IDEAS home Printed from https://ideas.repec.org/p/cdp/texdis/td446.html
   My bibliography  Save this paper

Equidade na utilização dos serviços de saúde no Brasil: um estudo comparativo entre as regiões brasileiras no período 1998-2008

Author

Listed:
  • Mônica Viegas Andrade

    (Cedeplar/UFMG)

  • Kenya Valéria M. de Souza Noronha

    (Cedeplar/UFMG)

  • Abhishek Singh

    (International Institute for Population Studies)

  • Cristina Guimarães Rodrigues

    (FEA/USP)

  • Sabu S. Padmadas

    (University of Southampton, Highfield)

Abstract

Antenatal care encompasses a broad spectrum of clinical procedures and care provided to pregnant women. Ideally, all pregnant women should have proper access to effective antenatal care irrespective of their social, economic, cultural and geographical background. This paper investigates the extent of inequalities in antenatal care and takes a step further in analysing some medical procedures followed during antenatal care in Brazil and India. Data are drawn from the 2006 Brazilian Demographic and Health Survey (DHS) and the third round of the DHS equivalent Indian National Family Health Survey (NFHS-3) conducted during 2005-06. Concentration index and concentration curves were estimated to quantify the degree of socioeconomic inequalities in antenatal care. Binary logistic regression models were used to determine the association between socioeconomic inequalities and antenatal care. The findings demonstrate evidence of wider socioeconomic inequalities in antenatal care utilisation and medical procedures in Brazil and India. Antenatal coverage is relatively much higher in Brazil and distributed uniformly across different socioeconomic groups than in India. The Indian case, however, presents problems of scale and equity in overall coverage and extent of utilisation whereas in Brazil, despite high utilisation of care, there is still considerable variation in the use of 6 or more ANC visits. The analyses suggest that Brazil overall has succeeded in reducing socioeconomic inequalities guaranteeing universal coverage to most essential antenatal services. This is different in India where antenatal utilisation is restricted mostly in southern and western geographical regions, yet the gap between the rich and the poor is substantial. The comparison between Brazil and India enabled a systematic examination of antenatal care taking into account different institutional and health policy regimes and socioeconomic background.

Suggested Citation

  • Mônica Viegas Andrade & Kenya Valéria M. de Souza Noronha & Abhishek Singh & Cristina Guimarães Rodrigues & Sabu S. Padmadas, 2011. "Equidade na utilização dos serviços de saúde no Brasil: um estudo comparativo entre as regiões brasileiras no período 1998-2008," Textos para Discussão Cedeplar-UFMG td446, Cedeplar, Universidade Federal de Minas Gerais.
    • Handle: RePEc:cdp:texdis:td446
    as

    Download full text from publisher

    File URL: https://www.cedeplar.ufmg.br/pesquisas/td/TD%20446.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896.
    2. Jowett, Matthew, 2000. "Safe motherhood interventions in low-income countries: an economic justification and evidence of cost effectiveness," Health Policy, Elsevier, vol. 53(3), pages 201-228, October.
    3. World Bank, 2005. "World Development Indicators 2005," World Bank Publications - Books, The World Bank Group, number 12425.
    4. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    5. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    6. Pallikadavath, Saseendran & Foss, Mary & Stones, R William, 2004. "Antenatal care: provision and inequality in rural north India," Social Science & Medicine, Elsevier, vol. 59(6), pages 1147-1158, September.
    7. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
    8. Magadi, Monica Akinyi & Madise, Nyovani Janet & Rodrigues, Roberto Nascimento, 2000. "Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities," Social Science & Medicine, Elsevier, vol. 51(4), pages 551-561, August.
    9. World Bank, 2005. "World Development Indicators 2005," World Bank Publications - Books, The World Bank Group, number 12426.
    10. Navaneetham, K. & Dharmalingam, A., 2002. "Utilization of maternal health care services in Southern India," Social Science & Medicine, Elsevier, vol. 55(10), pages 1849-1869, November.
    11. Mark Montgomery & Michele Gragnolati & Kathleen Burke & Edmundo Paredes, 2000. "Measuring living standards with proxy variables," Demography, Springer;Population Association of America (PAA), vol. 37(2), pages 155-174, May.
    12. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
    13. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    14. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    Full references (including those not matched with items on IDEAS)

    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. Abhishek Singh & Saseendran Pallikadavath & Faujdar Ram & Reuben Ogollah, 2012. "Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-8, September.
    2. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    3. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    4. Magnus Lindelow, 2006. "Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 263-279, March.
    5. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    6. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
    7. Wagstaff, Adam & Doorslaer, Eddy van, 2001. "Paying for health care : quantifying fairness, catastrophe, and impoverishment, with applications to Vietnam, 1993-98," Policy Research Working Paper Series 2715, The World Bank.
    8. Yasushi Ohkusa & Chika Honda, 2003. "Updated Horizontal Inequity in Health Care Utilization in Japan: Comparisons with OECD Countries Using an Original Survey," ISER Discussion Paper 0585, Institute of Social and Economic Research, Osaka University.
    9. Mohammad Hajizadeh & Luke Brian Connelly & James Robert Gerard Butler, 2014. "Health Policy and Equity of Health Care Financing in Australia: 1973–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 298-322, June.
    10. Hajizadeh, Mohammad & Pandey, Sujita & Pulok, Mohammad Habibullah, 2023. "Decomposition of socioeconomic inequalities in catastrophic out-of-pocket expenditure for healthcare in Canada," Health Policy, Elsevier, vol. 127(C), pages 51-59.
    11. Gerdtham, Ulf-G & Sundberg, Gun, 1996. "Measuring Income-Related Health Inequalities in Sweden," SSE/EFI Working Paper Series in Economics and Finance 120, Stockholm School of Economics.
    12. Cinaroglu, Songul, 2024. "Trends in out-of-pocket health expenditure inequality in Turkey under comprehensive health reforms," World Development Perspectives, Elsevier, vol. 34(C).
    13. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724, July.
    14. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    15. Dolores Jiménez‐Rubio & Peter C. Smith & Eddy Van Doorslaer, 2008. "Equity in health and health care in a decentralised context: evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 377-392, March.
    16. Meheus, Filip & Van Doorslaer, Eddy, 2008. "Achieving better measles immunization in developing countries: does higher coverage imply lower inequality?," Social Science & Medicine, Elsevier, vol. 66(8), pages 1709-1718, April.
    17. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    18. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    19. Kinyondo, Abel Alfred & Ntegwa, Magashi Joseph & Masawe, Cresencia Apolinary, 2022. "Socioeconomic Inequality in Maternal Healthcare Services: The Case of Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 10(1), January.
    20. Grimm, Michael & Harttgen, Kenneth & Klasen, Stephan & Misselhorn, Mark, 2008. "A Human Development Index by Income Groups," World Development, Elsevier, vol. 36(12), pages 2527-2546, December.

    More about this item

    Keywords

    Antenatal Care; Brazil; India; Socioeconomic Inequality; Health Inequalities.;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    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:cdp:texdis:td446. 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: Gustavo Britto (email available below). General contact details of provider: https://edirc.repec.org/data/pufmgbr.html .

    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.