Examining the “Urban Advantage” in Maternal Health Care in Developing Countries 英文参考文献.docVIP

PolicyForum Examiningthe‘‘UrbanAdvantage’’inMaternalHealth CareinDevelopingCountries Zoe¨ Matthews1,AmosChannon1*,SarahNeal1,DavidOsrin2,NyovaniMadise1,WilliamStones3 1DivisionofSocialStatisticsandCentreforGlobalHealth,Population,Poverty,andPolicy,UniversityofSouthampton,Southampton,UnitedKingdom,2UCLCentrefor InternationalHealthandDevelopment,InstituteofChildHealth,London,UnitedKingdom,3AgaKhanUniversity,Nairobi,Kenya Introduction levels of poverty. Most previous studies have not distinguished between poverty groupsinurbansettingsandthoseinrural areas, categorising the poor as mainly rural. Our study takes into account the different nature of deprivation in urban areas, and identifies health access indica- tors among the urban poor separately from the equivalent indicators for rural populations. It also shows patterns of inequalitieswithincitiesindifferentcoun- tries,andexploresthewaysthaturbanand rural inequalities interlink. By identifying patterns of unequal access to services for mothers and babies, we pinpoint barriers to access in these different contexts, and conclude by suggesting evidence-based policysolutionswheredocumented. tendedtoignoretheseinequitiesandfocus instead on simple average differences betweenurbanandruralareas,indicating thatmostnationsexperiencesubstantially better maternal and neonatal survival in urban than in rural areas [8–11]. The urban–rural difference is often explained by the greater access to health care services available to urban residents, and this is indeed supported by a number of studies[8,12–15]. Astheglobalurbanpopulationsurpass- es the rural, continuing growth in most developing countries means an inevitable increase in urban births. The majority of births in many countries will not be in remoteruralareas,butintownsandcities [1].Farfrombeinggoodnewsforthetwin Millennium Development Goals (MDGs) of maternal and child health—neither of which is currently on track for success [2]—high levels of urbanisation are likely