BACKGROUND Despite the pro-poor health policies in Ethiopia, the utilization of maternal, neonatal, and child health services remains a challenge for the country. Health equity became central in the post-2015 Sustainable Development Goals globally and is a priority for Ethiopia. The aim of this study was to assess equity in utilization of a range of maternal and child health services by applying absolute and relative equity indices. METHODS Data on maternal and child health utilization emanated from a baseline survey conducted for a large project 'Optimizing the Health Extension Program from December 2016 to February 2017 in four regions of Ethiopia. The utilization of four or more antenatal care visits; skilled birth attendance; postnatal care within 2 days after childbirth; immunization with BCG, polio 3, pentavalent 3, measles and full immunization of children aged 12-23 months; and vitamin A supplementation for 6-23 months old children were stratified by wealth quintiles. The socioeconomic status of the household was assessed by household assets and measured by constructing a wealth index using principal component analysis. Equity was assessed by applying two absolute inequity indices (Wealth index [quintile 5- quintile 1] and slope index of inequality) and two relative inequity indices (Wealth index [quintile5: quintile1] and concentration index). RESULTS The maternal health services utilization was low and inequitably distributed favoring the better-off women. About 44, 71, and 18% of women from the better-off households had four or more antenatal visits, utilized skilled birth attendance and postnatal care within two days compared to 20, 29, and 8% of women from the poorest households, respectively. Skilled birth attendance was the most inequitably distributed maternal health service. All basic immunizations: BCG, polio 3, pentavalent 3, measles, and full immunization in children aged 12-23 months and vitamin A supplementation were equitably distributed. CONCLUSION Utilization of maternal health services was low, inequitable, and skewed against women from the poorest households. In contrast, preventive child health services were equitably distributed. Efforts to increase utilization and reinforcement of pro-poor and pro-rural strategies for maternal, newborn and immunization services in Ethiopia should be strengthened.

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孕产妇，新生儿和儿童保健服务利用中基于财富的平等：来自埃塞俄比亚的横断面研究。

背景技术尽管埃塞俄比亚实行了扶贫卫生政策，但利用产妇，新生儿和儿童卫生服务仍然对该国构成挑战。卫生公平成为全球2015年后可持续发展目标的核心，也是埃塞俄比亚的优先事项。这项研究的目的是通过应用绝对和相对公平指数来评估一系列母婴保健服务的利用公平性。方法母婴健康利用的数据来自一项针对埃塞俄比亚四个地区的大型项目“优化健康扩展计划”（2016年12月至2017年2月）的基线调查。利用四次或更多次产前检查；熟练的接生服务；分娩后2天内的产后护理；卡介苗，脊髓灰质炎3，五价3免疫，12至23个月大的儿童的麻疹和全面免疫；6-23个月大的孩子的维生素A补充剂按财富五分位数分层。通过家庭资产评估家庭的社会经济状况，并通过使用主成分分析构建财富指数来衡量家庭的社会经济状况。通过应用两个绝对不平等指数（财富指数[五分位数5-五分位数1]和不平等斜率指数）和两个相对不平等指数（财富指数[五分位数5：五分位数1]和集中度指数）来评估公平。结果孕产妇保健服务利用率低，分配不均，有利于富裕的妇女。富裕家庭中约有44、71和18％的妇女在两天内进行了四次或更多次产前检查，并在两天内使用了熟练的接生和产后保健服务，而20、29，最贫困家庭的妇女比例分别为8％和8％。熟练的接生服务是分配最不均衡的产妇保健服务。所有基本免疫：BCG，脊髓灰质炎3，五价3，麻疹和12至23个月大的儿童全面免疫，并补充维生素A。结论孕产妇保健服务的利用率低，不公平且偏向最贫困家庭的妇女。相反，预防性儿童保健服务得到公平分配。埃塞俄比亚应加强努力，提高利用和加强扶贫，扶贫战略的孕产妇，新生儿和免疫服务。对12至23个月大的儿童进行了脊髓灰质炎3，五价3，麻疹和全面免疫，并补充了维生素A。结论孕产妇保健服务的利用率低，不公平且偏向最贫困家庭的妇女。相反，预防性儿童保健服务得到公平分配。埃塞俄比亚应加强努力，提高利用和加强扶贫，扶贫战略的孕产妇，新生儿和免疫服务。对12至23个月大的儿童进行了脊髓灰质炎3，五价3，麻疹和全面免疫，并补充了维生素A。结论孕产妇保健服务的利用率低，不公平且偏向最贫困家庭的妇女。相反，预防性儿童保健服务得到公平分配。埃塞俄比亚应加强努力，提高利用和加强扶贫，扶贫战略的孕产妇，新生儿和免疫服务。