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The role of private providers in treating child diarrhoea in Latin America

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Author Info

  • Hugh R. Waters

    (Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA)

  • Laurel E. Hatt

    (Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA)

  • Robert E. Black

    (Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA)

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    Abstract

    Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries - where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001). However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available. Copyright © 2007 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1239
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 17 (2008)
    Issue (Month): 1 ()
    Pages: 21-29

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    Handle: RePEc:wly:hlthec:v:17:y:2008:i:1:p:21-29

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Smith, Richard J & Blundell, Richard W, 1986. "An Exogeneity Test for a Simultaneous Equation Tobit Model with an Application to Labor Supply," Econometrica, Econometric Society, vol. 54(3), pages 679-85, May.
    2. Goldman, Noreen & Pebley, Anne R. & Gragnolati, Michele, 2002. "Choices about treatment for ARI and diarrhea in rural Guatemala," Social Science & Medicine, Elsevier, vol. 55(10), pages 1693-1712, November.
    3. Kenneth Bollen & David Guilkey & Thomas Mroz, 1995. "Binary outcomes and endogenous explanatory variables: Tests and solutions with an application to the demand for contraceptive use in tunisia," Demography, Springer, vol. 32(1), pages 111-131, February.
    4. Igun, U.A., 1994. "Reported and actual prescription of oral rehydration therapy for childhood diarrhoeas by retail pharmacists in Nigeria," Social Science & Medicine, Elsevier, vol. 39(6), pages 797-806, September.
    5. Glewwe, P. & Van Der Gaag, J., 1988. "Confronting Poverty In Developing Countries -," Papers 48, World Bank - Living Standards Measurement.
    6. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
    7. O'Higgins, Niall, 1994. "YTS, Employment, and Sample Selection Bias," Oxford Economic Papers, Oxford University Press, vol. 46(4), pages 605-28, October.
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    Cited by:
    1. Arrieta, Alejandro & García-Prado, Ariadna & Guillén, Jorge, 2011. "The Private Health Care Sector and the Provision of Prenatal Care Services in Latin America," World Development, Elsevier, vol. 39(4), pages 579-587, April.

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