Socioeconomic inequalities in informal payments for health care: An assessment of the ‘Robin Hood’ hypothesis in 33 African countries

Kankeu, Hyacinthe Tchewonpi; Ventelou, Bruno

doi:10.1016/j.socscimed.2016.01.015

Cited by 47 publications

(61 citation statements)

References 43 publications

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“…Romanian patients who seldom have difficulties in paying bills are significantly less likely to give informal payments than those having such difficulties most of the time ( P < 0.01). This result is in line with previous studies analysing 33 African countries or the case of Hungary which concluded that the occurrence of informal payments tends to disadvantage the poorest and, therefore, disclaiming the “Robin‐Hood” assumption reported by some authors.…”

Section: Findings and Discussion: Drivers Behind Informal Paymentssupporting

confidence: 92%

Drivers behind widespread informal payments in the Romanian public health care system: From tolerance to corruption to socio‐economic and spatial patterns

Horodnic

Mazilu

Oprea

2018

Health Planning & Management

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In order to explain informal payments in public health care services in Romania, this paper evaluates the relationship between extra payments or valuable gifts (apart from official fees) and the level of tolerance to corruption, as well as the socio-economic and spatial patterns across those individuals offering informal payments. To evaluate this, a survey undertaken in 2013 is reported. Using logistic regression analysis, the findings are that patients with a high tolerance to corruption, high socio-economic risk (those divorced, separated, or with other form of marital status, and those not working), and located in rural or less affluent areas are more likely to offer (apart from official fees) extra payments or valuable gifts for health care services. The paper concludes by discussing the health policy implications.

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Section: Findings and Discussion: Drivers Behind Informal Paymentssupporting

confidence: 92%

Drivers behind widespread informal payments in the Romanian public health care system: From tolerance to corruption to socio‐economic and spatial patterns

Horodnic

Mazilu

Oprea

2018

Health Planning & Management

View full text Add to dashboard Cite

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“…This has been identified in studies conducted in large geographical areas, such as in 35 European countries [26], Central Asia [30] as well as in 33 African countries [31], or in smaller studies comprising only one nation as, for example, Bulgaria [1,6,13,32,33], Poland [34,35], Hungary [2,[36][37][38][39][40], Greece [4,41], Lithuania [34,42], Russia [43,44]; Ukraine [34,45], Moldova [46], Serbia [47], Kazakhstan [48], Albania [5,49,50], Kosovo [8], Tajikistan [51,52], Kyrgyzstan [53], Taiwan [54], Cameroon [55], Tanzania [3,56] and Turkey [57]. Nevertheless, informal patient payments phenomenon is poorly examined at a cross-country level.…”

Section: Explaining the Informal Patient Payments: An Institutional Amentioning

confidence: 82%

“…Indeed, most previous studies reveal that women are more likely to make informal payments for health care services [6,40,42,46,59], as do younger persons [6,45,47,49,60], better educated persons [6,[40][41][42]47,49], those having a job [41], those married [49], those living in a smaller household [40,49,50], those living in rural areas [45,60,61], and those with lower income [31,37,57,61]. By testing this hypothesis, whether these populations also have a higher institutional asymmetry can be evaluated.…”

Section: Explaining the Informal Patient Payments: An Institutional Amentioning

confidence: 99%

Rethinking informal payments by patients in Europe: An institutional approach

Williams

Horodnic

2017

Health Policy

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“…The use of informal healthcare providers in Cameroon is common [14, 15]. Acquiring care from formal healthcare services is not always an obvious first step in Cameroon where most healthcare is an out-of-pocket expense [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

et al. 2017

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BackgroundIn Cameroon, poverty-related diseases (PRDs) are a major public health concern. Research and policies addressing PRDs are based on a particular understanding of the interaction between poverty and disease, usually an association between poverty indicators and health indicators for a specific country or region. Such indicators are useful but fail to explain the nature of the linkages between poverty and disease or poverty and health. This paper presents results of a study among university students, unravelling how they perceive diseases, the linkages with poverty, their responses to diseases and the motivations behind reported responses.Based on the health belief model, this cross-sectional study was carried out among 272 students at the universities of Buea and Yaoundé in Cameroon. Data were collected using questionnaires containing items matching the research objectives. The questionnaires were self-completed.ResultsMalaria was considered as the most common disease perceived and also a major PRD. Contrary to official rankings of HIV/AIDS and TB, cholera and diarrhoea were considered as other major PRDs. Also, typhoid fever was perceived to be more common and a PRD than HIV/AIDS and TB combined. The most prominently attributed cause for disease was (lack of) hygiene. In response, students deployed formal and/or informal healthcare strategies, depending on factors like available money, perceived severity of the disease and disease type. Discrepancies were observed in respondents’ response to diseases generally and to malaria in particular. Even though, overall, respondents pre-dominantly reported a formal healthcare response toward diseases in general, for malaria, informal responses dominated. There was an overall strong awareness and (pro)activity among students for dealing with diseases.ConclusionsAlthough the high use of informal facilities and medication for malaria may well be a reason why eradication is problematic, this seems to be a deliberate strategy linked to an awareness of the limitations of the formal health system. In any intervention intended to foster health, it is therefore vital to consider people’s perceptions toward diseases and their response strategies. Our results give important leads to health promotion interventions to develop group-specific programs.

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Socioeconomic inequalities in informal payments for health care: An assessment of the ‘Robin Hood’ hypothesis in 33 African countries

Cited by 47 publications

References 43 publications

Drivers behind widespread informal payments in the Romanian public health care system: From tolerance to corruption to socio‐economic and spatial patterns

Drivers behind widespread informal payments in the Romanian public health care system: From tolerance to corruption to socio‐economic and spatial patterns

Rethinking informal payments by patients in Europe: An institutional approach

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon

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