Conclusion
GEHIP’s community-based healthcare program was found to significantly
reduce adverse pregnancy outcomes but no effect on relative equity was
established. There was however a general reduction in adverse pregnancy
outcomes in both arms of the study owing to the expansion of access to
community-based primary healthcare services across the region which
mitigates the effects of household remoteness on basic preventive and
curative public health care. The results of this study are challenged by
limitations in the experimental designs but can be explained by the
inverse equity hypothesis.
Globally, improving maternal and child health in line with the United
Nations Sustainable Development Goal targets is constrained by
socio-economic inequalities in access to and use of essential healthcare
services. Community-based healthcare services as low-cost strategies
have an important role to play in improving services to remote
communities in culturally appropriate ways. However, program planners
and implementers should keep an eye to ensure that interventions do not
widen equity gaps.