Inequality in benefit distribution of public health spending in Ethiopia
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Date
2018-11
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Addis Ababa Universty
Abstract
Background: Health inequality is differences in health status or in the distribution of health determinants between different population groups. Health inequities are unfair differences in accessing and utilizing health services between different socioeconomic groups. Inequalities and inequities in health utilization are examined with health determinant variables and benefit incidence analysis is used to measure the distribution of government health spending.
Objective: To estimate the benefit distribution of public spending on health care across socio-economic groups, in Ethiopia.
Methods: A national representative Ethiopian living standard measurement survey having 23,393 set of households data in the year 2015/16 was used to measure the benefit incidence analysis of the government health expenditure. Concentration index was used to assess the degree of income-related inequality in the distribution of a health variable and decomposition of the concentration index provides socio economic and demographic contribution to the inequalities.
Result: Government unit subsidy at hospital level is 75.4 and 2018.6 Ethiopian birr and at health center 67.4 and 187.5 Ethiopian birr per outpatient and inpatient services respectively. Out of the total government subsidy 60.6 % of government spending goes to health centers and 39.4% to hospitals and more than two third of government spending concentrated to outpatient visit (72.5%) relative to inpatient visits (27.5%). The total share of public spending is low in the lowest quintile (3.6%) while high in the second quintile (27.9%).
Conclusion: In this study we found pro-poor public spending on health with concentration index of -0.039 which varies at different health delivery level and service type. The hospital level and inpatient visit preferentially benefit the wealthiest quintile while health center and outpatient visit is pro-poor.
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Health inequality