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Availability and inequality in accessibility of health centre-based primary healthcare in Ethiopia

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  • Abraha Woldemichael
  • Amirhossein Takian
  • Ali Akbari Sari
  • Alireza Olyaeemanesh

Abstract

Background: Achieving fair access to healthcare and improving population health are crucial in all settings. Properly staffed and fairly distributed primary health care (PHC) facilities are prerequisites to ensure accessible healthcare services. Nevertheless, availability and accessibility issues are common public health concerns, especially in under-resourced countries including Ethiopia. Measuring inequalities in accessibility of healthcare resources guide policy decisions to improve PHC services and ultimately achieving universal health coverage (UHC). Purpose: To assess availability and measure magnitude and trend of inequalities in accessibility of health centre-based PHC resources in Ethiopia during 2015 to 2017. Methods: We conducted a cross-sectional population-based analysis of district-level data collected from 16th December 2017 until 24th May 2018. Afar, Dire-Dawa, and Tigray regions were purposefully included in the study to represent the four pastoralist/semi-pastoralist, three urban and four agrarian regions in Ethiopia, respectively. We used ratios, different inequality indices and Gini decomposition techniques to characterise the inequalities. Results: In 2017, median of health centres (HCs) per 15,000 inhabitants and their Gini indices (GIs) for Afar, Dire-Dawa, and Tigray were 0.781, 0.566, 0.591 vs. 0.237, 0.280, 0.216 respectively. Median overall skilled health workers (SHWs) per 10,000 inhabitants were 5.250, 7.539, and 6.246, respectively. These accounted for 11.80%, 16.94% and 14.04% of the WHO target of 44.5 to achieve SDGs. The corresponding GIs for the regions were 0.347, 0.186 and 0.175. Despite a higher overall SHWs inequality in the urban districts of Tigray (GI = 0.301), only Tigray showed significant inequality reductions in GHE (p

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  • Abraha Woldemichael & Amirhossein Takian & Ali Akbari Sari & Alireza Olyaeemanesh, 2019. "Availability and inequality in accessibility of health centre-based primary healthcare in Ethiopia," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    • Handle: RePEc:plo:pone00:0213896
    DOI: 10.1371/journal.pone.0213896
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    References listed on IDEAS

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    1. Yi Tao & Kizito Henry & Qinpei Zou & Xiaoni Zhong, 2014. "Methods for measuring horizontal equity in health resource allocation: a comparative study," Health Economics Review, Springer, vol. 4(1), pages 1-10, December.
    2. Marc J. Epstein & Eric G. Bing, 2011. "Delivering Health Care to the Global Poor: Solving the Accessibility Problem," Innovations: Technology, Governance, Globalization, MIT Press, vol. 6(2), pages 117-141, April.
    3. Joan Costa‐Font & Jordi Pons‐Novell, 2007. "Public health expenditure and spatial interactions in a decentralized national health system," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 291-306, March.
    4. Brigit Obrist & Nelly Iteba & Christian Lengeler & Ahmed Makemba & Christopher Mshana & Rose Nathan & Sandra Alba & Angel Dillip & Manuel W Hetzel & Iddy Mayumana & Alexander Schulze & Hassan Mshinda, 2007. "Access to Health Care in Contexts of Livelihood Insecurity: A Framework for Analysis and Action," PLOS Medicine, Public Library of Science, vol. 4(10), pages 1-5, October.
    5. Karen Lucas & Bert Wee & Kees Maat, 2016. "A method to evaluate equitable accessibility: combining ethical theories and accessibility-based approaches," Transportation, Springer, vol. 43(3), pages 473-490, May.
    6. repec:ebl:ecbull:v:4:y:2003:i:7:p:1-6 is not listed on IDEAS
    7. Anthony Shorrocks & Guanghua Wan, 2005. "Spatial decomposition of inequality," Journal of Economic Geography, Oxford University Press, vol. 5(1), pages 59-81, January.
    8. Stéphane Mussard & Michel Terraza & Françoise Seyte, 2003. "Decomposition of Gini and the generalized entropy inequality measures," Economics Bulletin, AccessEcon, vol. 4(7), pages 1-6.
    9. Stephen P. Jenkins & Philippe Van Kerm, 2009. "Decomposition of inequality change into pro-poor growth and mobility components: -dsginideco-," United Kingdom Stata Users' Group Meetings 2009 11, Stata Users Group.
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    1. Alberto Posso & Udeni De Silva Perera & Ankita Mishra, 2021. "Community‐level health programs and child labor: Evidence from Ethiopia," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 2995-3015, December.
    2. Habtamu Kehali & Yemane Berhane & Addisu Gize, 2020. "A phenomenological study on the lived experiences of families of ICU patients, Addis Ababa, Ethiopia," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-17, December.

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