IDEAS home Printed from https://ideas.repec.org/p/hal/wpaper/hal-04244704.html
   My bibliography  Save this paper

Benevolent Doctors ? Inequity in Healthcare Access in post-soviet Tajikistan

Author

Listed:
  • Sandra Pellet

    (Legos - Laboratoire d'Economie et de Gestion des Organisations de Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

Abstract

After the collapse of USSR, Tajikistan overcame a devastating civil war (1992- 1997). Already under-financed at the end of the Soviet Union, the healthcare system has been severely damaged. Tajikistan has an officially universal and free access to healthcare, inherited from socialism. But after the collapse, the universality was no longer sustainable. The State allowed some facilities to charge fees according to a price list (like laboratory tests), and the habit of "thanking" the doctor has been generalized, due to the low wage of medical staff. Therefore, the debate in post-soviet studies is acute in Tajikistan. Does the out-of-pocket expenditure increase inequality, or is there an informal redistributive system due to the price-differentiation conducted by benevolent doctors? By means of innovative tools (Kakwani Progressivity Index, decomposition of concentration index), this paper measures the vertical equity in financing and the horizontal equity in access, to test the "Robin Hood" hypothesis, based on the nationally representative Tajik Living Standards Survey (2007). The main result is that the "progressivity" in financing is illusory and reflects rather the horizontal inequity in access to care, than the benevolence of doctors.

Suggested Citation

  • Sandra Pellet, 2023. "Benevolent Doctors ? Inequity in Healthcare Access in post-soviet Tajikistan," Working Papers hal-04244704, HAL.
    • Handle: RePEc:hal:wpaper:hal-04244704
    Note: View the original document on HAL open archive server: https://hal.science/hal-04244704
    as

    Download full text from publisher

    File URL: https://hal.science/hal-04244704/document
    Download Restriction: no
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hal:wpaper:hal-04244704. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: CCSD (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.