IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v68y2009i6p1145-1152.html
   My bibliography  Save this article

Gender equity and health sector reform in Colombia: Mixed state-market model yields mixed results

Author

Listed:
  • Ewig, Christina
  • Bello, Amparo Hernández

Abstract

In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.

Suggested Citation

  • Ewig, Christina & Bello, Amparo Hernández, 2009. "Gender equity and health sector reform in Colombia: Mixed state-market model yields mixed results," Social Science & Medicine, Elsevier, vol. 68(6), pages 1145-1152, March.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:6:p:1145-1152
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(08)00683-7
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Hirotoshi Yoshioka, 2006. "A Q-Analysis of Census Data: Intra-Household Income Allocation and School Attendance in Chiapas, Mexico," Quality & Quantity: International Journal of Methodology, Springer, vol. 40(6), pages 1061-1077, December.
    2. Doyal, Lesley, 2000. "Gender equity in health: debates and dilemmas," Social Science & Medicine, Elsevier, vol. 51(6), pages 931-939, September.
    3. Londono, Juan-Luis & Frenk, Julio, 1997. "Structured pluralism: towards an innovative model for health system reform in Latin America," Health Policy, Elsevier, vol. 41(1), pages 1-36, July.
    4. Homedes, Nuria & Ugalde, Antonio, 2005. "Why neoliberal health reforms have failed in Latin America," Health Policy, Elsevier, vol. 71(1), pages 83-96, January.
    5. Pollack, E. Molly, 2002. "Equidad de género en el sistema de salud chileno," Financiamiento para el Desarrollo 5103, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    6. Evelyn Forget & Raisa Deber & Leslie Roos & Randy Walld, 2005. "Canadian Health Reform: A Gender Analysis," Feminist Economics, Taylor & Francis Journals, vol. 11(1), pages 123-141.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jasmine Gideon & Fenella Porter, 2014. "Unpacking Women's Health in Public-Private Partnerships: A Return to Instrumentalism in Development Policy and Practice?," WIDER Working Paper Series wp-2014-009, World Institute for Development Economic Research (UNU-WIDER).
    2. Buitrago Echeverri, María Teresa & Abadía-Barrero, César Ernesto & Granja Palacios, Consuelo, 2017. "Work-related illness, work-related accidents, and lack of social security in Colombia," Social Science & Medicine, Elsevier, vol. 187(C), pages 118-125.
    3. Akpalu, Wisdom & Dasmani, Isaac & Normanyo, Ametefee K., 2013. "Optimum Fisheries Management Under Climate Variability: Evidence from Artisanal Marine Fishing in Ghana," WIDER Working Paper Series 052, World Institute for Development Economic Research (UNU-WIDER).
    4. Saji S Gopalan & Varatharajan Durairaj, 2012. "Addressing Women's Non-Maternal Healthcare Financing in Developing Countries: What Can We Learn from the Experiences of Rural Indian Women?," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-8, January.
    5. Martínez-Parra, Adriana Gisela & Pinilla-Alfonso, Maria Yaneth & Abadía-Barrero, César Ernesto, 2018. "Sociocultural dynamics that influence Chagas disease health care in Colombia," Social Science & Medicine, Elsevier, vol. 215(C), pages 142-150.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Cavagnero, Eleonora, 2008. "Health sector reforms in Argentina and the performance of the health financing system," Health Policy, Elsevier, vol. 88(1), pages 88-99, October.
    2. Abadia, Cesar Ernesto & Oviedo, Diana G., 2009. "Bureaucratic Itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems," Social Science & Medicine, Elsevier, vol. 68(6), pages 1153-1160, March.
    3. Kutzin, Joseph, 2001. "A descriptive framework for country-level analysis of health care financing arrangements," Health Policy, Elsevier, vol. 56(3), pages 171-204, June.
    4. Arturo Vargas Bustamante & Claudio A. Méndez, 2016. "Regulating self-selection into private health insurance in Chile and the United States," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 219-234, July.
    5. Ramiro Guerrero & Sergio I. Prada & Dov Chernichovsky, 2014. "La doble descentralización en el sector salud: evaluación y alternativas de política pública," Cuadernos de Fedesarrollo 12019, Fedesarrollo.
    6. Gabriela de Carvalho, 2022. "The World Bank and Healthcare Reforms: A Cross‐National Analysis of Policy Prescriptions in South America," Social Inclusion, Cogitatio Press, vol. 10(1), pages 5-18.
    7. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    8. Sandoval Moreno, Carlos, 2019. "Three essays on poverty measurement and risk protection," Other publications TiSEM 934c114b-7dce-431b-a613-a, Tilburg University, School of Economics and Management.
    9. Bila, Blandine & Egrot, Marc, 2009. "Gender asymmetry in healthcare-facility attendance of people living with HIV/AIDS in Burkina Faso," Social Science & Medicine, Elsevier, vol. 69(6), pages 854-861, September.
    10. Aitken, Zoe & Garrett, Cameryn C. & Hewitt, Belinda & Keogh, Louise & Hocking, Jane S. & Kavanagh, Anne M., 2015. "The maternal health outcomes of paid maternity leave: A systematic review," Social Science & Medicine, Elsevier, vol. 130(C), pages 32-41.
    11. World Bank, 2005. "Azerbaijan : Health Sector Review Note, Volume 1, Main Report," World Bank Publications - Reports 8692, The World Bank Group.
    12. Garcia-Subirats, Irene & Vargas, Ingrid & Mogollón-Pérez, Amparo Susana & De Paepe, Pierre & da Silva, Maria Rejane Ferreira & Unger, Jean Pierre & Vázquez, María Luisa, 2014. "Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil," Social Science & Medicine, Elsevier, vol. 106(C), pages 204-213.
    13. Cucunubá, Zulma M. & Manne-Goehler, Jennifer M. & Díaz, Diana & Nouvellet, Pierre & Bernal, Oscar & Marchiol, Andrea & Basáñez, María-Gloria & Conteh, Lesong, 2017. "How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis," Social Science & Medicine, Elsevier, vol. 175(C), pages 187-198.
    14. Kanako Ishida, 2010. "The Role of Ethnicity in Father Absence and Children’s School Enrollment in Guatemala," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 29(4), pages 569-591, August.
    15. Jorge Iván González, 2016. "Sentimientos y racionalidad en economía," Books, Universidad Externado de Colombia, Facultad de Economía, edition 1, number 75.
    16. Mansdotter, Anna & Lindholm, Lars & Ohman, Ann, 2004. "Women, men and public health--how the choice of normative theory affects resource allocation," Health Policy, Elsevier, vol. 69(3), pages 351-364, September.
    17. Makokha, Racheal Omukhulu, 2017. "Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya," Thesis Commons xef7a, Center for Open Science.
    18. Verónica Espinel-Flores & Gabriela Tiburcio-Lara & Ingrid Vargas & Pamela Eguiguren & Amparo-Susana Mogollón-Pérez & Marina Ferreira-de-Medeiros-Mendes & Julieta López-Vázquez & Fernando Bertolotto & , 2022. "Relational Continuity of Chronic Patients with Primary and Secondary Care Doctors: A Study of Public Healthcare Networks of Six Latin American Countries," IJERPH, MDPI, vol. 19(20), pages 1-13, October.
    19. César A. Macías-Chapula, 2002. "Bibliometric and webometric analysis of health system reforms in Latin America and the Caribbean," Scientometrics, Springer;Akadémiai Kiadó, vol. 53(3), pages 407-427, March.
    20. Huixia Liu & Linxiu Zhang & Gale Summerfield & Yaojiang Shi, 2009. "A gendered view of reforming health care access for farmers in China," China Agricultural Economic Review, Emerald Group Publishing Limited, vol. 1(2), pages 194-211, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:68:y:2009:i:6:p:1145-1152. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.