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1993–2013, including some of the OIC countries, allowing for comparisons between countries and
over time. This data allows us to look at the composite coverage index (see below), at physical
accessibility and financial access, risk factors and health outcomes.
Above, we show the distribution of the composite coverage index by economic status in 35 OIC
countries for which data is available . Given its composition, the index gives a good
‘overview’ on the continuum of care in RMNCH, including indicators for demand, accessibility of
services and medicine from before birth until the age of five.6 As can be seen, service coverage and its
distribution across different wealth quintiles varies substantially across the countries. In some
countries, e.g. Algeria, Egypt, Jordan, Kazakhstan, Kyrgyzstan, Tunisia and Turkmenistan, the coverage
for poorer population groups is not much different from those better off. On average, these are also
the countries where service coverage is generally higher than in countries where the difference in
coverage for the poor and richer are more pronounced. Access to health by the poor is particularly
small in absolute terms and relation to richer populations in countries of the African region, mirroring
other health indicators discussed before.
Below, we discuss in some more detail four health indicators from the HEM data repository, which
were discussed in the previous section: information on skilled birth attendance - which has been
shown to be the single most important means of preventing maternal (and newborn) deaths - as an
indicator for accessing health services; and mortality rates of newborns, infants and under-5 year old
children across wealth quintiles for countries for which data is available as indicators of health
outcomes.
We complement this data with information on the share of children with symptoms of ARI taken to a
health facility as another indicator for accessing health services. Furthermore, we look at the share of
women and men not covered by health insurance – as indication for financial barriers to access to
health services across socio-economic groups; and the distribution of two of the major risk factors to
health: access to improved water sources and access to improved, non-shared sanitation. All this
information was retrieved directly from the DHS online STATcompiler. 7
Physical access to healthcare amongst the poor in OIC countries
below shows access to skilled birth attendance across OIC countries and different wealth
groups. As can be seen, access to skilled birth attendance can vary substantially between different
wealth groups and countries. For example, women in Algeria, Jordan, Kazakhstan, Kyrgyzstan and
Turkmenistan are well-covered in terms of access to health care across all economic groups, including
the poor. In some countries, e.g. Chad or Guinea-Bissau, only the (two) richest quintile benefits from
‘enhanced’ access. However, in most countries, we observe very large differences and a relatively
‘steady’ increase in access to health services with increasing wealth. The most extreme example is
Nigeria where only 6.1 per cent of the women in the poorest quintile were supported by a skilled health
personnel, compared to 86.2 per cent of those in the highest quintile.
We also present information on the distribution of access to health service for children with symptoms
of ARI, highlighting the differences between the poorest and richest wealth quintiles .
Similar to the access to skilled birth attendance, the differences vary widely across and within
countries. Particularly low levels of access for the poor are observed in Cameroon, Mauritania, Chad,
Morocco, Benin and Cote d’Ivoire – and these low levels of access in those countries are also observed
for children from richer households when compared with other countries.
6 The composite coverage index is a weighted score reflecting coverage of eight RMNCH interventions along the continuum of care:
demand for family planning satisfied – modern methods; antenatal care coverage (at least four visits); births attended by skilled
health personnel; BCG immunization coverage among one-year-olds; measles immunization coverage among one-year-olds; DTP3
immunization coverage among one-year-olds; children aged less than five years with diarrhoea receiving oral rehydration therapy
and continued feeding; and children aged less than five years with pneumonia symptoms taken to a health facility.
Last accessed on January 31, 2019.