Inequality of Opportunity in Access to Antenatal Care in Districts of Punjab, Pakistan

Abstract

Inequality in the use of antenatal care (ANC) has long been a barrier to obtain universal access of the service. The aim of this work to analyze the inequality of opportunity in access toANC in districts of Punjab, Pakistan and explore the circumstance variables that contribute the most to the inequality. The study isconducted using Punjab's Multiple Indicator Cluster Survey 2017-18 and the data analyzed are taken from women with a live birth in the last 2 years who have had at least one ANC visit. The Human Opportunity Index is used to measure the coverage rate, inequality and universal access of opportunity across the districts of Punjab.It is noted that most of the southern districts of Punjab (Rajanpur, Bhakkar, Muzaffargarh and others) have poor coverage rates and low universal access for the ANC and northern districts (Rawalpindi, Jhelum, Lahore and others) have high coverage and universal access for the ANC.There is also higher inequalityin southern and central districts of Punjab.Further, Shapley Decomposition is utilized to identify the contribution of the circumstance variables to the inequality. It is found that household wealth status, birth order, birth interval, household head education, ethnicity, media access and residence were the most significant factors leading to inequality of opportunity in the accessibility of ANC services across the districts of Punjab. On the basis of the results, some policies are suggested to the Government at end.