SDG3-related inequalities in women?s, children?s and adolescents? health: an SDG monitoring baseline for Latin America and the Caribbean using national cross-sectional surveys

Objectives. Latin America and the Caribbean (LAC) countries have made important progress towards achie-ving the Sustainable Development Goal (SDG) targets related to health (SDG3) at the national level. However, vast within-country health inequalities remain. We present a baseline of health inequalities in the region, against which progress towards the SDGs can be monitored. Setting. We studied 21 countries in LAC using data from Demographic and Health Surveys and Multiple Indi-cator Cluster Survey carried out from 2011 to 2016. Participants. The surveys collect nationally representative data on women and children using multistage sam-pling. In total, 288 207 women and 195 092 children made part of the surveys in the 21 countries. Outcome measures. Five health intervention indicators were studied, related to reproductive and maternal health, along with adolescent fertility and neonatal and under-five mortality rates. Inequalities in these indica-tors were assessed through absolute and relative measures. Results. In most countries, subnational geographical health gradients were observed for nearly all women, child, and adolescent (WCA) indicators. Coverage of key interventions was higher in urban areas and among the richest, compared with rural areas and poorer quintiles. Analyses by woman???s age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequa-lities were also seen for mortality in most countries. Conclusions. Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children and adolescents. To achieve the SDG3 tar-gets and leave no one behind, it is essential to close health inequality gaps within as well as between countries.