Wealth-based inequalities in family planning and perinatal coverage among adolescent and young women: analyses of national surveys from Latin America and the Caribbean.

Background: This study aims to describe the coverage of key family planning (FP) and perinatal health indicators and to measure the associated social inequalities among adolescent and young women in the Latin American and Caribbean (LAC) region. Methods: Nationally representative data from 20 LAC countries were analyzed using Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2011 and 2016. Data were disaggregated by age group (15-19 and 20-24 years). Coverage was estimated for six key indicators, including FP, antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). Socioeconomic inequalities in coverage were assessed using the Slope Index of Inequality (SII) and the Concentration Index (CIX). Findings: Around 2015, median national coverage exceeded 90% for most ANC and PNC indicators, except for ANC with four or more visits and FP. Among adolescents, ANC coverage ranged from 44.6% in Uruguay (95% CI: 13.6-80.4) to 99.2% in Cuba (97.9-99.7); FP coverage was lowest in Guyana (16.7%, 11.7-23.3) and Haiti (28.7%, 22.7-35.6). Significant pro-rich inequalities were observed. The widest inequalities were observed, for ANC in Panama (SII = 46.5) and Haiti (SII = 48.8); for ANC quality in Guatemala (SII = 61.1); for SBA in Panama (SII = 90.0), and for FP inequalities in Guatemala (SII = 33.0). Interpretation: Adolescents and young women in LAC face persistent and unequal coverage of FP and perinatal services. These baseline findings underscore the urgent need for youth-friendly, equity-focused interventions to meet SDG targets. Funding: No direct funding was received.