On measuring and decomposing inequality of opportunity in access to health services among Tunisian children: a new approach for public policy

BACKGROUND: The early years in children’s life are the key to physical, cognitive-language, and, socio-emotional skills development. So, it is of paramount importance in this period to be interested in different indicators that would influence the child’s health. METHODS: This paper measures inequality of opportunities among Tunisian children concerning access to nutritional and healthy services using Human Opportunity-Index and Shapely decomposition methods. RESULTS: Many disparities between regions have been detected since 1982 until 2012. Tunisian children face unequal opportunities to develop in terms of health, nutrition, cognitive, social, and emotional development. Likewise, we found that, parents’ education, wealth, age of household head and geographic factors as key factors determining child development outcomes. CONCLUSION: Our findings suggested that childhood unequal opportunities in Tunisia are explained by pension funds deficiency and structural problem in the labor market. TRIAL REGISTRATION: The results of a health care intervention on human participants “retrospectively registered”.