Socioeconomic Inequalities in Access to Health Care: Examining the Case of Burkina Faso

Okolo, Chukwumezie O.; Reidpath, Daniel D.; Allotey, Pascale

doi:10.1353/hpu.2011.0039

Cited by 14 publications

(13 citation statements)

References 86 publications

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“…This is consistent with studies of Nigerian widows reporting many symptoms as well as financial hardship and poor support (Ogungbamila & Adeyanju, 2010; Onadeko et al, 2002). Overall, in an urban setting with proximity to health care, our findings suggest that despite strong cultural norms of interpersonal assistance and support, finances may play a stronger role than social factors in determining therapeutic trajectories (Abor et al, 2011; Ahmed et al, 2010; Okolo et al, 2011; Peters et al, 2008). …”

Section: Discussionmentioning

confidence: 73%

Women's health in urban Mali: Social predictors and health itineraries

Bove

Vala-Haynes

Valeggia

2012

Social Science & Medicine

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Social and marital factors may influence women's health outcomes. This is of particular relevance in sub-Saharan Africa, where women's health indicators lag behind the rest of the world. Our study examines the impact of social mediators of women's health during key events (pregnancy and illness) in urban Mali. In this cross-sectional study, we interviewed 324 women aged 15-80, living in Bamako, the capital city, in 1999. We used mixed quantitative and qualitative methods to obtain detailed histories of pregnancy and illness during specific time periods preceding the survey. We examined the role of marital factors (polygyny, widowhood), social factors (sources of support and scales derived for social network and social power), and household wealth on women's therapeutic itineraries. We compared the sociodemographic characteristics of our sample with those of the 2001 Mali Demographic and Health Survey and used their data on contraception to enrich analyses. We found that most pregnant women delivered in a health center and most women sought medical care during an illness event. Household wealth influenced illness reporting, and financial concerns were obstacles to medical care. Polygyny was associated with lower prevalence of contraceptive use, lower social power, as well as with less support received during pregnancy from women's husbands and in-laws. Widowhood appeared to increase susceptibility to illness, while decreasing resort to biomedical care. Our social composite scores highlighted differences in healthcare utilization in an urban setting with near-uniform access to biomedical care. We validate the utility of locally-derived composite scores, which may provide a deeper understanding into the social mediation of health outcomes for women.

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Section: Discussionmentioning

confidence: 73%

Women's health in urban Mali: Social predictors and health itineraries

Bove

Vala-Haynes

Valeggia

2012

Social Science & Medicine

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“…2. The headcount ratio and the catastrophic overshoot measure were calculated through two common approaches, the WHO researchers’ ( 1 ) and other approaches ( 6 , 7 , 9 , 28 - 30 ). According to WHO if out-of-pocket payment for health is equal or more than 40% of the capacity to pay, then the household faces catastrophic expenditure.…”

Section: Methodsmentioning

confidence: 99%

“…The accessibility and utilization of health services requires resources and facilities which first, are produced in sufficient levels and second, are distributed among sections of the society in an equitable way ( 1 , 2 ). Today, the idea that health is a merit good that everyone should have access to it, is approved by all scholars and policy makers; therefore, the only difference exists just about the method of sufficient and equitable provision ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…The thresholds in catastrophic health expenditure are different regarding the considered socio-economic variables. The World Health Organization (WHO) researchers defined the households’ payments on health equal or greater than 0.4 as the catastrophic health expenditure, while other researchers use the 10%, 20% and 30% of total consumption or nonfood expenditures as catastrophic health expenditure ( 1 , 6 - 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Catastrophic Health Expenditure Among Iranian Rural and Urban Households, 2013 - 2014

Ghiasvand

Gorji

Maleki

et al. 2015

Iran Red Crescent Med J

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Background:During the last two decades, the trend of out-of-pocket payments (OOP) for health services by Iranian households has been a matter of concern and it has exposed a significant proportion of them to catastrophic and impoverishing health expenditures.Objectives:The current study aimed to investigate three objectives: First, the mean of out-of-pocket payments among Iranian households for health services; second, the headcount and overshoot measures of catastrophic health expenditure; and finally the level of inequality in its distribution.Materials and Methods:This descriptive study on Iranian rural and urban households was conducted from April to June 2015. The sample sizes were 19437 rural and 18888 urban households that Iranian Statistical Centre (ISC) selected them through a three -step randomized clustered sampling. The headcount and overshoot measures for catastrophic health expenditure were calculated. Also, the concentration index was calculated in order to investigate the inequality in distribution of the mentioned measures.Results:The catastrophic health expenditure headcount ratio varied from 0.5% to 14.3% and from 0.48% to 13.27% for rural and urban households, respectively. Also, the overshoot of catastrophic health expenditure varied from 9.62% to 18.72% and from 8.8% to 17.74% for rural and urban households, respectively.Conclusions:Considering Iran’s economic condition during the last five years, the catastrophic health expenditure headcount ratio was more than 2% in Iran.

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“…The PCA approach was famously, although not first described by Filmer and Pritchett [17] and was adopted by the HNP/Poverty Thematic Group of the World Bank as a standard technique in their poverty and equity analyses covering 44 countries; (cf[23-25]). PCA is the approach taken in the DHS Wealth Index; [26] and it remains a common tool in health research today [7,27,28]. The PCA approach in wealth measurement has its early development in the recognition that multiple measures of wealth create analytic problems associated with collinearity, and PCA offers an efficient data reduction technique to extract orthogonal dimensions [29].…”

Section: Introductionmentioning

confidence: 99%

A novel nonparametric item response theory approach to measuring socioeconomic position: a comparison using household expenditure data from a Vietnam health survey, 2003

Reidpath

Ahmadi

2014

Emerg Themes Epidemiol

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BackgroundMeasures of household socio-economic position (SEP) are widely used in health research. There exist a number of approaches to their measurement, with Principal Components Analysis (PCA) applied to a basket of household assets being one of the most common. PCA, however, carries a number of assumptions about the distribution of the data which may be untenable, and alternative, non-parametric, approaches may be preferred. Mokken scale analysis is a non-parametric, item response theory approach to scale development which appears never to have been applied to household asset data. A Mokken scale can be used to rank order items (measures of wealth) as well as households. Using data on household asset ownership from a national sample of 4,154 consenting households in the World Health Survey from Vietnam, 2003, we construct two measures of household SEP. Seventeen items asking about assets, and utility and infrastructure use were used. Mokken Scaling and PCA were applied to the data. A single item measure of total household expenditure is used as a point of contrast.ResultsAn 11 item scale, out of the 17 items, was identified that conformed to the assumptions of a Mokken Scale. All the items in the scale were identified as strong items (Hi > .5). Two PCA measures of SEP were developed as a point of contrast. One PCA measure was developed using all 17 available asset items, the other used the reduced set of 11 items identified in the Mokken scale analaysis. The Mokken Scale measure of SEP and the 17 item PCA measure had a very high correlation (r = .98), and they both correlated moderately with total household expenditure: r = .59 and r = .57 respectively. In contrast the 11 item PCA measure correlated moderately with the Mokken scale (r = .68), and weakly with the total household expenditure (r = .18).ConclusionThe Mokken scale measure of household SEP performed at least as well as PCA, and outperformed the PCA measure developed with the 11 items used in the Mokken scale. Unlike PCA, Mokken scaling carries no assumptions about the underlying shape of the distribution of the data, and can be used simultaneous to order household SEP and items. The approach, however, has not been tested with data from other countries and remains an interesting, but under researched approach.

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Socioeconomic Inequalities in Access to Health Care: Examining the Case of Burkina Faso

Cited by 14 publications

References 86 publications

Women's health in urban Mali: Social predictors and health itineraries

Women's health in urban Mali: Social predictors and health itineraries

Catastrophic Health Expenditure Among Iranian Rural and Urban Households, 2013 - 2014

A novel nonparametric item response theory approach to measuring socioeconomic position: a comparison using household expenditure data from a Vietnam health survey, 2003

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