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An alternative approach to decomposing the redistributive effect of health financing between and within groups using the Gini index: the case of out of pocket payments in Nigeria

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dc.date.accessioned 2019-11-01T08:15:10Z
dc.date.available 2019-11-01T08:15:10Z
dc.date.issued 2019-11-01 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/14951
dc.description.abstract Equity in health financing remains significant in the universal health coverage discourse. The way a health system is financed, apart from determining whether people have access to needed health services, also has implications for income inequality in a country. Traditionally, the impact of health financing on income inequality or the redistributive effect of health financing is assessed by looking at whether income inequality reduces because of health financing. This is also decomposed into a vertical component (the extent of progressivity), a horizontal component (the extent to which households with similar incomes are treated equally when financing health services) and a reranking component (whether households change their relative socio-economic ranking after financing health services). Such an approach to decomposition is mainly essential to assess the equal treatment of equals and unequal treatment of unequals in the entire population. This paper argues that in decomposing the redistributive effect of health financing, the impact of health financing on changes in income inequality between and within population groups should be investigated as they are relevant for policy dialogues in many countries. It develops a framework for such analysis and applies this to data from Nigeria. Decomposing the Gini index of income inequality using the Shapley value approach, the results show that changes in inequality associated with out-of-pocket payments for health services within the geopolitical zones in Nigeria dominate the changes in income inequality between the geopolitical zones. Although not all the results in the application in this paper are statistically significant, this framework is still useful for policies in countries that aim to use health financing to reduce, among other things, income disparities between and within defined population groups. en
dc.format.medium Print en
dc.subject HEALTH en
dc.subject SUSTAINABLE DEVELOPMENT GOALS en
dc.subject NIGERIA en
dc.subject MEDICAL AID en
dc.subject INEQUALITY en
dc.title An alternative approach to decomposing the redistributive effect of health financing between and within groups using the Gini index: the case of out of pocket payments in Nigeria en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume October en
dc.BudgetYear 2019/20 en
dc.ResearchGroup Economic Perfomance and Development en
dc.SourceTitle Applied Health Economics and Health Policy en
dc.ArchiveNumber 11030 en
dc.URL http://ktree.hsrc.ac.za/doc_read_all.php?docid=21819 en
dc.PageNumber Online en
dc.outputnumber 10128 en
dc.bibliographictitle Ataguba, J.E., Ichoku, H.E., Nwosu, C.O. & Akazili, J. (2019) An alternative approach to decomposing the redistributive effect of health financing between and within groups using the Gini index: the case of out of pocket payments in Nigeria. <i>Applied Health Economics and Health Policy</i>. October:Online. en
dc.publicationyear 2019 en
dc.contributor.author1 Ataguba, J.E. en
dc.contributor.author2 Ichoku, H.E. en
dc.contributor.author3 Nwosu, C.O. en
dc.contributor.author4 Akazili, J. en


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