On Decomposing the Causes of Health Sector Inequalities with an Application to Malnutrition Inequalities in Vietnam
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World Bank, Washington, DC
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The authors propose a method for
decomposing inequalities in the health sector into their
causes, by coupling the concentration index with a
regression framework. They also show how changes in
inequality over time, and differences across countries, can
be decomposed into the following: Changes due to changing
inequalities in the determinants of the variable of
interest. Changes in the means of the determinants. Changes
in the effects of the determinants o the variable of
interest. The authors illustrate the method using data on
child malnutrition in Vietnam. They find that inequalities
in height-for-age in 1993 and 1998 are accounted for largely
by inequalities in household consumption and by unobserved
influences at the commune level. And they find that an
increase in such inequalities is accounted for largely by
changes in these two influences. In the case of household
consumption, rising inequalities play a part, but more
important have been the inequality-increasing effects of
rising average consumption and the increased protective
effect of consumption on nutritional status. In the case of
unobserved commune-level influences, rising inequality and
general improvements seem to have been roughly equally
important in accounting for rising inequality in malnutrition.
Palabras clave
HEALTH SERVICES, ACCESS TO HEALTH CARE, ACCESS TO HEALTH SERVICES, REGRESSION ANALYSIS, CHILDREN NUTRITION, CHILD NUTRITION, MALNUTRITION IN CHILDREN, HOUSEHOLD CONSUMPTION, INEQUITY, DECOMPOSITION METHOD CHILD MALNUTRITION, CHILD MORTALITY, DECOMPOSITION RESULTS, DECREASING FUNCTION, DISTRIBUTIONAL DATA, DRINKING WATER, EDUCATIONAL ATTAINMENT, ELASTICITIES, ELASTICITY, EMPIRICAL ANALYSIS, EMPIRICAL MODEL, EMPIRICAL RESULTS, EQUAL INCREASE, GINI COEFFICIENT, GIRLS, HEALTH OUTCOMES, HEALTH SERVICES, HOUSEHOLDS, HUMAN DEVELOPMENT, INCOME, INCOME DISTRIBUTION, INCOME GROUPS, INCOME INEQUALITY, INCOMES, INCREASING FUNCTION, INEQUALITY, INTERNATIONAL ORGANIZATIONS, LINEAR REGRESSION, MALNUTRITION, MEAN CONSUMPTION, MEASUREMENT ERROR, MODEL ESTIMATION, MORTALITY, MOTHERS, NEGATIVE EFFECT, NEGATIVE VALUE, NET CHANGE, NET EFFECT, NUTRITIONAL STATUS, OPPORTUNITY COSTS, PARENTS, POLICY RESEARCH, POOR CHILDREN, POOR PEOPLE, PRODUCTION FUNCTION, PROPORTIONAL INCREASE, PUBLIC EXPENDITURE, PUBLIC EXPENDITURES, PUBLIC HEALTH, REGRESSION ANALYSIS, REGRESSION RESULTS, RELATIVE IMPORTANCE, RELATIVE INCOME, RELATIVE INCOME INEQUALITY, RISING INEQUALITY, RURAL AREAS, SAFE DRINKING WATER, SANITATION, SIGNIFICANT NEGATIVE, STUNTING, VACCINATION, DECOMPOSITION METHOD, CHILD MALNUTRITION