According to a study published in the Lancet on Saturday, researchers from the University of Pelotas in Brazil tracking progress toward the Millennium Development Goals (MDGs) 4 and 5 — which promote maternal and child health — “discovered that the most equitable intervention was early initiation of breastfeeding, and that the attendance of a skilled person at birth proved to be the least equitable intervention,” Medical News Today reports. “The findings furthermore revealed that community-based interventions were more equally distributed in comparison with those delivered in health facilities,” the news service writes, noting that the “most inequitable countries of the evaluated interventions were Chad, Ethiopia, Laos, Nigeria, Niger and Somalia, followed by India, Madagascar and Pakistan, with the most equitable countries being Kyrgyzstan and Uzbekistan” (Rattue, 4/2).

In an accompanying commentary, Robert Goldenberg of the Department of Obstetrics and Gynecology at the Drexel University College of Medicine in Philadelphia, and Elizabeth McClure of the Research Triangle Institute in Research Triangle Park, North Carolina, write of the study, “Findings showed important differences in coverage for many of these interventions between countries, and differences in coverage by income level within countries.” They continue, “Dissimilarities in rates of adverse birth outcomes between the richest and poorest countries — especially the substantial differences in maternal mortality ratios — are among the greatest disparities ever recorded.” They conclude, “Policymakers can use these data and data for other disparities, such as those based on geography or racial and cultural factors, to better understand factors contributing to adverse pregnancy outcomes and to allocate resources to reduce within-country disparities” (3/31).