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Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis
BACKGROUND: Poor maternal and infant health indicators are mostly concentrated among low income households in Pakistan and health care expenditures – especially on medical emergencies – are the most common income shocks experienced by the poor. Public investments in health are therefore considered a...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962481/ https://www.ncbi.nlm.nih.gov/pubmed/27459961 http://dx.doi.org/10.1186/s12939-016-0405-x |
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author | Malik, Sadia Mariam Ashraf, Nabila |
author_facet | Malik, Sadia Mariam Ashraf, Nabila |
author_sort | Malik, Sadia Mariam |
collection | PubMed |
description | BACKGROUND: Poor maternal and infant health indicators are mostly concentrated among low income households in Pakistan and health care expenditures – especially on medical emergencies – are the most common income shocks experienced by the poor. Public investments in health are therefore considered as pro-poor interventions by the government of Pakistan. This study employs nationally representative household data for Pakistan for 2007–08 and 2010–11 to investigate whether benefits from publicly financed services on Mother and Newborn Child Health (MNCH) are effectively captured by the poor in terms of service utilization. METHODS: The study conducts a Utilization Incidence Analysis of the use of public health services for MNCH in Pakistan. For this purpose, the utilization shares of households, ranked by economic status, are computed. The concentration curves are plotted and their dominance is tested against an equal distribution and Lorenz curves to determine whether the distribution is pro-poor and progressive. RESULTS: Although the shares of bottom income groups in the utilization of most services for MNCH have increased between 2007 and 2011, the utilization of some services such as post-natal consultation; institutional maternal delivery; and Tetanus Toxoid injections for pregnant women remains pro-rich in 2011. The utilization of pre-natal consultation, especially through lady health workers and visitors; the use of Family Panning Units; and immunization services is somewhat evenly distributed. The use of Basic Health Units (BHUs) is found to be pro-poor. The provincial analysis reveals that the province of Baluchistan depicts an unusually high level of inequity in the distribution of utilization benefits from almost all public health services. Finally, in terms of progressivity, public spending on all health services analyzed in the study is found to be progressive at the national level implying that investment in MNCH has the potential to redistribute income from rich to the poor. CONCLUSION: To target the poor effectively, the study recommends expanding the network of BHUs as well as basic reproductive and child health care services. The outreach of health facilities in Baluchistan need to be expanded while targeting the poor effectively by mitigating various access costs that prevent them from using public health services. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12939-016-0405-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4962481 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49624812016-07-28 Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis Malik, Sadia Mariam Ashraf, Nabila Int J Equity Health Research BACKGROUND: Poor maternal and infant health indicators are mostly concentrated among low income households in Pakistan and health care expenditures – especially on medical emergencies – are the most common income shocks experienced by the poor. Public investments in health are therefore considered as pro-poor interventions by the government of Pakistan. This study employs nationally representative household data for Pakistan for 2007–08 and 2010–11 to investigate whether benefits from publicly financed services on Mother and Newborn Child Health (MNCH) are effectively captured by the poor in terms of service utilization. METHODS: The study conducts a Utilization Incidence Analysis of the use of public health services for MNCH in Pakistan. For this purpose, the utilization shares of households, ranked by economic status, are computed. The concentration curves are plotted and their dominance is tested against an equal distribution and Lorenz curves to determine whether the distribution is pro-poor and progressive. RESULTS: Although the shares of bottom income groups in the utilization of most services for MNCH have increased between 2007 and 2011, the utilization of some services such as post-natal consultation; institutional maternal delivery; and Tetanus Toxoid injections for pregnant women remains pro-rich in 2011. The utilization of pre-natal consultation, especially through lady health workers and visitors; the use of Family Panning Units; and immunization services is somewhat evenly distributed. The use of Basic Health Units (BHUs) is found to be pro-poor. The provincial analysis reveals that the province of Baluchistan depicts an unusually high level of inequity in the distribution of utilization benefits from almost all public health services. Finally, in terms of progressivity, public spending on all health services analyzed in the study is found to be progressive at the national level implying that investment in MNCH has the potential to redistribute income from rich to the poor. CONCLUSION: To target the poor effectively, the study recommends expanding the network of BHUs as well as basic reproductive and child health care services. The outreach of health facilities in Baluchistan need to be expanded while targeting the poor effectively by mitigating various access costs that prevent them from using public health services. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12939-016-0405-x) contains supplementary material, which is available to authorized users. BioMed Central 2016-07-26 /pmc/articles/PMC4962481/ /pubmed/27459961 http://dx.doi.org/10.1186/s12939-016-0405-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Malik, Sadia Mariam Ashraf, Nabila Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis |
title | Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis |
title_full | Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis |
title_fullStr | Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis |
title_full_unstemmed | Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis |
title_short | Equity in the use of public services for mother and newborn child health care in Pakistan: a utilization incidence analysis |
title_sort | equity in the use of public services for mother and newborn child health care in pakistan: a utilization incidence analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962481/ https://www.ncbi.nlm.nih.gov/pubmed/27459961 http://dx.doi.org/10.1186/s12939-016-0405-x |
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