Socio-Economic Inequalities in Maternity Care Under Political Instability: Evidence from Egypt, Jordan and Yemen

Medical care during pregnancy is crucial for protecting women from health risks during and after pregnancy, and has been consistently linked to better child health outcomes. Improving maternal health is one of the Millennium Development Goals (MDGs). This paper examines the socio-economic inequalities in maternity care utilization in Egypt, Jordan, and Yemen after the Arab Spring, using the most recent rounds of the National Demographic and Health Survey. Concentration curves and concentration indices are used to examine the demographic and socio-economic correlates of maternity care utilization, and to assess the situation under the political instability that followed the Arab Spring. In addition, we investigate the underlying factors that generate the socio-economic inequalities in maternity care utilization by decomposing the concentration index into its determinants. The analysis yields that the degree of the socio-economic inequalities in maternity care utilization varies largely within the Arab world. The level of inequality is severe in Yemen, moderate in Egypt, and minor in Jordan. Results of the decomposition analysis show that socio-economic disparities in maternity care utilization are mainly due to the lack of economic resources and its correlates among the poor. The political instability in the region did not hinder Egypt and Jordan from improving the maternal health indicators at the national level. Increasing women education, especially among the poor, and poverty reduction measures focusing on rural communities could help narrow the inequalities in maternity care and hence improves population health outcomes.