Evaluation of the effectiveness and equity of the maternity protection reform in Chile from 2000 to 2015

English version

Autoři: Iris Delgado ^aff001; Baltica Cabieses ^aff002; Mauricio Apablaza ^aff003; Carla Castillo ^aff001; Ximena Aguilera ^aff001; Isabel Matute ^aff001; Manuel Najera ^aff001; Juan M. Pericàs ^aff004; Joan Benach ^aff004
Působiště autorů: Centro de Epidemiología y Políticas de Salud, CEPS, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile ^aff001; Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, ICIM, Universidad del Desarrollo, Santiago, Chile ^aff002; Centro de Políticas Públicas, Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile ^aff003; Grupo Desigualdades en Salud (GREDS-EMCONET), Departamento Ciencias Políticas y Sociales, Universitat Pompeu Fabra, Barcelona, España ^aff004; JHU-UPF Public Policy Center, Universitat Pompeu Fabra, Barcelona, España ^aff005; Grupo de Investigación Transdisciplinar sobre Transiciones Socioecológicas (GinTRANS2), Universidad Autónoma de Madrid, Madrid, España ^aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0221150

Souhrn

Introduction

According to the International Labor Organization, Maternity Protection (MP) policies try to harmonize child care and women's paid work, without affecting family health and economic security. Chile Law 20.545 (2011) increased benefits for economically active women and reduced requirements for accessing these benefits. The goals of the reform included: 1) to increase MP coverage; and 2) to reduce inequities in access to the benefits.

Method

This study uses two data sources. First, using individual data routinely collected from 2000 to 2015, yearly MP coverage access over time was calculated. Second, using national representative household surveys collected before and after the Law (2009 and 2013), coverage and a set of measures of inequality were estimated. To compare changes over time, we used non-experimental, before-after intervention design for independent samples. For each variable, we estimated comparative proportions at 95% confidence interval before and after the intervention. Additionally, we included multivariate and propensity score analysis.

Results

Between 2000 and 2015, MP coverage grew from 24.4% to 44.8%. Using comparable 2009 and 2013 survey data, we observed the same trend, with 31.6% of estimated MP coverage in 2009, escalating to 39.5% in 2013. We conclude that: 1) after the reform, there was an increase in MP coverage; and, 2) there was no significant reduction of inequities in the distribution of MP benefits.

Discussion/Conclusion

Few scientific evaluations of MP reforms have been conducted worldwide; even fewer including an equity analysis. This study provides an empirically-based evaluation of MP reform from both a population-level and an equity-focused perspective. We conclude that this reform needs to be complemented with other policies to ensure maternity protection in terms of access and equity in a country with deep socioeconomic stratification.

Klíčová slova:

People and places – Population groupings – Families – Mothers – Geographical locations – South America – Chile (country) – Medicine and health sciences – Health care – Health care policy – Child and adolescent health policy – Public and occupational health – Socioeconomic aspects of health – Women's health – Maternal health – Pregnancy – Obstetrics and gynecology – Social sciences – Sociology – Education – Educational attainment – Economics – Labor economics – Employment – Ecology and environmental sciences – Conservation science

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Evaluation of the effectiveness and equity of the maternity protection reform in Chile from 2000 to 2015

Souhrn

Introduction

Method

Results

Discussion/Conclusion

Klíčová slova:

Zdroje

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