Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods
Abstract In Cameroon, major inequalities exist in women’s access to antenatal care (ANC), yet underlying circumstance drivers remain understudied. Using recently available Demographic and Health Survey data, we conducted multilevel model and spatial analyses to identify circumstance factors driving...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-03-01
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| Series: | Swiss Journal of Economics and Statistics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41937-024-00121-6 |
| _version_ | 1827309971625213952 |
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| author | Anne Darline Youmbi Betrand Fesuh Nono Christian Zamo Akono |
| author_facet | Anne Darline Youmbi Betrand Fesuh Nono Christian Zamo Akono |
| author_sort | Anne Darline Youmbi |
| collection | DOAJ |
| description | Abstract In Cameroon, major inequalities exist in women’s access to antenatal care (ANC), yet underlying circumstance drivers remain understudied. Using recently available Demographic and Health Survey data, we conducted multilevel model and spatial analyses to identify circumstance factors driving ANC disparities across the country's diverse regions. Drawing on a novel integration of theoretical frameworks, we evaluated how circumstances like geographic, economic and educational barriers combined to shape inequities. Both Shapley and Fields decomposition techniques apportioned contributors to ongoing inequality. Results from our study provide the first direct comparison of these approaches in Cameroon, finding a strong positive correlation between methods. Our findings show that ANC utilization overall was suboptimal, varying substantially between urban and rural areas. Key circumstance factors which disproportionately constrained disadvantaged groups’ opportunities for care included household wealth, level of education of the woman and spouse, and place of residence. Policy-relevant insights emerge from disentangling multifaceted opportunity gaps. Targeted interventions should address modifiable barriers facing underserved populations to promote more equal maternal health nationwide. Our multidisciplinary analytical approach offers lessons for analysing complex health disparities in diverse low-resource settings. Graphical abstract |
| first_indexed | 2024-04-24T19:52:15Z |
| format | Article |
| id | doaj.art-eac6104ec7b04b1f96026ff92d11772b |
| institution | Directory Open Access Journal |
| issn | 2235-6282 |
| language | English |
| last_indexed | 2024-04-24T19:52:15Z |
| publishDate | 2024-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Swiss Journal of Economics and Statistics |
| spelling | doaj.art-eac6104ec7b04b1f96026ff92d11772b2024-03-24T12:35:25ZengSpringerOpenSwiss Journal of Economics and Statistics2235-62822024-03-01160111710.1186/s41937-024-00121-6Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methodsAnne Darline Youmbi0Betrand Fesuh Nono1Christian Zamo Akono2University of Yaoundé II-SoaDepartment of Mathematics, Ecole Polytechnique de YaoundéUniversity of Yaoundé II-SoaAbstract In Cameroon, major inequalities exist in women’s access to antenatal care (ANC), yet underlying circumstance drivers remain understudied. Using recently available Demographic and Health Survey data, we conducted multilevel model and spatial analyses to identify circumstance factors driving ANC disparities across the country's diverse regions. Drawing on a novel integration of theoretical frameworks, we evaluated how circumstances like geographic, economic and educational barriers combined to shape inequities. Both Shapley and Fields decomposition techniques apportioned contributors to ongoing inequality. Results from our study provide the first direct comparison of these approaches in Cameroon, finding a strong positive correlation between methods. Our findings show that ANC utilization overall was suboptimal, varying substantially between urban and rural areas. Key circumstance factors which disproportionately constrained disadvantaged groups’ opportunities for care included household wealth, level of education of the woman and spouse, and place of residence. Policy-relevant insights emerge from disentangling multifaceted opportunity gaps. Targeted interventions should address modifiable barriers facing underserved populations to promote more equal maternal health nationwide. Our multidisciplinary analytical approach offers lessons for analysing complex health disparities in diverse low-resource settings. Graphical abstracthttps://doi.org/10.1186/s41937-024-00121-6Access to ANCCircumstancesInequality of opportunityLogistic mixed regressionSpatial analysisShapley and fields decompositions |
| spellingShingle | Anne Darline Youmbi Betrand Fesuh Nono Christian Zamo Akono Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods Swiss Journal of Economics and Statistics Access to ANC Circumstances Inequality of opportunity Logistic mixed regression Spatial analysis Shapley and fields decompositions |
| title | Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods |
| title_full | Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods |
| title_fullStr | Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods |
| title_full_unstemmed | Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods |
| title_short | Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods |
| title_sort | inequality in opportunity of access to antenatal care in cameroon multilevel modelling spatial analysis and decomposition methods |
| topic | Access to ANC Circumstances Inequality of opportunity Logistic mixed regression Spatial analysis Shapley and fields decompositions |
| url | https://doi.org/10.1186/s41937-024-00121-6 |
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