Socioeconomic inequalities in child and maternal health care in Cameroon

http://onlineresearchjournals.org/JSS/pdf/2012/nov/Nkwenkeu%20et%20al..pdfInternational audienceIn developing economies, a number of investigations have highlighted the fact that the increase in health expenditure will only contribute to poverty reduction if such expenditure is efficient and if access to health services becomes more equitable. This paper measured inequality trends in maternal and child health services access and use in Cameroon where health policies were redirected in the 90s. Using data from Demographic and Health Surveys (1991, 1998 and 2004), the relationship between socio-economic status and health inequalities was assessed. Concentration Index and an accurate estimate built from the capability theory were used to measure inequality trends in socio-economic status. The results show that the policies and interventions have been more effective in reaching the better-off than the worst-off. Increase in total health care access and use were detected for both variables (DPT3 and assistance at delivery) with concentration Index showing improved movements through equal distribution. This observation was contradicted by Lorenz curve for assistance at delivery. Trend differentials observed from health index reveal a significant correlation between health outcomes, deprivation and geographic affiliation. Health services access and use are determined by both socio-economic status and a number of factors including resource allocation and contextual factors. In such context, improvements in the monitoring of healthcare distribution is important to be carry out at both national and sub-national levels, especially in countries that have undergone decentralization and where socio-cultural factors may greatly differ from one region to another

Socioeconomic inequalities in child and maternal health care in Cameroon

http://onlineresearchjournals.org/JSS/pdf/2012/nov/Nkwenkeu%20et%20al..pdfInternational audienceIn developing economies, a number of investigations have highlighted the fact that the increase in health expenditure will only contribute to poverty reduction if such expenditure is efficient and if access to health services becomes more equitable. This paper measured inequality trends in maternal and child health services access and use in Cameroon where health policies were redirected in the 90s. Using data from Demographic and Health Surveys (1991, 1998 and 2004), the relationship between socio-economic status and health inequalities was assessed. Concentration Index and an accurate estimate built from the capability theory were used to measure inequality trends in socio-economic status. The results show that the policies and interventions have been more effective in reaching the better-off than the worst-off. Increase in total health care access and use were detected for both variables (DPT3 and assistance at delivery) with concentration Index showing improved movements through equal distribution. This observation was contradicted by Lorenz curve for assistance at delivery. Trend differentials observed from health index reveal a significant correlation between health outcomes, deprivation and geographic affiliation. Health services access and use are determined by both socio-economic status and a number of factors including resource allocation and contextual factors. In such context, improvements in the monitoring of healthcare distribution is important to be carry out at both national and sub-national levels, especially in countries that have undergone decentralization and where socio-cultural factors may greatly differ from one region to another

Promoting universal access to health services in post-conflict situations : what role can large scale cash transfer programmes play for better outcomes ?

11 p.Making well-informed decisions about how best to achieve MDGs depends on the ability of public policy makers in accessing the best available evidence about what is known to work and what could be potential benefits, and ways to integrate solutions into complex and often under-resourced health systems. Conditional cash transfer programmes have been largely explored as a policy for improving the education and health outcomes of poor children in developing countries as well as a tool for long-term poverty alleviation; but needs to be appropriate to the context and both fiscally and politically affordable. In DRC, the crisis and conflicts of the past decades severely affected the health status of the population and degraded the health system. Consequently, efforts in reducing infant and under-five morbidity and mortality are seriously hampered by widespread poverty and economic deregulation. The aim of this paper is to question the feasibility and affordability of cash transfer compared to 2 alternatives: an outreach health and nutrition programme with a behavioral change communication component and the elimination of basic health care user fees. The results show that children health outcomes may instead be driven by the equal distribution of quality services through outreach health and nutrition programmes (20% to real GDP) than a large scale health-oriented conditional cash transfer (25.9% to real GDP). A number of issues is outlined with regard to the country's socio-economic and political context : (i) health-oriented conditional cash transfer cannot operate in DRC due to supply-side constraints and lack of health supply strategy, logistics and engineering ; (ii) targeting is somewhat time consuming and irrelevant in such context with a headcount averaging 77% ; (iii) outcomes of a geographic focused cash transfer programme could be expected on improvement of nutritional status, but less on the rise of health demand and would be difficult to scale-up