title: Universal health care and equity: evidence of maternal health based on an analysis of demographic and household survey data.
abstract: BACKGROUND
  The drive toward universal health coverage (UHC) is central to the post 2015 agenda, and is incorporated as a target in the new Sustainable Development Goals. However, it is recognised that an equity dimension needs to be included when progress to this goal is monitored. WHO have developed a monitoring framework which proposes a target of 80% coverage for all populations regardless of income and place of residence by 2030, and this paper examines the feasibility of this target in relation to antenatal care and skilled care at delivery.
  
  
  METHODS
  We analyse the coverage gap between the poorest and richest groups within the population for antenatal care and presence of a skilled attendant at birth for countries grouped by overall coverage of each maternal health service. Average annual rates of improvement needed for each grouping (disaggregated by wealth quintile and urban/rural residence) to reach the goal are also calculated, alongside rates of progress over the past decades for comparative purposes.
  
  
  RESULTS
  Marked inequities are seen in all groups except in countries where overall coverage is high. As the monitoring framework has an absolute target countries with currently very low coverage are required to make rapid and sustained progress, in particular for the poorest and those living in rural areas. The rate of past progress will need to be accelerated markedly in most countries if the target is to be achieved, although several countries have demonstrated the rate of progress required is feasible both for the population as a whole and for the poorest.
  
  
  CONCLUSIONS
  For countries with currently low coverage the target of 80% essential coverage for all populations will be challenging. Lessons should be drawn from countries who have achieved rapid and equitable progress in the past.
authors.affiliation: Department of Social Statistics and Demography, University of Southampton, Building 58, Highfield Campus, Southampton, SO17 1BJ, UK. S.Neal@soton.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Neal
authors.affiliation: Department of Social Statistics and Demography, University of Southampton, Building 58, Highfield Campus, Southampton, SO17 1BJ, UK. A.R.Channon@soton.ac.uk.
authors.forename: Andrew Amos
authors.initials: AA
authors.lastname: Channon
authors.affiliation: Department of Social Statistics and Demography, University of Southampton, Building 58, Highfield Campus, Southampton, SO17 1BJ, UK. S.A.Carter@soton.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Carter
authors.affiliation: ESRC Centre for Population Change, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK. J.C.Falkingham@soton.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Falkingham
mesh_terms: D003710:Demography; D005260:Female; D014943:Global Health / Q000191:economics / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000191:economics / Q000941:ethics / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D000068097:Maternal Health / Q000191:economics / Q000941:ethics / Q000706:statistics & numerical data*; D011203:Poverty / Q000941:ethics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D019472:Universal Health Insurance / Q000191:economics / Q000941:ethics / Q000706:statistics & numerical data*