Climbing the Ladder to Equitable Access for Mothers and Children: Health System Transitions to Universal Coverage in Urban and Rural Settings

Andrew A. R. Channon, University of Southampton
Zoe Matthews, University of Southampton
Sarah Neal, University of Southampton

With increasing urbanisation there is a need to identify population groups that are excluded or marginalised from receiving healthcare. Furthermore, the implementation of appropriate interventions to increase access is required. This paper will propose a general theory of the transition that a country undertakes from a situation where no healthcare is offered to one where the whole population, irrespective of location or wealth, obtains healthcare. Using information from Demographic and Health Surveys, countries with more than two surveys will be analysed to assess inequalities in health care with regards to wealth and urban/rural residence. It is proposed that a country moves through a series of different stages, or rungs, in the transition towards universal coverage. Throughout this transition access in rural and urban areas differ, with urban areas usually having higher utilisation rates. Interventions to improve healthcare access will be proposed for each step of this transition ladder.