Do Inequalities in Health Care Utilization in Developing Countries Change When We Take into Account Traditional Medicines?
One of the primary objectives of health system reform throughout the world is to guarantee that use of health care is as high for the poor as it is for the most affluent in society, once need is controlled for. The WHO ranks health systems according to evidence on such inequalities. However, in measuring equity in the use of health care, studies typically disregard the use of traditional medicines. Therefore, it is assumed that the failure to use modern health care is equivalent to not receiving any health care at all. Although traditional medicines are less effective than modern medicines, they have the potential to provide relief and cure and are commonly used. Using data from Ghana, this paper hypothesizes and finds evidence for reductions in inequality estimates once traditional medicines are taken into account. Further, it explores inequities in utilization of modern medicine (from public institutions, private sources, and by self) and traditional medicines (by self and through healers) and finds the former to be pro rich whereas the latter is pro poor. These figures are then decomposed into socioeconomic determinants to show nonneed factors to be significant contributors of horizontal inequity.
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- Van Ourti, Tom & van Doorslaer, Eddy & Koolman, Xander, 2009. "The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel," Journal of Health Economics, Elsevier, vol. 28(3), pages 525-539, May.
- Lu, Jui-fen R. & Leung, Gabriel M. & Kwon, Soonman & Tin, Keith Y.K. & Van Doorslaer, Eddy & O'Donnell, Owen, 2007. "Horizontal equity in health care utilization evidence from three high-income Asian economies," Social Science & Medicine, Elsevier, vol. 64(1), pages 199-212, January.
- Develay, A. & Sauerborn, R. & Diesfeld, H. J., 1996. "Utilization of health care in an African urban area: Results from a household survey in Ouagadougou, Burkina-Faso," Social Science & Medicine, Elsevier, vol. 43(11), pages 1611-1619, December.
- Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724.
- Waters, Hugh R., 2000. "Measuring equity in access to health care," Social Science & Medicine, Elsevier, vol. 51(4), pages 599-612, August.
- Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896.
- Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996.
"Quality of health care, survival and health outcomes in Ghana,"
Journal of Health Economics,
Elsevier, vol. 15(3), pages 333-357, June.
- Lavy, V & Strauss, J & Thomas, D & de Vreyer, P, 1996. "Quality of Health Care, Survivial and Health Outcomes in Ghana," Papers 96-20, RAND - Reprint Series.
- Buor, Daniel, 2004. "Gender and the utilisation of health services in the Ashanti Region, Ghana," Health Policy, Elsevier, vol. 69(3), pages 375-388, September.
- Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
- Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
- Wagstaff, Adam & Van Doorslaer, Eddy & Watanabe, Naoko, 2001. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Policy Research Working Paper Series 2714, The World Bank.
- Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
- Teresa Bago d'Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of Horizontal Inequity in Health Care Utilisation using European Panel Data," Tinbergen Institute Discussion Papers 07-059/3, Tinbergen Institute.
- Teresa Bago d’Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of horizontal inequity in health care utilisation using European Panel data," Health, Econometrics and Data Group (HEDG) Working Papers 07/17, HEDG, c/o Department of Economics, University of York.
- Asante, Augustine Danso & Zwi, Anthony Barry & Ho, Maria Theresa, 2006. "Equity in resource allocation for health: A comparative study of the Ashanti and Northern Regions of Ghana," Health Policy, Elsevier, vol. 78(2-3), pages 135-148, October.
- Leonard, Kenneth L., 2003. "African traditional healers and outcome-contingent contracts in health care," Journal of Development Economics, Elsevier, vol. 71(1), pages 1-22, June.
- Pradhan, Jalandhar & Arokiasamy, Perianayagam, 2010. "Socio-economic inequalities in child survival in India: A decomposition analysis," Health Policy, Elsevier, vol. 98(2-3), pages 114-120, December.
- Culyer, A. J. & van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Utilisation as a measure of equity by Mooney, Hall, Donaldson and Gerard," Journal of Health Economics, Elsevier, vol. 11(1), pages 93-98, May.
- Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
- Erik Schokkaert & Geert Dhaene & Carine Van De Voorde, 1998. "Risk adjustment and the trade-off between efficiency and risk selection: an application of the theory of fair compensation," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 465-480.
- Green, Edward C., 1985. "Traditional healers, mothers and childhood diarrheal disease in Swaziland: The interface of anthropology and health education," Social Science & Medicine, Elsevier, vol. 20(3), pages 277-285, January.
- Gilson, Lucy & Kalyalya, Denny & Kuchler, Felix & Lake, Sally & Oranga, Hezron & Ouendo, Marius, 2001. "Strategies for promoting equity: experience with community financing in three African countries," Health Policy, Elsevier, vol. 58(1), pages 37-67, October.
- Magnus Lindelow, 2005. "The Utilisation of Curative Healthcare in Mozambique: Does Income Matter?," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 14(3), pages 435-482, September.
- Gort, Enid, 1989. "Changing traditional medicine in rural Swaziland: The effects of the global system," Social Science & Medicine, Elsevier, vol. 29(9), pages 1099-1104, January.
- Sutton, Matthew & Carr-Hill, Roy & Gravelle, Hugh & Rice, Nigel, 1999. "Do measures of self-reported morbidity bias the estimation of the determinants of health care utilisation?," Social Science & Medicine, Elsevier, vol. 49(7), pages 867-878, October.
- van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
- Huber, Hélène, 2008. "Decomposing the causes of inequalities in health care use: A micro-simulations approach," Journal of Health Economics, Elsevier, vol. 27(6), pages 1605-1613, December.
- Hélène Huber, 2008. "Decomposing the causes of inequalities in health care use: A micro-simulations approach," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00311162, HAL.
- Onwujekwe, Obinna, 2005. "Inequities in healthcare seeking in the treatment of communicable endemic diseases in Southeast Nigeria," Social Science & Medicine, Elsevier, vol. 61(2), pages 455-463, July.
- Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
- Habtom, GebreMichael Kibreab & Ruys, Pieter, 2007. "The choice of a health care provider in Eritrea," Health Policy, Elsevier, vol. 80(1), pages 202-217, January.
- Geissler, P. W. & Nokes, K. & Prince, R. J. & Achieng' Odhiambo, R. & Aagaard-Hansen, J. & Ouma, J. H., 2000. "Children and medicines: self-treatment of common illnesses among Luo schoolchildren in western Kenya," Social Science & Medicine, Elsevier, vol. 50(12), pages 1771-1783, June.
- Alexander S. Preker & Guy Carrin, 2004. "Health Financing for Poor People : Resource Mobilization and Risk Sharing," World Bank Publications, The World Bank, number 15019.
- Onwujekwe, Obinna & Chima, Reginald & Shu, Elvis & Nwagbo, Douglas & Akpala, Cyril & Okonkwo, Paul, 2002. "Altruistic willingness to pay in community-based sales of insecticide-treated nets exists in Nigeria," Social Science & Medicine, Elsevier, vol. 54(4), pages 519-527, February.
- Mooney, Gavin & Hall, Jane & Donaldson, Cam & Gerard, Karen, 1991. "Utilisation as a measure of equity: weighing heat?," Journal of Health Economics, Elsevier, vol. 10(4), pages 475-480.
- Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
- Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656. Full references (including those not matched with items on IDEAS)
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