The equity impact of a universal child health promotion programme
Background Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery...
Published in: | Journal of Epidemiology and Community Health |
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Online Access: | http://dx.doi.org/10.1136/jech-2019-213503 https://syndication.highwire.org/content/doi/10.1136/jech-2019-213503 |
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crjcrbmj:10.1136/jech-2019-213503 2024-06-23T07:55:36+00:00 The equity impact of a universal child health promotion programme Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna 2020 http://dx.doi.org/10.1136/jech-2019-213503 https://syndication.highwire.org/content/doi/10.1136/jech-2019-213503 en eng BMJ http://creativecommons.org/licenses/by-nc/4.0/ Journal of Epidemiology and Community Health page jech-2019-213503 ISSN 0143-005X 1470-2738 journal-article 2020 crjcrbmj https://doi.org/10.1136/jech-2019-213503 2024-05-24T13:15:50Z Background Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery. Methods Using the mother’s place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents’ earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach. Results Income-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers’ healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time. Conclusion In northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers’ healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time. Article in Journal/Newspaper Northern Sweden The BMJ Journal of Epidemiology and Community Health jech-2019-213503 |
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The BMJ |
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English |
description |
Background Real-world evaluations of complex interventions are scarce. We evaluated the effect of the Salut Programme, a universal child health promotion intervention in northern Sweden, on income-related inequalities in positive birth outcomes and healthcare utilisation up to 2 years after delivery. Methods Using the mother’s place of residence at delivery, the child and the mother were classified as belonging to either the control area (received care-as-usual) or the intervention area (where the intervention was implemented from 2006) and either the premeasure (children born between 2002 and 2004) or the postmeasure (children born between 2006 and 2008) period. Parents’ earned income was used as the socioeconomic ranking variable. The Relative Concentration Index was computed for six binary birth outcome indicators and for inpatient and day patient care for children and their mothers. Changes in inequality over time were compared using a difference-in-difference approach. Results Income-related inequalities in birth outcomes and child healthcare utilisation were absent, except that full-term pregnancies were concentrated among the poor at premeasure in the intervention area. In contrast, mothers’ healthcare utilisation was significantly pro-poor in the control area. The extent of inequality changed differentially between premeasure and postmeasure for two birth outcomes: full-term pregnancies and infants with normal birth weight. Inequalities in healthcare utilisation did not change significantly in either area over time. Conclusion In northern Sweden, income-related inequalities in birth outcomes and child healthcare utilisation are largely absent. However, relative inequalities in mothers’ healthcare utilisation are large. We found no evidence that the Salut Programme affected changes in inequality over time. |
format |
Article in Journal/Newspaper |
author |
Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna |
spellingShingle |
Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna The equity impact of a universal child health promotion programme |
author_facet |
Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna |
author_sort |
Pulkki-Brännström, Anni-Maria |
title |
The equity impact of a universal child health promotion programme |
title_short |
The equity impact of a universal child health promotion programme |
title_full |
The equity impact of a universal child health promotion programme |
title_fullStr |
The equity impact of a universal child health promotion programme |
title_full_unstemmed |
The equity impact of a universal child health promotion programme |
title_sort |
equity impact of a universal child health promotion programme |
publisher |
BMJ |
publishDate |
2020 |
url |
http://dx.doi.org/10.1136/jech-2019-213503 https://syndication.highwire.org/content/doi/10.1136/jech-2019-213503 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_source |
Journal of Epidemiology and Community Health page jech-2019-213503 ISSN 0143-005X 1470-2738 |
op_rights |
http://creativecommons.org/licenses/by-nc/4.0/ |
op_doi |
https://doi.org/10.1136/jech-2019-213503 |
container_title |
Journal of Epidemiology and Community Health |
container_start_page |
jech-2019-213503 |
_version_ |
1802648257404338176 |