Private health care market shaping and changes in inequities in childhood diarrhoea treatment coverage: evidence from the analysis of baseline and endline surveys of an ORS and zinc scale-up program in Nigeria

Abstract Background Nearly 90,000 under-five children die from diarrhoea annually in Nigeria. Over 90% of the deaths can be prevented with oral rehydration salt (ORS) and zinc treatment but coverage nationally was less than 34% for ORS 3% wide inequities. A program implemented eight states to address critical barriers optimal functioning health care market deliver these treatments. In this study, we examine changes inequities over intervention period. Methods Baseline endline household surveys were used measure assets. Principal component analysis construct wealth quintiles. We multi-level logistic regression models estimate predictive by urbanicity at each survey Simple measures disparity concentration indices curves evaluate Results At baseline, 28% (95% CI: 22–35%) poorest quintile received compared 50% 52–58%) richest. This inequality reduced as increased 21%-points ( P < 0.001) 17%-points Zinc significantly both quintiles an equally low baseline level. Consistent findings pairwise comparison richest, summary across all showed a narrowing endline. Concentration shifted towards equality treatments, declined 0.1012 0.0480 0.2640 0.0567 zinc. Disparities between rural urban time points insignificant except that use higher 38% (95%CI: 35–41%) 29% (95%CI, 25–33%) urban. Conclusion The results show pro-rural improvement reduction gives indication initiatives focused on shaping healthcare systems may effective reducing gaps without detracting equity policy objective.