5C: Diversity, Equity and Inclusion
Tracks
Track 3
| Thursday, September 18, 2025 |
| 1:15 PM - 2:45 PM |
| Charles Throsby Room |
Overview
Long Oral Presentations
Speaker
Ms Lisa Woodland
Director, Equity and Prevention Service and NSW MHCS
South Eastern Sydney Local Health District
Addressing Racism in healthcare – a public health issue
Abstract
Racism is a public health issue, impacting mental health, physical health, and access to healthcare. While racism is less prevalent in healthcare settings, compared with other public spaces, the harm caused when experienced in this setting is greater. The health harms associated with racism, are cumulative - the more people are exposed to racist comments and incidents, the greater harm they experience.
This paper presents the results of a pre-post study examining effectiveness of bystander intervention training as part of a comprehensive, multi-faceted strategy aimed at addressing racism in a local health district in Sydney.
Based on evidence from the Challenging Racism Project (WSU) three short bystander intervention videos were co-designed and co-produced with Aboriginal staff and staff from culturally and linguistically diverse backgrounds. These videos were embedded in training for staff.
Data was collected over two years (January 2021 to February 2023), at three time points through online surveys (pre, post and 3 months following training). Supplementary data were obtained from the public sector’s state annual employee experience survey (PMES).
Findings indicated that the training significantly enhanced staff awareness of racism and its impact on health outcomes, improved their confidence and likelihood of intervening during racist incidents, and increased perceptions of workplace and managerial support for addressing racism. Data from PMES indicated a slight decline in reported incidents of racism and a more than twofold increase in staff satisfaction with how such reports were managed
The Addressing Racism in Healthcare Strategy was a comprehensive, organisational approach, which supports successful bystander anti-racism initiatives require: raising awareness, executive and senior staff support; building staff knowledge and skills in context specific actions and confidence to use them. The strategy is a successful model that other local health districts and similar organisations can adapt to promote inclusivity and cultural safety in healthcare.
This paper presents the results of a pre-post study examining effectiveness of bystander intervention training as part of a comprehensive, multi-faceted strategy aimed at addressing racism in a local health district in Sydney.
Based on evidence from the Challenging Racism Project (WSU) three short bystander intervention videos were co-designed and co-produced with Aboriginal staff and staff from culturally and linguistically diverse backgrounds. These videos were embedded in training for staff.
Data was collected over two years (January 2021 to February 2023), at three time points through online surveys (pre, post and 3 months following training). Supplementary data were obtained from the public sector’s state annual employee experience survey (PMES).
Findings indicated that the training significantly enhanced staff awareness of racism and its impact on health outcomes, improved their confidence and likelihood of intervening during racist incidents, and increased perceptions of workplace and managerial support for addressing racism. Data from PMES indicated a slight decline in reported incidents of racism and a more than twofold increase in staff satisfaction with how such reports were managed
The Addressing Racism in Healthcare Strategy was a comprehensive, organisational approach, which supports successful bystander anti-racism initiatives require: raising awareness, executive and senior staff support; building staff knowledge and skills in context specific actions and confidence to use them. The strategy is a successful model that other local health districts and similar organisations can adapt to promote inclusivity and cultural safety in healthcare.
Biography
Lisa Woodland is Director, Equity and Prevention Service, South Eastern Sydney Local Health District and NSW Multicultural Health Communication Service. Lisa is a registered Psychologist who has post graduate qualifications in health service research and development, clinical redesign of health services, and health communication.
Lisa has over 20 years’ experience working with priority populations. She is passionate about addressing health inequities, through improving health communication, access to health services and preventative health care, and environments in which people live and work. Lisa’s work has focused on health issues in which cultural understandings and stigma play a significant role, including cancer, mental health, and vaccination. She has extensive experience in consumer and community engagement and in the co-design and co-production of health information and campaigns.
Lisa’s recent research interests have included examining acceptability, feasibility and effectiveness of an organisational strategy to address racism in healthcare settings.
Mr Andrew Reid
Research Officer
Centre For Health Equity Training, Research & Evaluation (chetre)|
Advancing Health Equity through Collaborative Action in a Disadvantaged Community
Abstract
Background: The 2025 Australian Public Health Conference theme, Leadership and Collaboration to Connect a Divided World, emphasises the collective need to address health inequities driven by socioeconomic disadvantage. Since 1999, the Centre for Health Equity Training, Research and Evaluation (CHETRE) has conducted household surveys in a disadvantaged New South Wales community. Surveys in 2002, 2005, 2007, and 2010 informed the Community 2168 Project—an urban renewal and capacity-building initiative. The 2022 survey was the first in over a decade.
Aim: The 2022–2023 Household Survey aimed to capture service use, community perceptions, and unmet needs in a disadvantaged NSW community to guide local and regional policy, planning, and service delivery for improved health equity.
Methods: A repeated cross-sectional survey targeted 600 randomly selected households, using local residents as community researchers. A mixed-mode approach involved face-to-face door knocking, paper surveys, and an online QR code option. Validated tools, like the SF-12 for health status, assessed service access, trust, safety, and wellbeing. Descriptive and thematic analyses identified barriers, strengths, and priorities.
Findings: Of 600 households, 310 (51.6%) participated. Key barriers included long waiting times (46%) and poor public transport (36%), disproportionately affecting low-income and overseas-born residents (50%, e.g., Lebanon, Vietnam). Mental health scores (SF-12: 30.6) were significantly below the national average (45.3), with only 4% accessing services. Financial barriers persisted (18%). Community connection increased (62% feel at home vs 55% in 2010), but trust in neighbours declined (40% vs 50%). Safety concerns after dark improved (60% vs 74% in 2010), and litter concerns decreased (57% to 41%).
Outcomes and Translational Actions: Findings were disseminated through community forums and networks, informing collaborative initiatives to enhance local service planning and delivery.
Conclusion: Community-led data and local partnerships are essential for shaping equitable policy and improving service responses.
Aim: The 2022–2023 Household Survey aimed to capture service use, community perceptions, and unmet needs in a disadvantaged NSW community to guide local and regional policy, planning, and service delivery for improved health equity.
Methods: A repeated cross-sectional survey targeted 600 randomly selected households, using local residents as community researchers. A mixed-mode approach involved face-to-face door knocking, paper surveys, and an online QR code option. Validated tools, like the SF-12 for health status, assessed service access, trust, safety, and wellbeing. Descriptive and thematic analyses identified barriers, strengths, and priorities.
Findings: Of 600 households, 310 (51.6%) participated. Key barriers included long waiting times (46%) and poor public transport (36%), disproportionately affecting low-income and overseas-born residents (50%, e.g., Lebanon, Vietnam). Mental health scores (SF-12: 30.6) were significantly below the national average (45.3), with only 4% accessing services. Financial barriers persisted (18%). Community connection increased (62% feel at home vs 55% in 2010), but trust in neighbours declined (40% vs 50%). Safety concerns after dark improved (60% vs 74% in 2010), and litter concerns decreased (57% to 41%).
Outcomes and Translational Actions: Findings were disseminated through community forums and networks, informing collaborative initiatives to enhance local service planning and delivery.
Conclusion: Community-led data and local partnerships are essential for shaping equitable policy and improving service responses.
Biography
Andrew Reid is an early career researcher at the Centre for Health Equity Training, Research, and Evaluation (CHETRE), now within the UNSW International Centre for Future Health Systems, part of Population Health – Population Health Research & Epidemiology at South Western Sydney Local Health District (SWSLHD). His research centres on health equity, social determinants, and harms from alcohol and gambling. Reid led the 2022–2023 Miller Household Survey, engaging 600 disadvantaged NSW households to guide service planning. Previously, as a Health Promotion Officer at SWSLHD, he received the 2014 SWSRAC Award for Best Practice Initiative working with Pacific Communities in South Western Sydney. Reid holds a Bachelor of Arts in Asian Studies and Politics from Western Sydney University, a Postgraduate Diploma in International Relations and a Master’s in Politics and Public Policy from Macquarie University, and dual Master’s degrees in International Public Health and Public Health from UNSW.
Mr Levin Wong
Student
Monash University
Association of Self-reported Oral Health and Edentulism with Disability-Free-Survival in Older Adults
Abstract
Abstract
Objective
To investigate the longitudinal association of self-reported oral health and presence of natural teeth with disability-free survival in older adults.
Methods
A total of 12,332 adults aged 70 years and over (54.2% females), participants of the ASPirin in Reducing Events in Elderly (ASPREE; trial of low-dose aspirin in healthy older adults) and ASPREE Longitudinal Study of Older Persons (ALSOP), self-reported the presence of natural teeth and oral health status. The outcome was a composite endpoint derived from the first occurrences of death, dementia, or persistent physical disability. Association of self-reported oral health, presence of natural teeth and the integrative measure of the two with disability-free survival was explored using Cox-regression models adjusted for age, sex, socio-economic-status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.
Results
Twenty two percent of participants reported edentulism at baseline, 13.8% fair/poor oral health and 1.7% reported both edentulism and fair/poor oral health status. Over a median follow-up of 6.4-years (5.4 years, 7.8 years), 1,687 participants (13.7%) failed to sustain disability-free survival. After adjustment for confounders, the risk (HR (95 %CI) of disability-free survival was higher among those with edentulism (vs. no edentulism (1.24 (1.11, 1.39)); those reporting fair/poor oral health (vs. good/very good/excellent oral health) (1.15 (1.01, 1.31)); those reporting edentulism and poor/fair oral health 1.51 (1.12, 2.03), or those with some natural teeth but reporting poor/fair oral health (1.18 (1.12–1.41)) compared to participants reporting no edentulism and good/very good/excellent oral health.
Conclusions
The risk of failing to sustain disability-free survival was 51% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. Maintaining good oral health and natural teeth may play a crucial role in promoting disability-free survival among older adults.
Objective
To investigate the longitudinal association of self-reported oral health and presence of natural teeth with disability-free survival in older adults.
Methods
A total of 12,332 adults aged 70 years and over (54.2% females), participants of the ASPirin in Reducing Events in Elderly (ASPREE; trial of low-dose aspirin in healthy older adults) and ASPREE Longitudinal Study of Older Persons (ALSOP), self-reported the presence of natural teeth and oral health status. The outcome was a composite endpoint derived from the first occurrences of death, dementia, or persistent physical disability. Association of self-reported oral health, presence of natural teeth and the integrative measure of the two with disability-free survival was explored using Cox-regression models adjusted for age, sex, socio-economic-status, health-related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.
Results
Twenty two percent of participants reported edentulism at baseline, 13.8% fair/poor oral health and 1.7% reported both edentulism and fair/poor oral health status. Over a median follow-up of 6.4-years (5.4 years, 7.8 years), 1,687 participants (13.7%) failed to sustain disability-free survival. After adjustment for confounders, the risk (HR (95 %CI) of disability-free survival was higher among those with edentulism (vs. no edentulism (1.24 (1.11, 1.39)); those reporting fair/poor oral health (vs. good/very good/excellent oral health) (1.15 (1.01, 1.31)); those reporting edentulism and poor/fair oral health 1.51 (1.12, 2.03), or those with some natural teeth but reporting poor/fair oral health (1.18 (1.12–1.41)) compared to participants reporting no edentulism and good/very good/excellent oral health.
Conclusions
The risk of failing to sustain disability-free survival was 51% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self-reported oral health. Maintaining good oral health and natural teeth may play a crucial role in promoting disability-free survival among older adults.
Biography
Levin Wong is an Honours student studying at the School of Public Health and Preventive Medicine, Monash University. He is part of the Behavioural and Social Epidemiology Research Group. His research interests focus on chronic disease epidemiology and prevention.
Dr Andrew Mathieson
Senior Lecturer
Australian National University
Empowering Island Futures: A DFAT-Initiated Public Health and Gender Equity Intervention.
Abstract
In remote regions of the Solomon Islands, adolescent girls face intersecting barriers to education, health, and safety. These barriers intensify after puberty, when socio-cultural norms, economic limitations, and gendered expectations often compel early school dropout, limit mobility, and increase vulnerability to violence and exploitation. This presentation examines a public health initiative designed to interrupt this cycle of marginalisation through a locally-led, gender-transformative intervention.
The project provided seed funding to women in remote communities to develop sustainable, small-scale income-generating enterprises. In turn, these funds were strategically invested in girls’ education—supporting tuition, transport, uniforms, and boarding fees for secondary, college, and university access. Beyond financial support, the project built community capacity by engaging elders and male leaders, fostering gender-inclusive dialogue, and promoting models of successful young women as community role models.
Aligned with core public health values of equity, participation, and empowerment, this initiative operationalised Sustainable Development Goals (SDGs) 3 (Good Health and Wellbeing), 4 (Quality Education), 5 (Gender Equality), and 10 (Reduced Inequalities). Early evidence from community reports and stakeholder interviews suggests enhanced school retention, delayed age of marriage, reduced risk of gender-based violence, and increased aspirations among younger cohorts. Importantly, the program demonstrated the power of culturally anchored, community-owned strategies in addressing entrenched gender hierarchies and improving population health outcomes.
This presentation highlights transferable insights for gender equity and public health advancement in Pacific Island contexts and other low-resource, high-vulnerability settings. It argues for the continued role of adaptive, grassroots economic empowerment in advancing GEDSI (Gender Equality, Disability, and Social Inclusion) goals within the broader scope of public health programming.
References: UN Women (2020); WHO (2018); Solomon Islands National Gender Equality and Women’s Development Policy.
Biography
Dr Mathieson is a Senior lecturer in public and environmental health at the Australian National University, Canberra. Andrew arrived (with his family) in Canberra, Australia in 2013 and received citizenship in 2018. He is a Chartered Fellow of Chartered Institute of Environmental Health, member of PHSS, Fellow of the Higher Education Academy, Fellow Royal Society of Public Health and Fellow Royal Society of Medicine (first and only EHO to have that honour). Andrew is the current president of PHAA ACT.
Andrew is passionate about teaching.
In 2010, he was appointed as a consultant for the European Union, focusing on public health, sanitary and phytosanitary measures (SPS), and monitoring and evaluation missions. HE has deployed to over 45 Countries.
Dr. Mathieson's research interests encompass a broad interpretation of environmental health, health systems monitoring and evaluation, health communication and education, strategies for removing technical barriers to trade, and food safety compliance.
Dr Tess Bright
Research Fellow
University Of Melbourne
Housing transitions of young people with disability in Australia: a descriptive analysis
Abstract
Background
Housing is currently a key issue in Australia and a critical social determinant of health, particularly for Australians with disabilities. There is a growing trend for young people to stay living in the parental home, and this has been linked to poor mental health outcomes. This study explores transitions from parental coresidence for young people with disabilities, where there is very little evidence.
Methods
This study used data from three waves of the Australian Census Longitudinal Dataset (ACLD), a 5% sample of the records from consecutive Censuses linked at the individual level. Two sets of analyses were conducted comparing two consecutive waves of ACLD data: 1) 2011 to 2016; 2) 2016 to 2021. The sample included people in the ACLD dataset aged 15-34 and living with parents in wave 1 who had complete data on disability and housing tenure variables. We describe tenure (ownership, public or private rental, or living with parents) in wave 2, comparing people with and without disabilities and according to sociodemographic characteristics.
Results
Regardless of age, sex, income, engagement in employment or education, and location (in/outside major city), young people with disabilities were less likely to become homeowners, or live in private rentals, and more likely to live in public rentals than people without disabilities. The difference was more pronounced for people with disability: aged 25-29; who lived outside major city; had personal income in highest 60%.
Conclusions
We found housing transition disadvantage for young people with disabilities. As a key social determinant of health, this is likely to have health impacts, particularly on mental health. Young people with disabilities need additional support to leave the parental home and live independently, with government policies required to assist this process in the context of the current housing affordability and cost of living crisis.
Housing is currently a key issue in Australia and a critical social determinant of health, particularly for Australians with disabilities. There is a growing trend for young people to stay living in the parental home, and this has been linked to poor mental health outcomes. This study explores transitions from parental coresidence for young people with disabilities, where there is very little evidence.
Methods
This study used data from three waves of the Australian Census Longitudinal Dataset (ACLD), a 5% sample of the records from consecutive Censuses linked at the individual level. Two sets of analyses were conducted comparing two consecutive waves of ACLD data: 1) 2011 to 2016; 2) 2016 to 2021. The sample included people in the ACLD dataset aged 15-34 and living with parents in wave 1 who had complete data on disability and housing tenure variables. We describe tenure (ownership, public or private rental, or living with parents) in wave 2, comparing people with and without disabilities and according to sociodemographic characteristics.
Results
Regardless of age, sex, income, engagement in employment or education, and location (in/outside major city), young people with disabilities were less likely to become homeowners, or live in private rentals, and more likely to live in public rentals than people without disabilities. The difference was more pronounced for people with disability: aged 25-29; who lived outside major city; had personal income in highest 60%.
Conclusions
We found housing transition disadvantage for young people with disabilities. As a key social determinant of health, this is likely to have health impacts, particularly on mental health. Young people with disabilities need additional support to leave the parental home and live independently, with government policies required to assist this process in the context of the current housing affordability and cost of living crisis.
Biography
Dr Tess Bright is a Research Fellow at the Disability and Health Unit, Melbourne School of Population and Global Health, University of Melbourne. Her current work focuses on housing and community inclusion for people with disability, with an emphasis on safe, individualised alternatives to group homes. Tess collaborates closely with people with lived experience across all stages of research and works with lived experience researchers on the NHMRC Synergy-funded Research Alliance for Youth Disability and Mental Health (RAY). She is committed to improving research practices that enable safe, inclusive, and meaningful partnerships—particularly with young people with disability.
Dr Sadia Hossain
Lecturer In Public Health
Western Sydney University
Co-designing Reproductive Health Resources with Muslim Women in NSW: WARDA Phase 1
Abstract
Background
Muslim women in Australia face reproductive health disparities due to intersecting barriers including unique demographic features, modesty concerns, migration, stigma, discrimination, distrust, and lack of culturally appropriate care. Mosques serve as vital spaces for fostering social cohesion and community engagement in Australia.[1] Community-based participatory research (CBPR)[2] and mosque-based reproductive health promotion programs[3] for Muslim women have been effective internationally but remain underexplored in Australia. Women's Awareness in ReproDuctive 'Aafiya (WARDA) aims to fill this gap by codesigning reproductive health resources. Funded by NSW Government, WARDA is based at Western Sydney University,.
Methods
WARDA employs a CBPR approach to ensure shared decision-making and relevance. Muslim women in NSW (aged 18-45 years) were invited via community channels to participate in a co-design workshop to capture perspectives on strengths and weakness of existing health resources. Data collection involved Slido facilitated discussions, surveys, and interactive ranking exercises addressing reproductive health priorities.
Results
Eight workshops engaged 91 Muslim women (mean age: 33.9 ± 8.1 years) from diverse backgrounds (born in Australia, Bangladesh, Egypt, Fiji, India, Lebanon, Malaysia, New Zealand, Pakistan, Singapore, South Africa), with 63% speaking languages other than English at home. Early findings underscore the need for culturally/religiously tailored, same-gender peer-led education in mosque setting. Participants emphasised challenges in navigating mainstream health resources, preferring community workshops, booklets, online contents, videos, webinars, accessible FAQs and culturally tailored education formats. Participants emphasised the importance of educating men on reproductive health to strengthen community-wide support and engagement. Workshop participants expressed that these conversations are rare but valued in trusted, faith-aligned spaces.
Conclusion
Strong engagement in mosque women’s spaces underscores the importance of community leadership in reproductive health communication. Next steps include refining resources, piloting learning sessions, evaluating impact, and finally creating sustainable online tools for long-term community benefit.
Reference
[1]https://doi.org/10.17645/si.v2i2.165
[2]doi: 10.1007/s11126-022-10002-x
[3]doi: 10.1177/1090198118769371
Muslim women in Australia face reproductive health disparities due to intersecting barriers including unique demographic features, modesty concerns, migration, stigma, discrimination, distrust, and lack of culturally appropriate care. Mosques serve as vital spaces for fostering social cohesion and community engagement in Australia.[1] Community-based participatory research (CBPR)[2] and mosque-based reproductive health promotion programs[3] for Muslim women have been effective internationally but remain underexplored in Australia. Women's Awareness in ReproDuctive 'Aafiya (WARDA) aims to fill this gap by codesigning reproductive health resources. Funded by NSW Government, WARDA is based at Western Sydney University,.
Methods
WARDA employs a CBPR approach to ensure shared decision-making and relevance. Muslim women in NSW (aged 18-45 years) were invited via community channels to participate in a co-design workshop to capture perspectives on strengths and weakness of existing health resources. Data collection involved Slido facilitated discussions, surveys, and interactive ranking exercises addressing reproductive health priorities.
Results
Eight workshops engaged 91 Muslim women (mean age: 33.9 ± 8.1 years) from diverse backgrounds (born in Australia, Bangladesh, Egypt, Fiji, India, Lebanon, Malaysia, New Zealand, Pakistan, Singapore, South Africa), with 63% speaking languages other than English at home. Early findings underscore the need for culturally/religiously tailored, same-gender peer-led education in mosque setting. Participants emphasised challenges in navigating mainstream health resources, preferring community workshops, booklets, online contents, videos, webinars, accessible FAQs and culturally tailored education formats. Participants emphasised the importance of educating men on reproductive health to strengthen community-wide support and engagement. Workshop participants expressed that these conversations are rare but valued in trusted, faith-aligned spaces.
Conclusion
Strong engagement in mosque women’s spaces underscores the importance of community leadership in reproductive health communication. Next steps include refining resources, piloting learning sessions, evaluating impact, and finally creating sustainable online tools for long-term community benefit.
Reference
[1]https://doi.org/10.17645/si.v2i2.165
[2]doi: 10.1007/s11126-022-10002-x
[3]doi: 10.1177/1090198118769371
Biography
Dr. Sadia Hossain, an Epidemiologist and Public Health Lecturer at Western Sydney University, earned her PhD from UNSW before relocating away from Sydney to support her family. This transition proved to be an unexpected advantage, broadening her experience across diverse public health research areas. Her work spans child health, injury prevention, family violence prevention, linked health data analysis, chronic disease, and First Nations health, reflecting her commitment to addressing critical health challenges through multidisciplinary approaches. Currently she is leading a NSW Government grant funded project Women's Awareness in Reproductive 'Aafiya (WARDA) which is a Community Based Participatory Research (CBPR) action research with and for Muslim women in NSW.
Mr Ebisa Turi Jambola
Phd Student, And Sessional Academic
Deakin University
Socioeconomic Inequality in Antenatal Care: A Multilevel Analysis via Disability Lens
Abstract
Background: Quality of antenatal care (ANC) is a cornerstone to achieving progress on maternal and child health. ANC quality has not been fully explored among women with disability (WwD). We assess socioeconomic inequalities in utilization of quality ANC among reproductive aged women with and without disability.
Methods: This study utilized Demographic and Health Survey, which is population-based survey conducted nine low-and middle-income countries (LMICs). Disability status was measured by the Washington Group Short Set questionnaires and quality of ANC was measured by a validated tool (ANCq), constructed from seven aspects of quality ANC: number of ANC, timely initiation, blood pressure measurement, blood and urine samples taken, and minimum of two doses of tetanus toxoid immunization. Wealth-related inequality in utilization of quality ANC was measured by concentration indices. Mixed-effects logistic regression fitted, and result presented in Adjusted odds ratio (AOR) with 95% confidence interval (CI).
Results: One in seven women (14.0%) had at least some difficulty in at least one domain of function. While most participants (90.3%) had at least one ANC visit, high-quality ANC was received by only 42.6% with 38.8% among WwD. Five out of seven aspects of ANCq were lower among WwD compared to WwoD. The overall receipt of high-quality ANC is pro-rich (CCI 0.27, 95% CI: 0.26-0.29), however the inequality among WwD and WwoD differs across countries. Coverage of high-quality antenatal care varied between countries, from 78.5% in Cambodia to 30.9% in Mali. The odds of receiving high-quality ANC were lower among WwD (AOR= 0.88, 95% CI: 0.83-0.94), higher for wealthier households (AOR= 2.16: 95% CI: 1.94-2.41) richest compared to poorest quintile) and lower for women facing significant barriers to healthcare (AOR=0.76, 95% CI: 0.72-0.80)
Conclusions: Despite high initial engagement, a significant portion of women, especially WwD, received lower quality ANC than recommended. These findings highlight the disadvantages faced by WwD, who have fewer ANC visits and substandard care when services are available. Regional disparities demonstrate the need for region-specific strategies. Reducing barriers to healthcare access, particularly for disadvantaged populations, are crucial steps towards achieving equitable maternal health outcomes across LMICs and achievement of SDG3.1 by 2030.
Methods: This study utilized Demographic and Health Survey, which is population-based survey conducted nine low-and middle-income countries (LMICs). Disability status was measured by the Washington Group Short Set questionnaires and quality of ANC was measured by a validated tool (ANCq), constructed from seven aspects of quality ANC: number of ANC, timely initiation, blood pressure measurement, blood and urine samples taken, and minimum of two doses of tetanus toxoid immunization. Wealth-related inequality in utilization of quality ANC was measured by concentration indices. Mixed-effects logistic regression fitted, and result presented in Adjusted odds ratio (AOR) with 95% confidence interval (CI).
Results: One in seven women (14.0%) had at least some difficulty in at least one domain of function. While most participants (90.3%) had at least one ANC visit, high-quality ANC was received by only 42.6% with 38.8% among WwD. Five out of seven aspects of ANCq were lower among WwD compared to WwoD. The overall receipt of high-quality ANC is pro-rich (CCI 0.27, 95% CI: 0.26-0.29), however the inequality among WwD and WwoD differs across countries. Coverage of high-quality antenatal care varied between countries, from 78.5% in Cambodia to 30.9% in Mali. The odds of receiving high-quality ANC were lower among WwD (AOR= 0.88, 95% CI: 0.83-0.94), higher for wealthier households (AOR= 2.16: 95% CI: 1.94-2.41) richest compared to poorest quintile) and lower for women facing significant barriers to healthcare (AOR=0.76, 95% CI: 0.72-0.80)
Conclusions: Despite high initial engagement, a significant portion of women, especially WwD, received lower quality ANC than recommended. These findings highlight the disadvantages faced by WwD, who have fewer ANC visits and substandard care when services are available. Regional disparities demonstrate the need for region-specific strategies. Reducing barriers to healthcare access, particularly for disadvantaged populations, are crucial steps towards achieving equitable maternal health outcomes across LMICs and achievement of SDG3.1 by 2030.
Biography
Ebisa is a PhD candidate in the School of Health and Social Development at Deakin University, focusing on reproductive health services for women with disabilities. His research examines the equity and level of utilization of maternal health services among women with disabilities, as well as the extent to which existing reproductive health policies and programs incorporate the core human rights of women with disabilities in low- and middle-income countries. He is passionate about maternal health services for vulnerable groups. Ebisa looks forward to sharing his findings and engaging with fellow researchers at the Australian Public health Conference 2025.
You can reach me at: s222386281@deakin.edu.au or ebakoturi@gmail.com
