Background Many governments have made commitments to tackle inequalities in healthcare access based on studies which assessed the association between several socio-demographic factors and late initiation or fewer antenatal visits. This study addressed the question of whether socio-demographic determinants were significant in explaining differences in antenatal care in an administrative region of Italy (i.e., Umbria) with specific focus on migrant women, and whether the implementation of regional policies of the integration process effectively was reduced over time. Methods Data were obtained from the administrative source of regional Standard Certificate of Live Birth between 2005 and 2010. Standard and bivariate probit regression models were used to analyse the magnitude of the association of country of birth and citizenship, along with occupation, education, and parity and interaction variables with respect to late access to the first visit and low number of visits. To estimate disparities effects of the healthcare access of migrant women on the pregnancy outcome, we also implement a bivariate probit. Results The study included approximately 37,000 women. Heterogeneous effects of socio-demographic variables which refer to migrant women were documented on the prenatal care indicators analysed. From a multivariate model, we found that women born abroad Italy presented a higher probability to make the first visit later than the 12th week and low number of prenatal visits; the estimated odds ratio (OR) for the analysed indicators range from 2.25 to 3.05. Access inequality was also observed when interactions were build for young age, pluriparity, and low education. In addition, we found that employment in migrant women improved access equality, possibly through the transmission of information of the negative consequences related with delayed or few prenatal visits. Interestingly, we showed an important reduction of the inequality of access to healthcare in recent years for both indicators, which supports the recent regional policy of integration process in prenatal healthcare access inequalities.
Socio-Demographi Determinants of Migrant Women and access Equlity to Prnatal Care in Italy
CHIAVARINI, Manuela;LANARI, Donatella;MINELLI, Liliana;PIERONI, Luca;SALMASI, LUCA
2014
Abstract
Background Many governments have made commitments to tackle inequalities in healthcare access based on studies which assessed the association between several socio-demographic factors and late initiation or fewer antenatal visits. This study addressed the question of whether socio-demographic determinants were significant in explaining differences in antenatal care in an administrative region of Italy (i.e., Umbria) with specific focus on migrant women, and whether the implementation of regional policies of the integration process effectively was reduced over time. Methods Data were obtained from the administrative source of regional Standard Certificate of Live Birth between 2005 and 2010. Standard and bivariate probit regression models were used to analyse the magnitude of the association of country of birth and citizenship, along with occupation, education, and parity and interaction variables with respect to late access to the first visit and low number of visits. To estimate disparities effects of the healthcare access of migrant women on the pregnancy outcome, we also implement a bivariate probit. Results The study included approximately 37,000 women. Heterogeneous effects of socio-demographic variables which refer to migrant women were documented on the prenatal care indicators analysed. From a multivariate model, we found that women born abroad Italy presented a higher probability to make the first visit later than the 12th week and low number of prenatal visits; the estimated odds ratio (OR) for the analysed indicators range from 2.25 to 3.05. Access inequality was also observed when interactions were build for young age, pluriparity, and low education. In addition, we found that employment in migrant women improved access equality, possibly through the transmission of information of the negative consequences related with delayed or few prenatal visits. Interestingly, we showed an important reduction of the inequality of access to healthcare in recent years for both indicators, which supports the recent regional policy of integration process in prenatal healthcare access inequalities.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
