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Objective To examine inequalities in the coverage of reproductive and maternal health interventions in low- and middle- income countries and territories using a composite index of socioeconomic deprivation status. Methods We obtained data on education and living standards from national household surveys conducted between 2015 and 2019 to calculate socioeconomic deprivation status. We assessed the coverage of reproductive and maternal health interventions, using three indicators: (i) demand for family planning satisfied with modern methods; (ii) women who received antenatal care in at least four visits; and (iii) the presence of a skilled attendant at delivery. Absolute and relative inequalities were evaluated both directly and using the slope index of inequality and the concentration index. Findings In the 73 countries and territories with available data, the median proportions of deprivation were 41% in the low-income category, 11% in the lower-middle-income category and less than 1% in the upper-middle- income category. The coverage analysis, conducted for 48 countries with sufficient data, showed consistently lower median coverage among deprived households across all health indicators. The coverage of skilled attendant at delivery showed the largest inequalities, where coverage among the socioeconomically deprived was substantially lower in almost all countries. Antenatal care visits and demand for family planning satisfied with modern methods also showed significant disparities, favouring the less deprived population. Conclusion The findings highlight persistent disparities in the coverage of reproductive and maternal health interventions, requiring efforts to reduce those disparities and improve coverage, particularly for skilled attendant at delivery. Objectif Examiner les inegalites dans la couverture des interventions de sante reproductive et maternelle dans les pays et territoires a revenu faible et intermediaire a l'aide d'un indice composite du statut de privation socioeconomique. Methodes Nous avons obtenu des donnees sur l'education et les niveaux de vie a partir d'enquetes nationales sur les menages menees entre 2015 et 2019 pour calculer le statut de privation socioeconomique. Nous avons evalue la couverture des interventions de sante reproductive et maternelle a l'aide de trois indicateurs: (i) une demande de planification familiale satisfaite avec des methodes modernes; (ii) le fait que les femmes recoivent des soins prenatals lors d'au moins quatre visites; et (iii) la presence de personnel qualifie present lors de l'accouchement. Les inegalites absolues et relatives ont ete evaluees a la fois directement et a l'aide de l'indice de pente et l'indice de concentration des inegalites. Resultats Dans les 73 pays et territoires pour lesquels des donnees sont disponibles, les proportions medianes de privation etaient de 41% dans la categorie a faibles revenus, de 11% dans la categorie a revenus moyens inferieurs et de moins de 1% dans la categorie des revenus moyens superieurs. L'analyse de cette couverture, menee dans 48 pays disposant de donnees suffisantes, a mis en evidence que la couverture mediane etait systematiquement plus faible dans les menages defavorises pour tous les indicateurs de sante. La couverture de personnel qualifie present lors de l'accouchement est celle qui presente les inegalites les plus importantes, le chiffre pour les menages defavorises etant nettement inferieur dans presque tous les pays. Les visites de soins prenatals et la demande en planning familial satisfait par des methodes modernes ont egalement indique des disparites considerables, en faveur des populations moins demunies. Conclusion Les resultats mettent en evidence des disparites persistantes dans la couverture des interventions de sante reproductive et maternelle, ce qui necessite des efforts pour reduire ces disparites et ameliorer la couverture, en particulier en ce qui concerne l'accouchement assiste par du personnel qualifie. Objetivo Estudiar las desigualdades en la cobertura de las intervenciones de salud reproductiva y materna en paises y territorios de ingresos bajos y medios mediante un indice compuesto del nivel de privacion socioeconomica. Metodos Se obtuvieron datos sobre el nivel educativo y de vida a partir de encuestas nacionales de hogares realizadas entre 2015 y 2019 para calcular el estado de privacion socioeconomica. Se evaluo la cobertura de las intervenciones de salud reproductiva y materna mediante tres indicadores: (i) demanda de planificacion familiar satisfecha con metodos modernos; (ii) mujeres que recibieron atencion prenatal en al menos cuatro visitas; y (iii) presencia de personal calificado para atender partos. Las desigualdades absolutas y relativas se evaluaron directamente y mediante el indice de pendiente de la desigualdad y el indice de concentracion. Resultados En los 73 paises y territorios con datos disponibles, los porcentajes medios de privacion eran del 41% en la categoria de ingresos bajos, del 11% en la de ingresos medios-bajos y de menos del 1% en la de ingresos medios-altos. El analisis de la cobertura, que se realizo en 48 paises con datos suficientes, mostro una cobertura mediana sistematicamente inferior entre los hogares desfavorecidos en todos los indicadores de salud. La cobertura de personal calificado para atender partos mostro las mayores desigualdades, ya que la cobertura entre las personas socioeconomicamente desfavorecidas fue sustancialmente inferior en casi todos los paises. Las visitas de atencion prenatal y la demanda de planificacion familiar satisfecha con metodos modernos tambien mostraron diferencias significativas, favoreciendo a la poblacion menos desfavorecida. Conclusion Los resultados evidencian la persistencia de diferencias en la cobertura de las intervenciones de salud reproductiva y materna, lo que exige esfuerzos para reducir esas diferencias y mejorar la cobertura, en especial de personal calificado para la atencion de partos., Introduction Eliminating poverty in all its forms is the first of the 17 sustainable development goals (SDGs). (1) People living in conditions of poverty are likely to have fewer opportunities [...]

Objectives: This study aims to evaluate the gender inequalities in accelerometer-based physical activity (PA) across different age groups using data from 5 Pelotas (Brazil) cohorts. Methods: The data come from 4 birth cohort studies, covering all live births in the urban area of Pelotas for each respective year (1982, 1993, 2004, and 2015), and the Como vai? cohort study focusing on 60 years and above. Raw accelerometry data were collected on the nondominant wrist using GENEActive/ActiGraph devices and processed with the GGIR package. Overall PA was calculated at ages 1, 2, 4, 6, 11, 15, 18, 23, 30, and 60+ years, while moderate to vigorous PA was calculated from 6 years onward. Absolute (difference) and relative (ratio) gender inequalities were calculated and intersectionality between gender and wealth was also evaluated. Results: The sample sizes per cohort ranged from 965 to 3462 participants. The mean absolute gender gap was 19.3 minutes (95% confidence interval, 12.7–25.9), with the widest gap at 18 years (32.9 min; 95% confidence interval, 30.1–35.7) for moderate to vigorous PA. The highest relative inequality was found in older adults (ratio 2.0; 95% confidence interval, 1.92–2.08). Our intersectionality results showed that the poorest men being the most active group, accumulating around 60 minutes more moderate to vigorous PA per day compared with the wealthiest women at age 18. Conclusions: Men were more physically active than women in all ages evaluated. PA gender inequalities start at an early age and intensify in transition periods of life. Relative inequalities were marked among older adults. [ABSTRACT FROM AUTHOR]

Background: The present study aims to estimate leisure-time physical activity and television (TV) viewing curves according to age stratified by sex, area of residence, and socioeconomic position. Methods: Using data from the Brazilian National Health Survey, we estimated the prevalence of leisure-time physical activity and TV viewing according to continuous age. The estimates were calculated using fractional polynomials and stratified by sex, wealth, skin color, and area of residence. Results: The sample included 87,376 adults (aged 18 y or over). In general, leisure-time physical activity decreased according to age while TV viewing increased. Regarding behavior of curves according to stratifiers, for leisure-time physical activity the disadvantaged groups maintained a pattern of low physical activity across all age groups or presented the decrease earlier when compared to groups in social advantage. On the other hand, for TV viewing, women presented an increase in prevalence before men, and individuals living in the urban area and the wealthiest group were those with a higher increase according to age. Conclusions: Our findings may help researchers and policymakers further explore inequalities in physical activity across life in different settings, as well as develop sensitive cultural actions to support more vulnerable people to adopt public health recommendations. [ABSTRACT FROM AUTHOR]

Background: This study aims to describe changes in gender and wealth inequalities in leisure-time physical activity (PA) of Brazilians during a 6-year interval. It also aims to evaluate inequalities regarding PA public programs awareness, participation, and access to public spaces for PA. Methods: Data from 2 population-based surveys conducted in 2013 and 2019 were used. Leisure-time PA prevalence was assessed considering those reporting ≥150 minutes per week. The authors evaluated gender inequalities calculating differences and ratios, and wealth inequalities using the slope index of inequality and the concentration index— assessing changes over time. Results: National levels of leisure-time PA increased from 2013 to 2019, and an increase in inequalities was observed; women and the poorest groups still presented lower prevalence. A decline in socioeconomic inequalities was observed from 2013 to 2019 regarding the availability of public spaces and awareness about public programs. However, outcomes remained more common among the richest group. Inequalities did not vary for participation in public programs. Conclusion: Although leisure-time PA increased from 2013 to 2019 at a national level, there were no improvements in gender inequalities, and wealth inequalities worsened over time. Indicators of public strategies for PA increased for the population, but inequalities remain. [ABSTRACT FROM AUTHOR]