Health care demand in rural Mozambique
Despite rapid economic growth in recent years, Mozambique remains a very poor country. Expenditure-based poverty measures are reflected in widespread food insecurity and poor health status. In recognition of these problems, the Government of Mozambique is promoting expanded and improved quality and equity in access to health care as an important component in the global strategy to fight poverty. Given years of colonial neglect and systematic destruction of health facilities during the civil war, recent government policy has focused on expanding the rural health network. However, insofar as the ultimate objective of the provision of curative services is to ensure that those in need of care receive effective treatment, it is also necessary to think beyond supply. Specifically, we need to consider how individuals behave during episodes of illness, and what factors affect this behavior. This paper provides quantitative evidence on the importance of individual, household, and community characteristics on individuals' care-seeking decisions during episodes of illness. The paper estimates a “flexible” multinomial model of health care provider choice conditional on illness using data from the 1996/97 Mozambique National Household Survey on Living Conditions (IAF). The empirical analysis is underpinned by a basic theoretical framework of utility maximization and household production of health. A number of individual and household characteristics, e.g., age, education, and reported symptoms, stand out as highly significant determinants of health seeking behavior. Also, prices, defined in the model as the composite of user fees and time costs associated with consultations at different providers, are found to be important determinants of choice. The results indicate that the eradication of poverty, independent of improvements in physical access to health care and education, will have only a negligible effect on health care choices.
|Date of creation:||2002|
|Date of revision:|
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- Gertler, Paul J. & Hammer, Jeffrey S., 1997. "Strategies for pricing publicly provided health services," Policy Research Working Paper Series 1762, The World Bank.
- Schultz, T. Paul & Tansel, Aysit, 1997.
"Wage and labor supply effects of illness in Cote d'Ivoire and Ghana: instrumental variable estimates for days disabled,"
Journal of Development Economics,
Elsevier, vol. 53(2), pages 251-286, August.
- Schultz, T-P, 1996. "Wage and Labor Supply effects of Illness in Cote d'Ivoire and Ghana : Instrumental Variable Estimates for Days Disabled," Papers 757, Yale - Economic Growth Center.
- James J. Heckman, 1976. "The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models," NBER Chapters, in: Annals of Economic and Social Measurement, Volume 5, number 4, pages 475-492 National Bureau of Economic Research, Inc.
- McFadden, Daniel L., 1984. "Econometric analysis of qualitative response models," Handbook of Econometrics, in: Z. Griliches† & M. D. Intriligator (ed.), Handbook of Econometrics, edition 1, volume 2, chapter 24, pages 1395-1457 Elsevier.
- Hausman, Jerry & McFadden, Daniel, 1984.
"Specification Tests for the Multinomial Logit Model,"
Econometric Society, vol. 52(5), pages 1219-40, September.
- D. McFadden & J. Hausman, 1981. "Specification Tests for the Multinominal Logit Model," Working papers 292, Massachusetts Institute of Technology (MIT), Department of Economics.
- Litvack, Jennie I. & Bodart, Claude, 1993. "User fees plus quality equals improved access to health care: Results of a field experiment in Cameroon," Social Science & Medicine, Elsevier, vol. 37(3), pages 369-383, August.
- Acton, Jan Paul, 1975. "Nonmonetary Factors in the Demand for Medical Services: Some Empirical Evidence," Journal of Political Economy, University of Chicago Press, vol. 83(3), pages 595-614, June.
- Filmer, Deon & Hammer, Jeffrey & Pritchett, Lant, 1998. "Health policy in poor countries : weak links in the chain," Policy Research Working Paper Series 1874, The World Bank.
- Paul J. Gertler & Luis Locay & Warren C. Sanderson, 1987.
"Are User Fees Regressive? The Welfare Implications of Health Care Financing Proposals in Peru,"
NBER Working Papers
2299, National Bureau of Economic Research, Inc.
- Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
- Akin, John S, et al, 1986. "The Demand for Primary Health Care Services in the Bicol Region of the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 34(4), pages 755-82, July.
- Bouis, Howarth E., 1994. "Agricultural technology and food policy to combat iron deficiency in developing countries," FCND discussion papers 1, International Food Policy Research Institute (IFPRI).
- Pollak, Robert A & Wachter, Michael L, 1975. "The Relevance of the Household Production Function and Its Implications for the Allocation of Time," Journal of Political Economy, University of Chicago Press, vol. 83(2), pages 255-77, April.
- Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711 Elsevier.
- Germano Mwabu & Martha Ainsworth & Andrew Nyamete, 1993. "Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 28(4), pages 838-862.
- Victor Lavy and John M. Quigley., 1991.
"Willingness to Pay for the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana,"
Economics Working Papers
91-178, University of California at Berkeley.
- Lavy, Victor & Quigley, John M., 1991. "Willingness to Pay for the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana," Department of Economics, Working Paper Series qt4p02g6nq, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
- Lavy, Victor & Quigley, John M., 1991. "Willingness to Pay For the Quality and Intensity of Medical Care: Evidence from Low Income Households in Ghana," Berkeley Program on Housing and Urban Policy, Working Paper Series qt8237c6g3, Berkeley Program on Housing and Urban Policy.
- Datt, Gaurav & Simler, Kenneth & Mukherjee, Sanjukta & Dava, Gabriel, 2000. "Determinants of poverty in Mozambique (1996-97)," FCND discussion papers 78, International Food Policy Research Institute (IFPRI).
- Small, Kenneth A & Hsiao, Cheng, 1985. "Multinomial Logit Specification Tests," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 26(3), pages 619-27, October.
- John S. Akin & David K. Guilkey & Paul L. Hutchinson & Michael T. Mcintosh, 1998. "Price elasticities of demand for curative health care with control for sample selectivity on endogenous illness: an analysis for Sri Lanka," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 509-531.
- Wolfe, Barbara L & Behrman, Jere R, 1984. "Determinants of Women's Health Status and Health-Care Utilization in a Developing Country: A Latent Variable Approach," The Review of Economics and Statistics, MIT Press, vol. 66(4), pages 696-703, November.
- Akin, John S. & Guilkey, David K. & Hazel?Denton, E., 1995. "Quality of services and demand for health care in Nigeria: A multinomial probit estimation," Social Science & Medicine, Elsevier, vol. 40(11), pages 1527-1537, June.
- Alderman, Harold & Lavy, Victor, 1996. "Household Responses to Public Health Services: Cost and Quality Tradeoffs," World Bank Research Observer, World Bank Group, vol. 11(1), pages 3-22, February.
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