Impact of Urban Slum Residence on Coverage of Maternal, Neonatal, and Child Health Service Indicators in the Greater Accra Region of Ghana: an Ecological Time‑Series Analysis, 2018–2021
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Date
2023
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Publisher
Journal of Urban Health
Abstract
Among other focus areas, the global Sustainable Development Goals (SDGs) 3 and 11 seek to
advance progress toward universal coverage of maternal, neonatal, and child health (MNCH) services and
access to safe and affordable housing and basic services by 2030. Governments and development agencies have historically neglected the health and well-being associated with living in urban slums across
major capital cities in sub-Saharan Africa since health
Policies and programs have tended to focus on people living in rural communities. This study assessed
the trends and compared inequities in MNCH service
utilization between slum and non-slum districts in
the Greater Accra region of Ghana. It analyzed information from 29 districts using monthly time-series
Health Management Information System (HMIS)
data on MNCH service utilization between January
2018 and December 2021. Multivariable quantile
regression models with robust standard errors
used to quantify the impact of urban slum residence
on MNCH service utilization. We assessed the inequalities of MNCH coverage indicators between slum
and non-slum districts using the Gini index with
bootstrapped standard errors and the generalized Lorenz curve. The results indicate that rates of vaccination coverage and antenatal care (ANC) attendance
have declined significantly in slum districts compared
to those in non-slum districts. However, skilled birth
delivery and postnatal care (PNC) were found to be
higher in urban slum areas compared to those in non-urban slum areas. To help achieve the SDGs’ targets,
it is important for the government of Ghana and other
relevant stakeholders to prioritize the implementation
of effective policies, programs, and interventions that
will improve access to and utilization of ANC and
immunization services among urban slum dwellers.
Description
Research Article
Keywords
Urban slum, Ecological time series, child health outcomes