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 deliver...
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ftpubmed:oai:pubmedcentral.nih.gov:7337232 2023-05-15T17:44:29+02:00 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 2020-06 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337232/ http://www.ncbi.nlm.nih.gov/pubmed/32303594 https://doi.org/10.1136/jech-2019-213503 en eng BMJ Publishing Group http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337232/ http://www.ncbi.nlm.nih.gov/pubmed/32303594 http://dx.doi.org/10.1136/jech-2019-213503 © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. CC-BY-NC J Epidemiol Community Health Evidence-Based Public Health Policy and Practice Text 2020 ftpubmed https://doi.org/10.1136/jech-2019-213503 2020-07-19T00:23:28Z 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. Text Northern Sweden PubMed Central (PMC) Journal of Epidemiology and Community Health jech-2019-213503 |
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English |
topic |
Evidence-Based Public Health Policy and Practice |
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Evidence-Based Public Health Policy and Practice 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 |
topic_facet |
Evidence-Based Public Health Policy and Practice |
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 |
Text |
author |
Pulkki-Brännström, Anni-Maria Lindkvist, Marie Eurenius, Eva Häggström, Jenny Ivarsson, Anneli Sampaio, Filipa Feldman, Inna |
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 Publishing Group |
publishDate |
2020 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337232/ http://www.ncbi.nlm.nih.gov/pubmed/32303594 https://doi.org/10.1136/jech-2019-213503 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_source |
J Epidemiol Community Health |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337232/ http://www.ncbi.nlm.nih.gov/pubmed/32303594 http://dx.doi.org/10.1136/jech-2019-213503 |
op_rights |
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
op_rightsnorm |
CC-BY-NC |
op_doi |
https://doi.org/10.1136/jech-2019-213503 |
container_title |
Journal of Epidemiology and Community Health |
container_start_page |
jech-2019-213503 |
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