. These results are important and present a preliminary attempt to understand this complex relationship between financing and the uptake of health interventions. In addition, the coverage change metrics utilized are important can have a significant impact on the results of coverage change analyses. Lastly, in our analyses that examined individual level factors associated with maternal health service utilization, maternal education and employment are shown to be important factors associated with utilization regardless of socioeconomic status. Understanding the dynamics between individual level predictors and the uptake of interventions is important to ensure that those in need are appropriately targeted for health interventions.