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Understanding Inequalities in Child Health in Ethiopia: Health Achievements Are Improving in the Period 2000–2011

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  • Eirin Krüger Skaftun
  • Merima Ali
  • Ole Frithjof Norheim

Abstract

Objective: In Ethiopia, coverage of key health services is low, and community based services have been implemented to improve access to key services. This study aims to describe and assess the level and the distribution of health outcomes and coverage for key services in Ethiopia, and their association with socioeconomic and geographic determinants. Methods: Data were obtained from the 2000, 2005 and 2011 Ethiopian Demographic and Health Surveys. As indicators of access to health care, the following variables were included: Under-five and neonatal deaths, skilled birth attendance, coverage of vaccinations, oral rehydration therapy for diarrhoea, and antibiotics for suspected pneumonia. For each of the indicators in 2011, inequality was described by estimating their concentration index and a geographic Gini index. For further assessment of the inequalities, the concentration indices were decomposed. An index of health achievement, integrating mean coverage and the distribution of coverage, was estimated. Changes from 2000 to 2011 in coverage, inequality and health achievement were assessed. Results: Significant pro-rich inequalities were found for all indicators except treatment for suspected pneumonia in 2011. The geographic Gini index showed significant regional inequality for most indicators. The decomposition of the 2011 concentration indices revealed that the factor contributing the most to the observed inequalities was different levels of wealth. The mean of all indicators improved from 2000 to 2011, and the health achievement index improved for most indicators. The socioeconomic inequalities seem to increase from 2000 to 2011 for under-five and neonatal deaths, whereas they are stable or decreasing for the other indicators. Conclusion: There is an unequal socioeconomic and geographic distribution of health and access to key services in Ethiopia. Although the health achievement indices improved for most indicators from 2000 to 2011, socioeconomic determinants need to be addressed in order to achieve better and more fairly distributed health.

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  • Eirin Krüger Skaftun & Merima Ali & Ole Frithjof Norheim, 2014. "Understanding Inequalities in Child Health in Ethiopia: Health Achievements Are Improving in the Period 2000–2011," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-10, August.
    • Handle: RePEc:plo:pone00:0106460
    DOI: 10.1371/journal.pone.0106460
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    References listed on IDEAS

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    Cited by:

    1. Gebretsadik Shibre & Dina Idriss-Wheeler & Sanni Yaya, 2020. "Inequalities and trends in Neonatal Mortality Rate (NMR) in Ethiopia: Evidence from the Ethiopia Demographic and Health Surveys, 2000–2016," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-10, June.
    2. Atakelti Abraha & Anna Myléus & Peter Byass & Asmelash Kahsay & John Kinsman, 2019. "Social determinants of under-5 child health: A qualitative study in Wolkayit Woreda, Tigray Region, Ethiopia," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-16, June.
    3. Netsanet Fetene & Erika Linnander & Binyam Fekadu & Hibret Alemu & Halima Omer & Maureen Canavan & Janna Smith & Peter Berman & Elizabeth Bradley, 2016. "The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters?," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-19, May.

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