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On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam

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  • Wagstaff, Adam
  • Van Doorslaer, Eddy
  • Watanabe, Naoko

Abstract

The authors propose a method for decomposing inequalities in the health sector into their causes, by coupling the concentration index with a regression framework. They also show how changes in inequality over time, and differences across countries, can be decomposed into the following: Changes due to changing inequalities in the determinants of the variable of interest. Changes in the means of the determinants. Changes in the effects of the determinants o the variable of interest. The authors illustrate the method using data on child malnutrition in Vietnam. They find that inequalities in height-for-age in 1993 and 1998 are accounted for largely by inequalities in household consumption and by unobserved influences at the commune level. And they find that an increase in such inequalities is accounted for largely by changes in these two influences. In the case of household consumption, rising inequalities play a part, but more important have been the inequality-increasing effects of rising average consumption and the increased protective effect of consumption on nutritional status. In the case of unobserved commune-level influences, rising inequality and general improvements seem to have been roughly equally important in accounting for rising inequality in malnutrition.

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Bibliographic Info

Paper provided by The World Bank in its series Policy Research Working Paper Series with number 2714.

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Date of creation: 30 Nov 2001
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Handle: RePEc:wbk:wbrwps:2714

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Keywords: Environmental Economics&Policies; Public Health Promotion; Health Monitoring&Evaluation; Early Child and Children's Health; Disease Control&Prevention; Health Monitoring&Evaluation; Inequality; Regional Rural Development; Environmental Economics&Policies; Early Child and Children's Health;

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  1. Thomas, Duncan & Lavy, Victor & Strauss, John, 1996. "Public policy and anthropometric outcomes in the Cote d'Ivoire," Journal of Public Economics, Elsevier, Elsevier, vol. 61(2), pages 155-192, August.
  2. Wagstaff, Adam & Watanabe, Naoko, 2000. "Socioeconomic inequalities in child malnutrition in the developing world," Policy Research Working Paper Series 2434, The World Bank.
  3. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, Elsevier, vol. 33(5), pages 545-557, January.
  4. David E. Sahn & Stephen D. Younger, 2000. "Expenditure incidence in Africa: microeconomic evidence," Fiscal Studies, Institute for Fiscal Studies, Institute for Fiscal Studies, vol. 21(3), pages 329-347, September.
  5. Castro-Leal, Florencia & Dayton, Julia & Demery, Lionel & Mehra, Kalpana, 1999. "Public Social Spending in Africa: Do the Poor Benefit?," World Bank Research Observer, World Bank Group, World Bank Group, vol. 14(1), pages 49-72, February.
  6. Lavy, V & Strauss, J & Thomas, D & de Vreyer, P, 1996. "Quality of Health Care, Survivial and Health Outcomes in Ghana," Papers, RAND - Reprint Series 96-20, RAND - Reprint Series.
  7. Paul Contoyannis & Martin Forster, 1999. "'Our healthier nation'?," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 289-296.
  8. Podder, Nripesh, 1993. "The Disaggregation of the Gini Coefficient by Factor Components and Its Applications to Australia," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 39(1), pages 51-61, March.
  9. Shorrocks, Anthony F, 1983. "Ranking Income Distributions," Economica, London School of Economics and Political Science, London School of Economics and Political Science, vol. 50(197), pages 3-17, February.
  10. Wagstaff, Adam & Nga Nguyet Nguyen, 2002. "Poverty and survival prospects of Vietnamese children under Doi Moi," Policy Research Working Paper Series 2832, The World Bank.
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