IDEAS home Printed from https://ideas.repec.org/p/hal/cdiwps/halshs-01535112.html
   My bibliography  Save this paper

Subsidized antimalarial drugs in Dakar (Senegal): Do the poor benefit?

Author

Listed:
  • Georges Karna Kone

    (HFG - Health finance and government Project - Health finance and government Project)

  • Martine Audibert

    (CERDI - Centre d'Études et de Recherches sur le Développement International - UdA - Université d'Auvergne - Clermont-Ferrand I - CNRS - Centre National de la Recherche Scientifique)

  • Richard Lalou

    (LPED - Laboratoire Population-Environnement-Développement - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université)

  • Hervé Lafarge

    (CERDI - Centre d'Études et de Recherches sur le Développement International - UCA [2017-2020] - Université Clermont Auvergne [2017-2020] - CNRS - Centre National de la Recherche Scientifique)

  • Jean-Yves Le Hesran

    (IRD - Laboratoire de parasitologie - IRD [IRD])

Abstract

Senegal opted for an antimalarial drug policy (artemisinin-based combination therapy) of partial and then full exemption from health care costs for the whole population respectively in 2008 and 2010. Has this policy reduced access inequalities in children's health care between rich and poor households? Data were collected in Dakar between 2008 and 2009 as part of a research program on urban malaria. A survey was conducted among the population of the Dakar metropolitan area. The sample was based on a two-stage sampling. The three questionnaires used for the survey were based on validated data collection tools. Indicators were built to characterize individuals, households and neighborhoods. Bivariate analysis (chi2 test) revealed social gradients within the Dakar agglomeration and characterized health care behaviors of the poorest and richest households. Data have therefore been adjusted by a double zero-inflated Poisson model. Results show that the policy of subsidizing antimalarial drugs in Senegal has reduced health care costs, including for the poor, but without improving its distributive equity. In contrast, this policy has benefited more the richest than the poorest, without mitigating social and financial inequalities. In light of the lessons learnt by the subsidy policy for antimalarial drugs, our study recommends that universal health coverage, currently implemented in Senegal, should seek to mitigate economic inequalities in access to health care for the poorest as well as to improve the health outcomes for the whole population.

Suggested Citation

  • Georges Karna Kone & Martine Audibert & Richard Lalou & Hervé Lafarge & Jean-Yves Le Hesran, 2017. "Subsidized antimalarial drugs in Dakar (Senegal): Do the poor benefit?," CERDI Working papers halshs-01535112, HAL.
    • Handle: RePEc:hal:cdiwps:halshs-01535112
    Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-01535112
    as

    Download full text from publisher

    File URL: https://shs.hal.science/halshs-01535112/document
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Haddad, Slim & Fournier, Pierre, 1995. "Quality, cost and utilization of health services in developing countries. A longitudinal study in Zaïre," Social Science & Medicine, Elsevier, vol. 40(6), pages 743-753, March.
    2. Martine Audibert & Stéphanie dos Santos & Georges Kone & Hervé Lafarge & Richard Lalou & Jean-Yves Le Hesran & Alphousseyni Ndonky, 2015. "Use of health care among febrile children from urban poor households in Senegal: does the neighbourhood have an impact?," Post-Print halshs-01413418, HAL.
    3. Sahn, David E. & Stifel, David C., 2000. "Poverty Comparisons Over Time and Across Countries in Africa," World Development, Elsevier, vol. 28(12), pages 2123-2155, December.
    4. Xu, Ke & Evans, David B. & Kadama, Patrick & Nabyonga, Juliet & Ogwal, Peter Ogwang & Nabukhonzo, Pamela & Aguilar, Ana Mylena, 2006. "Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda," Social Science & Medicine, Elsevier, vol. 62(4), pages 866-876, February.
    5. Bernard Delhausse, 2002. "Noyau dur de la pauvreté en Wallonie : Une actualisation," Reflets et perspectives de la vie économique, De Boeck Université, vol. 0(4), pages 55-63.
    6. Aurélien Franckel & Frédéric Arcens & Richard Lalou, 2008. "Contexte villageois et recours aux soins dans la région de Fatick au Sénégal," Population (french edition), Institut National d'Études Démographiques (INED), vol. 63(3), pages 531-553.
    7. Masiye, Felix & Chitah, Bona M. & McIntyre, Diane, 2010. "From targeted exemptions to user fee abolition in health care: Experience from rural Zambia," Social Science & Medicine, Elsevier, vol. 71(4), pages 743-750, August.
    8. Barry I. Graubard & Edward L. Korn, 1999. "Predictive Margins with Survey Data," Biometrics, The International Biometric Society, vol. 55(2), pages 652-659, June.
    9. Sen, Amartya, 1999. "Commodities and Capabilities," OUP Catalogue, Oxford University Press, number 9780195650389.
    10. Rafal Raciborski, 2011. "Right-censored Poisson regression model," Stata Journal, StataCorp LP, vol. 11(1), pages 95-105, March.
    11. Diagne, Oumar Diop & Faye, Ousmane & Faye, Salimata, 2005. "Le noyau dur de la pauvreté au Sénégal," Conference papers 331441, Purdue University, Center for Global Trade Analysis, Global Trade Analysis Project.
    12. Joseph Hilbe, 1999. "Robust variance estimators for MLE Poisson and negative binomial regression," Stata Technical Bulletin, StataCorp LP, vol. 8(45).
    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. Georges Karna Kone & Martine Audibert & Richard Lalou & Hervé Lafarge & Jean-Yves Le Hesran, 2017. "Subsidized antimalarial drugs in Dakar (Senegal): Do the poor benefit?," Working Papers halshs-01535112, HAL.
    2. Georges Karna KONE & Martine AUDIBERT & Richard LALOU & Hervé LAFARGE & Jean-Yves LE HESRAN, 2017. "Subsidized antimalarial drugs in Dakar (Senegal): Do the poor benefit?," Working Papers 201711, CERDI.
    3. Georges Kone & Richard Lalou & Martine Audibert & Hervé Lafarge & Stéphanie dos Santos & Jean-Yves Le Hesran, 2013. "Use of health care among the urban poor in Africa: Does the neighbourhood have an impact?," CERDI Working papers halshs-00878946, HAL.
    4. Johnson, Ari & Goss, Adeline & Beckerman, Jessica & Castro, Arachu, 2012. "Hidden costs: The direct and indirect impact of user fees on access to malaria treatment and primary care in Mali," Social Science & Medicine, Elsevier, vol. 75(10), pages 1786-1792.
    5. Georges Kone & Richard Lalou & Martine Audibert & Hervé Lafarge & Stéphanie dos Santos & Jean-Yves Le Hesran, 2013. "Use of health care among the urban poor in Africa: Does the neighbourhood have an impact?," Working Papers halshs-00878946, HAL.
    6. Hadley, Mary, 2011. "Does increase in utilisation rates alone indicate the success of a user fee removal policy? A qualitative case study from Zambia," Health Policy, Elsevier, vol. 103(2), pages 244-254.
    7. Patrick Gueswendé Ilboudo & Alain Siri, 2023. "Effects of the free healthcare policy on maternal and child health in Burkina Faso: a nationwide evaluation using interrupted time-series analysis," Health Economics Review, Springer, vol. 13(1), pages 1-13, December.
    8. Felix Masiye & Oliver Kaonga & Joses M Kirigia, 2016. "Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
    9. Aurélia Lépine & Mylène Lagarde & Alexis Le Nestour, 2018. "How effective and fair is user fee removal? Evidence from Zambia using a pooled synthetic control," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 493-508, March.
    10. Anna Fabry & Goedele Broeck & Miet Maertens, 2022. "Gender Inequality and Job Satisfaction in Senegal: A Multiple Mediation Model," Journal of Happiness Studies, Springer, vol. 23(5), pages 2291-2311, June.
    11. Jitender Singh, 2016. "Quality of Public Goods, Public Policy and Human Development: A State-wise Analysis," Indian Journal of Human Development, , vol. 10(2), pages 215-235, August.
    12. Yoshifusa Kitabatake, 2007. "Sen’s capability approach applied to the identification of new heritage value: empirical study on the effects of flood control project," Environmental Economics and Policy Studies, Springer;Society for Environmental Economics and Policy Studies - SEEPS, vol. 8(4), pages 295-313, December.
    13. McGrath, F.L. & Carrasco, L.R. & Leimona, B., 2017. "How auctions to allocate payments for ecosystem services contracts impact social equity," Ecosystem Services, Elsevier, vol. 25(C), pages 44-55.
    14. Zhang, Yingqiang & Eriksson, Tor, 2010. "Inequality of opportunity and income inequality in nine Chinese provinces, 1989-2006," China Economic Review, Elsevier, vol. 21(4), pages 607-616, December.
    15. Ahmed Shoukry Rashad, 2014. "The Catastrophic Economic Consequences of Illness and their Effect on Poverty Estimates in Egypt, Jordan, and Palestine," Working Papers 842, Economic Research Forum, revised Oct 2014.
    16. Duclos, Jean-Yves & Sahn, David & Younger, Stephen D., 2003. "Polarization: Robust Multidimensional Poverty Comparisons," Cahiers de recherche 0304, CIRPEE.
    17. Janina Isabel Steinert & Lucie Dale Cluver & G. J. Melendez-Torres & Sebastian Vollmer, 2018. "One Size Fits All? The Validity of a Composite Poverty Index Across Urban and Rural Households in South Africa," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(1), pages 51-72, February.
    18. R Burger & S du Plessis, 2011. "Examining the Robustness of Competing Explanations of Slow Growth in African Countries," Studies in Economics and Econometrics, Taylor & Francis Journals, vol. 35(3), pages 21-47, December.
    19. Aydın, Cem İskender, 2020. "Nuclear energy debate in Turkey: Stakeholders, policy alternatives, and governance issues," Energy Policy, Elsevier, vol. 136(C).
    20. Yuting Sun & Shu-Nung Yao, 2022. "Sustainability Trade-Offs in Media Coverage of Poverty Alleviation: A Content-Based Spatiotemporal Analysis in China’s Provinces," Sustainability, MDPI, vol. 14(16), pages 1-26, August.

    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:hal:cdiwps:halshs-01535112. 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: Contact - CERDI - Université Clermont Auvergne (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    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.