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Household wealth relative to community wealth: Associations with maternal and reproductive health

Sara Riese, ICF Macro
William Winfrey, Avenir Health

The relationship between absolute wealth and health has been well established. More wealth, greater access to resources is associated with better health outcomes. However, evidence is emerging that relative wealth – one’s socioeconomic position relative to others within a hierarchy – may also affect health. This report explores this question by describing inequalities in antenatal care, health facility delivery, and modern contraceptive use in 57 countries according to a woman’s relative wealth compared to the community average (poor compared to community, similar to community, rich compared to community). We use DHS data to create logistic regression models for each outcome, adjusting for sociodemographic covariates, to calculate predicted probabilities and average marginal effects at each relative wealth status. Overall there are lower effects of relative wealth on coverage of interventions which can be provided in community-based settings, such as antenatal care and contraception. Larger effects are observed on health facility delivery. In general we saw positive effects when a woman is poor relative to community average, and negative effect when a woman is rich relative to community average on intervention coverage when an effect is seen. These findings may support a focus on improving equity in maternal and reproductive health.

Keywords: Inequality, Cross-country comparative analyses, Family planning and contraception, Sexual and Reproductive Health and Rights

See extended abstract.

  Presented in Session P8.