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

Listed author(s):
  • 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)

Registered author(s):

    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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    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
    DOI: 10.1002/hec.1239
    Contact details of provider: Web page:

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    1. Glewwe, P. & Van Der Gaag, J., 1988. "Confronting Poverty In Developing Countries -," Papers 48, World Bank - Living Standards Measurement.
    2. 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 679-685, May.
    3. Russell, Steven, 2005. "Treatment-seeking behaviour in urban Sri Lanka: Trusting the state, trusting private providers," Social Science & Medicine, Elsevier, vol. 61(7), pages 1396-1407, October.
    4. 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.
    5. Langsten, Ray & Hill, Kenneth, 1995. "Treatment of childhood diarrhea in rural Egypt," Social Science & Medicine, Elsevier, vol. 40(7), pages 989-1001, April.
    6. O'Higgins, Niall, 1994. "YTS, Employment, and Sample Selection Bias," Oxford Economic Papers, Oxford University Press, vol. 46(4), pages 605-628, October.
    7. 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;Population Association of America (PAA), vol. 32(1), pages 111-131, February.
    8. 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.
    9. 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.
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