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Finding the gap: revealing local disparities in coverage of maternal, newborn and child health services in South Sudan using lot quality assurance sampling
Author(s) -
Valadez Joseph J.,
Berendes Sima,
Lako Richard,
Gould Simon,
Vargas William,
Milner Susan
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12613
Subject(s) - lot quality assurance sampling , environmental health , medicine , millennium development goals , psychological intervention , socioeconomics , population , developing country , geography , economic growth , nursing , sociology , simple random sample , economics
Objectives We adapted a rapid monitoring method to South Sudan, a new nation with one of the world's highest maternal and child mortality rates, aiming to assess coverage of maternal, neonatal and child health ( MNCH ) services at the time of independence, and introducing a monitoring and evaluation system (M&E) for equity‐sensitive tracking of progress related to Millennium Development Goals ( MDG ) 4 and 5 at national, state and county levels to detect local variability. Methods We conducted a national cross‐sectional household survey among women from six client populations in all, but six of South Sudan's 79 counties. We used lot quality assurance sampling ( LQAS ) to measure coverage with diverse MNCH indicators to obtain information for national‐, state‐ and county‐level health system management decision‐making. Results National coverage of MNCH services was low for all maternal and neonatal care, child immunisation, and child care indicators. However, results varied across states and counties. Central Equatoria State ( CES ), where the capital is located, showed the highest coverage for most indicators (e.g. ≥4 antenatal care visits range: 4.5% in Jonglei to 40.1% in CES ). Urban counties often outperformed rural ones. Conclusions This adaptation of LQAS to South Sudan demonstrates how it can be used in the future as an M&E system to track progress of MDG s at national, state and county levels to detect local disparities. Overall, our data reveal a desperate need for improving MNCH service coverage in all states.