Measuring pro-poor sectoral analysis for Pakistan: trickle down?

The study aims to establish a pro-poor growth index called the ‘Poverty Equivalent Growth Rate’, which considers both the extent of sectoral growth and the benefits reaching the poor in Pakistan, using 21 household surveys between 1964 and 2011. The result reveals that despite the positive signs in agriculture growth, the growth process may not be classifiable as pro-poor. The result points out that compared with the non-poor, the poor overall benefited less from the revitalisation of agricultural processes; however, the trend was reversed during 2002 to 2011 when the poverty equivalent growth rates are higher than the growth rate of industry, manufacturing, commodity producing and services value added, which shows sectoral growth favours the poor more than non-poor in Pakistan

Measuring Income Polarization for Twenty European Countries, 2004–13: A Shapley Growth-Redistribution Decomposition

Hervorming Sociale Regelgevin

Addressing Inequity to Achieve the Maternal and Child Health Millennium Development Goals: Looking Beyond Averages.

Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania. We used the Lives Saved Tool (LiST) to estimate potential reductions in maternal and child mortality and the number of lives saved across wealth quintiles and between rural and urban settings. High impact maternal and child health interventions were modelled for a five-year scale up, by linking intervention coverage, effectiveness and cause of mortality using data from Tanzania. Concentration curves were drawn and the concentration index estimated to measure the equity impact of the scale up. In the poorest population quintiles in Tanzania, the lives of more than twice as many mothers and under-fives were likely to be saved, compared to the richest quintile. Scaling up coverage to equal levels across quintiles would reduce inequality in maternal and child mortality from a pro rich concentration index of -0.11 (maternal) and -0.12 (children) to a more equitable concentration index of -0,03 and -0.03 respectively. In rural areas, there would likely be an eight times greater reduction in maternal deaths than in urban areas and a five times greater reduction in child deaths than in urban areas. Scaling up priority maternal and child health interventions to equal levels would potentially save far more lives in the poorest populations, and would accelerate equitable progress towards maternal and child health MDGs

Decomposing socioeconomic inequality for binary health outcomes: an improved estimation that does not vary by choice of reference group

BACKGROUND Decomposition of concentration indices yields useful information regarding the relative importance of various determinants of inequitable health outcomes. But the two estimation approaches to decomposition in current use are not suitable for binary outcomes. FINDINGS The paper compares three estimation approaches for decomposition of inequality concentration indices: Ordinary Least Squares (OLS), probit, and the Generalized Linear Model (GLM) binomial distribution and identity link. Data are from the Thai Health and Welfare Survey 2003. The OLS estimates do not take into account the binary nature of the outcome and the probit estimates depend on the choice of reference groups, whereas the GLM binomial identity approach has neither of these problems. CONCLUSIONS The GLM with binomial distribution and identity link allows the inequality decomposition model to hold, and produces valid estimates of determinants that do not vary according to choice of reference groups. This GLM approach is readily available in standard statistical packages.The study was conducted under the auspices of the overarching project "The Thai Health-Risk Transition: a National Cohort Study", funded by the Wellcome Trust UK (GR071587 MA) and the Australian National Health and Medical Research Council (268055)

Equity in health care financing: The case of Malaysia

Background: Equitable financing is a key objective of health care systems. Its importance is evidenced in policy documents, policy statements, the work of health economists and policy analysts. The conventional categorisations of finance sources for health care are taxation, social health insurance, private health insurance and out-of-pocket payments. There are nonetheless increasing variations in the finance sources used to fund health care. An understanding of the equity implications would help policy makers in achieving equitable financing. Objective: The primary purpose of this paper was to comprehensively assess the equity of health care financing in Malaysia, which represents a new country context for the quantitative techniques used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes, contributions to Employee Provident Fund and Social Security Organization, private insurance and out-of-pocket payments) independently, and subsequently by combined the financing sources to evaluate the whole financing system. Methods: Cross-sectional analyses were performed on the Household Expenditure Survey Malaysia 1998/99, using Stata statistical software package. In order to assess inequality, progressivity of each finance sources and the whole financing system was measured by Kakwani's progressivity index. Results: Results showed that Malaysia's predominantly tax-financed system was slightly progressive with a Kakwani's progressivity index of 0.186. The net progressive effect was produced by four progressive finance sources (in the decreasing order of direct taxes, private insurance premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance source (indirect taxes). Conclusion: Malaysia's two tier health system, of a heavily subsidised public sector and a user charged private sector, has produced a progressive health financing system. The case of Malaysia exemplifies that policy makers can gain an in depth understanding of the equity impact, in order to help shape health financing strategies for the nation

Relative income change and pro-poor growth

Most methods for the analysis of distributional change rely on the changes in the income of a particular group of people, taking either the situation of this group in the previous period, or the average change in the population, as reference point. By contrast, we propose a measure of distributional change based on the comparison of a group’s wellbeing standard against a richer group, thereby capturing a notion of change in relative income, which embodies the influence of others’ wellbeing on the judgment of the group’s own situation. The indices, and related relative income change (RIC) curves, are based on ratios of generalized mean incomes between two groups, which render them closely related to Zenga’s inequality measures and Lorenz curve comparisons, when arithmetic means are used. We consider both relative and absolute income cut-offs for the group partitions. Differences and similarities between our measures of relative income change and the Growth Incidence Curve are also discussed. These are highlighted in an empirical illustration on European countries