On the use of socioeconomic status indicators in the analysis of health inequalities and poverty in Africa

Ichoku, Hyacinth E.

doi:10.1002/jid.1697

Cited by 7 publications

(4 citation statements)

References 35 publications

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“…We identified socio-cultural resourcefulness as capturing the socio-cultural capital of the woman whose maternal health-seeking behaviour as well as additional characteristics of the household. Economic resourcefulness reflected the unobserved construct of accumulated resources available to rural households [ 31 , 32 ]. Together, they described the individual and household-level factors that are hypothesised to be associated with the process of choice related to pregnancy and delivery care [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Socio-economic factors associated with maternal health-seeking behaviours among women from poor households in rural Egypt

Beňová

Campbell

Sholkamy

et al. 2014

Int J Equity Health

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IntroductionSocio-economic inequalities in basic maternal health interventions exist in Egypt, yet little is known about health-seeking of poor households. This paper assesses levels of maternal health-seeking behaviours in women living in poor households in rural Upper Egypt, and compares these to national averages. Secondly, we construct innovative measures of socio-economic resourcefulness among the rural poor in order to examine the association between the resulting variables and the four dimensions of maternal health-seeking behaviour.MethodsWe analysed a cross-sectional survey conducted in Assiut and Sohag governorates in 2010–2011 of 2,242 women in households below the poverty line in 65 poorest villages in Egypt. The associations between four latent socio-economic constructs (socio-cultural resourcefulness, economic resourcefulness, dwelling quality and woman’s status) and receipt of any antenatal care (ANC), regular ANC (four or more visits), facility delivery and private sector delivery for women’s most recent pregnancy in five years preceding survey were assessed using multivariate logistic regression.ResultsIn the sample, 58.5% of women reported using any ANC and 51.1% facility delivery, lower than national coverage (74.2% and 72.4%, respectively). The proportion of ANC users receiving regular ANC was lower (67%) than nationally (91%). Among women delivering in facilities, 18% of women in the poor Upper Egypt sample used private providers (63% nationally). In multivariate analysis, higher economic resourcefulness was associated with higher odds of receiving ANC but with lower odds of facility delivery. Socio-cultural resourcefulness was positively associated with receiving any ANC, regular ANC and facility delivery, whereas it was not associated with private delivery care. Dwelling quality was positively associated with private delivery facility use. Woman’s status was not independently associated with any of the four behaviours.ConclusionsCoverage of basic maternal health interventions and utilisation of private providers are lower among rural poor women in Upper Egypt than nationally. Variables capturing socio-cultural resourcefulness and economic resourcefulness were useful predictors of ANC and facility delivery. Further understanding of issues surrounding availability, affordability and quality of maternal health services among the poor is crucial to eliminating inequalities in maternal health coverage in Egypt.

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Section: Discussionmentioning

confidence: 99%

Socio-economic factors associated with maternal health-seeking behaviours among women from poor households in rural Egypt

Beňová

Campbell

Sholkamy

et al. 2014

Int J Equity Health

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“…Nevertheless, data gathering on expenditure requires appropriately-designed questionnaires, trained interviewers and lengthy collection periods (Howe et al 2008). Non-monetary income may be an important constituent of the households' total income in low-and middle-income countries (Ichoku 2011) and expenditure information gathered in these settings may not be fully reliable (Howe et al 2008;Rutstein and Johnson 2004). As a result, expenditure data is rarely available in these countries (Vyas and Kumaranayake 2006).…”

Section: Literature Reviewmentioning

confidence: 99%

“…However, neither the asset-approach nor class analysis can be routinely applied to underdeveloped and developing countries. Asset indices may include valued items, but their importance and weight are likely to differ from one country to another and also over time (Ichoku 2011). While a social class schema is appropriate for countries where the majority of the working population have a contractual employment relationship, it may not be suitable for countries like Brazil with constrained labor markets and a significant share of informal, unprotected workers.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Classification of the Working-Age Brazilian Population: A Joint Latent Class Analysis Using Social Class and Asset-Based Perspectives

Caetano

Dias

2017

Soc Indic Res

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“…The study of SDH and particularly inequalities in health has generally been seen from the narrow perspective of proximate SDH and from the prism of Western culture. That culture, as one of us has argued elsewhere (9), is epistemologically empiricist in outlook. As such, it tends to ignore other nonempiricist, more hermeneutical approaches to understanding health and health care.…”

mentioning

confidence: 91%

Africanizing the Social Determinants of Health: Embedded Structural Inequalities and Current Health Outcomes in Sub-Saharan Africa

Ichoku¹,

Mooney²,

Ataguba³

2013

Int J Health Serv

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There is a growing interest in health policy in the social determinants of health. This has increased the demand for a paradigm shift within the discipline of health economics from health care economics to health economics. While the former involves what is essentially a medical model that emphasizes the maximization of individual health outcomes and considers the social organization of the health system as merely instrumental, the latter emphasizes that health and its distribution result from political, social, economic, and cultural structures. The discipline of health economics needs to refocus its energy on the social determinants of health but, in doing so, must dig deeper into the reasons for structurally embedded inequalities that give rise to inequalities in health outcomes. Especially is this the case in Africa and other low- and middle-income regions. This article seeks to provide empirical evidence from sub-Saharan Africa, including Ghana and Nigeria, on why such inequalities exist, arguing that these are in large part a product of hangovers from historically entrenched institutions. It argues that there is a need for research in health economics to embrace the social determinants of health, especially inequality, and to move away from its current mono-cultural focus.

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On the use of socioeconomic status indicators in the analysis of health inequalities and poverty in Africa

Cited by 7 publications

References 35 publications

Socio-economic factors associated with maternal health-seeking behaviours among women from poor households in rural Egypt

Socio-economic factors associated with maternal health-seeking behaviours among women from poor households in rural Egypt

Socioeconomic Classification of the Working-Age Brazilian Population: A Joint Latent Class Analysis Using Social Class and Asset-Based Perspectives

Africanizing the Social Determinants of Health: Embedded Structural Inequalities and Current Health Outcomes in Sub-Saharan Africa

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