Inequalities in public health care delivery in Zambia

dc.contributor.authorPhiri, Jane
dc.contributor.authorAtaguba, John E
dc.date.accessioned2015-02-16T19:05:05Z
dc.date.available2015-02-16T19:05:05Z
dc.date.issued2014-03-19
dc.date.updated2015-01-15T17:54:05Z
dc.description.abstractBackground: Access to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documents, there is evidence suggesting that those needing health services are not receiving their fair share. This study seeks therefore, to assess if socioeconomic related inequalities/inequities in public health service utilisation in Zambia still persist. Methods: The 2010 nationally representative Zambia Living Conditions and Monitoring Survey data are used. Inequality is assessed using concentration curves and concentrations indices while inequity is assessed using a horizontal equity index: an index of inequity across socioeconomic status groups, based on standardizing health service utilisation for health care need. Public health services considered include public health post visits, public clinic visits, public hospital visits and total public facility visits. Results: There is evidence of pro-poor inequality in public primary health care utilisation but a pro-rich inequality in hospital visits. The concentration indices for public health post visits and public clinic visits are −0.28 and −0.09 respectively while that of public hospitals is 0.06. After controlling for need, the pro-poor distribution is maintained at primary facilities and with a pro-rich distribution at hospitals. The horizontal equity indices for health post and clinic are estimated at −0.23 and −0.04 respectively while that of public hospitals is estimated at 0.11. A pro-rich inequity is observed when all the public facilities are combined (horizontal equity index = 0.01) though statistically insignificant. Conclusion: The results of the paper point to areas of focus in ensuring equitable access to health services especially for the poor and needy. This includes strengthening primary facilities that serve the poor and reducing access barriers to ensure that health care utilisation at higher-level facilities is distributed in accordance with need for it. These initiatives may well reduce the observed inequities and accelerate the move towards universal health coverage in Zambia.en_ZA
dc.identifier.apacitationPhiri, J., & Ataguba, J. E. (2014). Inequalities in public health care delivery in Zambia. <i>International Journal for Equity in Health</i>, http://hdl.handle.net/11427/12487en_ZA
dc.identifier.chicagocitationPhiri, Jane, and John E Ataguba "Inequalities in public health care delivery in Zambia." <i>International Journal for Equity in Health</i> (2014) http://hdl.handle.net/11427/12487en_ZA
dc.identifier.citationPhiri, J., & Ataguba, J. E. (2014). Inequalities in public health care delivery in Zambia. International journal for equity in health, 13(1), 24.en_ZA
dc.identifier.issn1475-9276
dc.identifier.ris TY - Journal Article AU - Phiri, Jane AU - Ataguba, John E AB - Background: Access to adequate health services that is of acceptable quality is important in the move towards universal health coverage. However, previous studies have revealed inequities in health care utilisation in the favour of the rich. Further, those with the greatest need for health services are not getting a fair share. In Zambia, though equity in access is extolled in government documents, there is evidence suggesting that those needing health services are not receiving their fair share. This study seeks therefore, to assess if socioeconomic related inequalities/inequities in public health service utilisation in Zambia still persist. Methods: The 2010 nationally representative Zambia Living Conditions and Monitoring Survey data are used. Inequality is assessed using concentration curves and concentrations indices while inequity is assessed using a horizontal equity index: an index of inequity across socioeconomic status groups, based on standardizing health service utilisation for health care need. Public health services considered include public health post visits, public clinic visits, public hospital visits and total public facility visits. Results: There is evidence of pro-poor inequality in public primary health care utilisation but a pro-rich inequality in hospital visits. The concentration indices for public health post visits and public clinic visits are −0.28 and −0.09 respectively while that of public hospitals is 0.06. After controlling for need, the pro-poor distribution is maintained at primary facilities and with a pro-rich distribution at hospitals. The horizontal equity indices for health post and clinic are estimated at −0.23 and −0.04 respectively while that of public hospitals is estimated at 0.11. A pro-rich inequity is observed when all the public facilities are combined (horizontal equity index = 0.01) though statistically insignificant. Conclusion: The results of the paper point to areas of focus in ensuring equitable access to health services especially for the poor and needy. This includes strengthening primary facilities that serve the poor and reducing access barriers to ensure that health care utilisation at higher-level facilities is distributed in accordance with need for it. These initiatives may well reduce the observed inequities and accelerate the move towards universal health coverage in Zambia. DA - 2014-03-19 DB - OpenUCT DO - 10.1186/1475-9276-13-24 DP - University of Cape Town J1 - International Journal for Equity in Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 1475-9276 T1 - Inequalities in public health care delivery in Zambia TI - Inequalities in public health care delivery in Zambia UR - http://hdl.handle.net/11427/12487 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/12487
dc.identifier.urihttp://dx.doi.org/10.1186/1475-9276-13-24
dc.identifier.vancouvercitationPhiri J, Ataguba JE. Inequalities in public health care delivery in Zambia. International Journal for Equity in Health. 2014; http://hdl.handle.net/11427/12487.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderPhiri and Ataguba; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceInternational Journal for Equity in Healthen_ZA
dc.source.urihttp://www.equityhealthj.com
dc.subject.otherHealth inequalityen_ZA
dc.subject.otherHealth inequityen_ZA
dc.subject.otherPublic health careen_ZA
dc.subject.otherZambiaen_ZA
dc.titleInequalities in public health care delivery in Zambiaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Phiri_Inequalities_PHC_Zambia_2014.pdf
Size:
380.53 KB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.72 KB
Format:
Item-specific license agreed upon to submission
Description:
Collections