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Objective To examine inequalities and opportunity gaps in co-coverage of health and nutrition interventions in seven countries. Methods We used data from the most recent (2015-2018) demographic and health surveys of mothers with children younger than 5 years in Afghanistan (n = 19 632), Bangladesh (n = 5051), India (n = 184 641), Maldives (n = 2368), Nepal (n = 3998), Pakistan (n = 8285) and Sri Lanka (n = 7138). We estimated co-coverage for a set of eight health and eight nutrition interventions and assessed within-country inequalities in co-coverage by wealth and geography. We examined opportunity gaps by comparing coverage of nutrition interventions with coverage of their corresponding health delivery platforms. Findings Only 15% of 231 113 mother-child pairs received all eight health interventions (weighted percentage). The percentage of mother-child pairs who received no nutrition interventions was highest in Pakistan (25%). Wealth gaps (richest versus poorest) for co-coverage of health interventions were largest for Pakistan (slope index of inequality: 62 percentage points) and Afghanistan (38 percentage points). Wealth gaps for co-coverage of nutrition interventions were highest in India (32 percentage points) and Bangladesh (20 percentage points). Coverage of nutrition interventions was lower than for associated health interventions, with opportunity gaps ranging from 4 to 54 percentage points. Conclusion Co-coverage of health and nutrition interventions is far from optimal and disproportionately affects poor households in south Asia. Policy and programming efforts should pay attention to closing coverage, equity and opportunity gaps, and improving nutrition delivery through health-care and other delivery platforms. Objectif Examen des inegalites et des ecarts de perspectives dans la couverture commune des interventions en matiere de sante et de nutrition dans sept pays. Methodes Nous avons utilise les donnees des enquetes demographiques et sanitaires les plus recentes (2015-2018) aupres de meres ayant des enfants de moins de 5 ans en Afghanistan (n = 19 632), au Bangladesh (n = 5051), en Inde (n = 184 641), aux Maldives (n = 2368), au Nepal (n = 3998), au Pakistan (n = 8285) et au Sri Lanka (n = 7138). Nous avons estime la couverture commune pour un ensemble de huit interventions dans le domaine de la sante et huit autres liees a la nutrition et nous avons evalue les inegalites au sein des pays en matiere de couverture commune en fonction de la richesse et de la geographie. Nous avons examine les ecarts de perspectives en comparant la couverture des interventions en matiere de nutrition avec celle des plateformes de prestation de soins correspondantes. Resultats Seuls 15 % des 231 113 couples mere-enfant ont beneficie des huit interventions sanitaires (pourcentage pondere). Le taux de couples mere-enfant n'ayant beneficie d'aucune intervention en matiere de nutrition etait le plus eleve au Pakistan (25 %). Les ecarts de richesse (les plus riches par rapport aux plus pauvres) pour la couverture commune des interventions sanitaires etaient les plus importants au Pakistan (indice de pente des inegalites : 62 points de pourcentage) et en Afghanistan (38 points de pourcentage). Les ecarts de richesse pour la couverture commune des interventions en nutrition etaient les plus eleves en Inde (32 points de pourcentage) et au Bangladesh (20 points de pourcentage). La couverture des interventions en matiere de nutrition etait plus faible que celle des interventions sanitaires associees, avec des ecarts de perspectives s'etalant de 4 a 54 points de pourcentage. Conclusion La couverture commune des interventions en matiere de sante et de nutrition est loin d'etre optimale et affecte de maniere disproportionnee les menages pauvres d'Asie du Sud. Les efforts en matiere de politique et de programmation devraient viser a combler les ecarts en matiere de couverture, dequite et de perspective et a ameliorer la fourniture d'interventions de nutrition au travers de soins de sante et d'autres plateformes de prestation. Objetivo Analizar las desigualdades y la falta de oportunidades en la cobertura conjunta de las intervenciones sanitarias y de nutricion en siete paises. Metodos Se utilizaron los datos de las encuestas demograficas y sanitarias mas recientes (entre 2015 y 2018) de madres con hijos menores de 5 anos en Afganistan (n= 19 632), Bangladesh (n= 5051), India (n= 184 641), Maldivas (n= 2368), Nepal (n= 3998), Pakistan (n= 8285) y Sri Lanka (n= 7138). Se calculo la cobertura conjunta de un grupo de ocho intervenciones sanitarias y ocho de nutricion y se evaluaron las desigualdades en la cobertura conjunta dentro del pais segun la riqueza y la geografia. Se analizaron las diferencias de oportunidad al comparar la cobertura de las intervenciones de nutricion con la cobertura de sus correspondientes plataformas de prestacion de servicios sanitarios. Resultados Solo el 15 % de 231 113 parejas madre e hijo recibieron las ocho intervenciones sanitarias (porcentaje ponderado). El porcentaje de parejas madre e hijo que no recibieron ninguna intervencion de nutricion fue mayor en Pakistan (25 %). Las diferencias de riqueza (los mas ricos frente a los mas pobres) para la cobertura conjunta de las intervenciones sanitarias fueron mayores en Pakistan (indice de desigualdad de la pendiente: 62 puntos porcentuales) y en Afganistan (38 puntos porcentuales). Las diferencias de riqueza para la cobertura conjunta de las intervenciones de nutricion fueron mayores en India (32 puntos porcentuales) y en Bangladesh (20 puntos porcentuales). La cobertura de las intervenciones de nutricion fue menor que la de las intervenciones sanitarias asociadas, con diferencias de oportunidad que iban de 4 a 54 puntos porcentuales. Conclusion La cobertura conjunta de las intervenciones sanitarias y de nutricion esta lejos de ser optima y afecta de manera desproporcionada a los hogares pobres de Asia Meridional. Los esfuerzos en materia de politica y programacion deben prestar atencion a la reduccion de las diferencias de cobertura, equidad y oportunidad, y a la mejora de la prestacion de servicios de nutricion a traves de la atencion sanitaria y demas plataformas de prestacion. [phrase omitted], Introduction Universal health coverage (UHC) is fundamental to achieving the sustainable development goals (SDGs), reducing inequalities and ensuring that no one is left behind. (1) Timely delivery of a complete [...]

Objective To examine inequalities and opportunity gaps in co-coverage of health and nutrition interventions in seven countries. Methods We used data from the most recent (2015-2018) demographic and health surveys of mothers with children younger than 5 years in Afghanistan (n = 19 632), Bangladesh (n = 5051), India (n = 184 641), Maldives (n = 2368), Nepal (n = 3998), Pakistan (n = 8285) and Sri Lanka (n = 7138). We estimated co-coverage for a set of eight health and eight nutrition interventions and assessed within-country inequalities in co-coverage by wealth and geography. We examined opportunity gaps by comparing coverage of nutrition interventions with coverage of their corresponding health delivery platforms. Findings Only 15% of 231 113 mother--child pairs received all eight health interventions (weighted percentage). The percentage of mother--child pairs who received no nutrition interventions was highest in Pakistan (25%). Wealth gaps (richest versus poorest) for cocoverage of health interventions were largest for Pakistan (slope index of inequality: 62 percentage points) and Afghanistan (38 percentage points). Wealth gaps for co-coverage of nutrition interventions were highest in India (32 percentage points) and Bangladesh (20 percentage points). Coverage of nutrition interventions was lower than for associated health interventions, with opportunity gaps ranging from 4 to 54 percentage points. Conclusion Co-coverage of health and nutrition interventions is far from optimal and disproportionately affects poor households in south Asia. Policy and programming efforts should pay attention to closing coverage, equity and opportunity gaps, and improving nutrition delivery through health-care and other delivery platforms. [ABSTRACT FROM AUTHOR]