72016 Health Equity and Financial Protection Datasheets sub-saharan Africa Acknowledgements These datasheets were produced by a task team consisting of Caryn Bredenkamp (Task Team Leader, Health Economist, HDNHE), Adam Wagstaff (Research Manager, DECHD), Leander Buisman (consultant), Leah Prencipe (consultant) and Devon Rohr (consultant, graphic design), under the overall supervision of the Sector Manager, HDNHE, Nicole Klingen. The financial contributions of the Rapid Social Results Trust Fund (RSR-MDTF) and the Trust Fund for Environmentally and Socially Sustainable Development (TFESSD) are gratefully acknowledged. Table of contents Benin..............................................................................................................5 Burkina Faso.................................................................................................7 Burundi........................................................................................................12 Cameroon...................................................................................................13 Central African Republic..........................................................................15 Chad.............................................................................................................17 Comoros.................................................................................................... 20 Côte d’Ivoire.............................................................................................. 23 Democratic Republic of the Congo....................................................... 26 Ethiopia...................................................................................................... 28 Gabon......................................................................................................... 32 Ghana......................................................................................................... 33 Guinea........................................................................................................ 38 Guinea-Bissau........................................................................................... 40 Kenya.......................................................................................................... 41 Lesotho....................................................................................................... 46 Liberia......................................................................................................... 48 Madagascar................................................................................................ 50 Malawi........................................................................................................ 52 Maldives......................................................................................................57 Mali.............................................................................................................. 58 Mauritania...................................................................................................61 Mauritius.................................................................................................... 64 Mozambique.............................................................................................. 66 Namibia...................................................................................................... 68 Niger............................................................................................................71 Nigeria........................................................................................................ 73 Republic of Congo................................................................................... 76 Rwanda....................................................................................................... 79 São Tomé and Príncipe............................................................................ 81 Senegal....................................................................................................... 82 Sierra Leone............................................................................................... 85 Somalia....................................................................................................... 88 South Africa............................................................................................... 89 Swaziland................................................................................................... 92 Tanzania..................................................................................................... 95 The Gambia............................................................................................... 97 Togo............................................................................................................ 98 Uganda..................................................................................................... 100 Zambia...................................................................................................... 102 Zimbabwe................................................................................................ 106 Interpretation of Results Measurement of Indicators HealtH equity and Financial Protection dataSHeet BENIN the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1996 1a outcoMeS infant mortality rate 124.5 124.5 113.6 105.3 72.7 111.0 -0.077*** under-five mortality rate 222.4 201.8 214.9 195.4 115.6 195.7 -0.079*** Stunting 39.6% 38.9% 33.8% 30.2% 24.4% 34.4% -0.089*** underweight 34.6% 33.0% 23.6% 20.8% 17.6% 27.0% -0.146*** diarrhea 28.5% 30.7% 25.1% 25.1% 18.5% 26.2% -0.067*** acute respiratory infection 17.4% 19.2% 14.9% 12.8% 13.5% 15.8% -0.070*** Fever 55.8% 59.6% 57 .2% 52.3% 43.2% 54.5% -0.041*** 2001 1b infant mortality rate 123.9 118.8 112.3 80.6 52.3 102.6 -0.124*** under-five mortality rate 213.0 186.7 175.4 143.3 102.6 172.1 -0.110*** Stunting 45.3% 45.1% 38.4% 34.5% 23.9% 38.5% -0.103*** underweight 28.2% 28.0% 21.3% 16.7% 7.9% 21.5% -0.181*** diarrhea 15.3% 15.9% 13.5% 12.7% 10.2% 13.8% -0.077*** acute respiratory infection 12.1% 11.9% 12.2% 13.6% 11.5% 12.3% 0.013 Fever 46.0% 45.0% 45.0% 41.0% 30.6% 42.3% -0.058*** 2006 1c infant mortality rate 91.8 96.3 91.7 86.1 55.0 86.3 -0.065*** under-five mortality rate 166.4 170.2 164.5 147.6 88.3 152.7 -0.079*** Stunting 50.0% 47.5% 47.6% 40.0% 29.2% 43.5% -0.090*** underweight 26.8% 22.1% 21.2% 16.2% 10.9% 19.9% -0.156*** diarrhea 10.8% 11.0% 8.9% 8.4% 5.9% 9.2% -0.113*** acute respiratory infection 10.8% 10.6% 9.7% 8.7% 8.2% 9.7% -0.064*** Fever 29.4% 30.5% 31.2% 29.9% 22.8% 29.0% -0.035*** adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci 1996 1a obesity among non-pregnant 1.1% 0.8% 1.0% 3.8% 10.8% 2.9% 0.538*** women 2001 1b obesity among non-pregnant 0.9% 1.4% 2.6% 7.2% 14.9% 6.2% 0.506*** women 2006 1c obesity among non-pregnant 1.4% 1.6% 3.3% 6.3% 14.2% 6.0% 0.471*** women inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2006 1c Smoking (women) 7.1% 3.1% 1.6% 0.6% 0.2% 2.3% -0.576*** Mosquito net use by children 9.8% 16.5% 21.4% 27.6% 35.0% 21.3% 0.242*** Mosquito net use by pregnant 10.9% 18.0% 30.3% 37.7% 43.9% 26.7% 0.265*** women 5 inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interVentionS1a,1b,1c,2 utiliZation 1996 1a Full immunization 38.1% 53.4% 63.8% 58.6% 75.6% 56.0% 0.120*** treatment of diarrhea 25.9% 26.2% 38.8% 33.0% 55.0% 32.7% 0.141*** Medical treatment of ari 24.0% 27.2% 29.2% 35.4% 59.5% 31.9% 0.175*** Skilled antenatal care (4+ visits) 35.2% 43.0% 57.3% 69.1% 82.0% 54.5% 0.176*** Skilled birth attendance 35.3% 53.8% 66.1% 88.0% 97.3% 64.5% 0.201*** 2001 1b Full immunization 49.0% 53.8% 57.3% 65.6% 74.1% 59.3% 0.088*** treatment of diarrhea 31.3% 24.0% 33.6% 39.9% 36.6% 32.1% 0.067** Medical treatment of ari 26.5% 33.5% 35.7% 36.4% 50.4% 35.3% 0.104*** Skilled antenatal care (4+ visits) 40.3% 51.7% 63.0% 73.8% 88.5% 62.1% 0.154*** Skilled birth attendance 49.7% 61.7% 77.8% 91.1% 99.7% 73.9% 0.142*** 2006 1c Full immunization 33.9% 43.3% 48.2% 49.2% 66.5% 47.5% 0.123*** treatment of diarrhea 22.4% 29.7% 34.6% 32.3% 40.4% 30.4% 0.105*** Medical treatment of ari 27.9% 32.2% 37.3% 39.4% 48.0% 35.7% 0.107*** Skilled antenatal care (4+ visits) 39.5% 50.0% 59.6% 72.5% 88.0% 61.0% 0.162*** Skilled birth attendance 56.3% 70.9% 80.3% 92.4% 97.5% 78.3% 0.111*** contraceptive prevalence 27.0% 29.2% 28.4% 29.5% 33.7% 30.9% 0.041*** among women note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1996 Benin demographic and Health Survey, 1b=2001 Benin demographic and Health Survey, 1c=2006 Benin demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Benin. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: yosef Hadar, 1984 6 HealtH equity and Financial Protection dataSHeet BURK INA FASO the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1993 1a outcoMeS infant mortality rate 134.0 139.0 150.2 123.5 92.0 129.2 -0.036** under-five mortality rate 225.1 247.7 243.7 226.9 161.9 223.0 -0.025* Stunting 43.3% 43.5% 42.8% 40.4% 27 .8% 40.0% -0.055*** underweight 30.1% 30.2% 32.4% 32.5% 19.3% 29.3% -0.035*** diarrhea 13.5% 10.9% 12.3% 11.9% 11.1% 12.0% -0.011 acute respiratory infection 3.9% 5.3% 4.9% 4.4% 4.8% 4.7% 0.032 Fever 33.5% 36.7% 36.1% 37.9% 32.7% 35.5% 0.014 1998-99 1b infant mortality rate 134.3 142.3 139.7 140.5 82.1 130.5 -0.038*** under-five mortality rate 252.5 248.4 248.7 249.2 157.7 236.1 -0.043*** Stunting 51.7% 46.4% 46.6% 45.7% 31.0% 45.1% -0.063*** underweight 39.4% 36.4% 34.5% 32.7% 22.3% 33.7% -0.080*** diarrhea 11.2% 11.5% 12.9% 12.4% 13.2% 12.1% 0.043** acute respiratory infection 4.1% 6.3% 5.2% 5.3% 5.4% 5.2% 0.046 Fever 36.9% 37.2% 38.1% 36.8% 33.4% 36.6% -0.004 2002-03 3 Malaria 33.6% 34.6% 33.4% 39.2% 59.2% 40.6% 0.115*** 2003 1c infant mortality rate 125.4 126.3 104.7 112.9 84.4 112.6 -0.037*** under-five mortality rate 212.4 224.1 210.0 213.3 146.0 205.2 -0.023* Stunting 49.7% 46.6% 45.5% 41.4% 25.7% 42.8% -0.078*** underweight 40.9% 37.0% 39.6% 34.6% 20.1% 35.4% -0.070*** diarrhea 20.8% 21.8% 21.5% 19.5% 22.0% 21.1% 0.013 acute respiratory infection 8.5% 8.7% 9.8% 9.1% 7.5% 8.8% 0.016 Fever 38.1% 37.8% 40.1% 38.4% 30.9% 37 .5% -0.008 2006 2 Stunting 52.0% 48.3% 43.9% 39.3% 25.6% 42.7% -0.112*** underweight 44.6% 41.2% 38.2% 35.5% 24.3% 37.5% -0.093*** diarrhea 19.8% 19.6% 22.1% 20.0% 17.2% 19.9% -0.017 acute respiratory infection 12.1% 10.6% 11.4% 10.6% 4.6% 10.2% -0.108*** Fever 18.3% 20.3% 19.4% 20.9% 20.5% 19.8% 0.026 7 inequalitieS adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci in HealtH 1993 1a outcoMeS obesity among non-pregnant 0.7% 0.7% 1.5% 1.2% 4.8% 1.8% 0.413*** (cont.) women 1998-99 1b obesity among non-pregnant 0.7% 0.8% 0.7% 0.6% 4.9% 1.4% 0.466*** women 2002-03 3 tuberculosis 17 .2% 13.9% 16.3% 13.7% 8.9% 14.0% -0.086*** road traffic accident 0.8% 0.7% 1.3% 1.8% 4.4% 1.8% 0.386*** non-road traffic accident 3.8% 3.3% 4.0% 4.9% 5.8% 4.4% 0.101** angina 11.1% 8.8% 11.4% 16.1% 13.6% 12.2% 0.079*** arthritis 14.5% 14.4% 12.6% 13.6% 11.8% 13.4% -0.043* asthma 2.7% 1.7% 2.6% 0.9% 3.7% 2.3% 0.046 depression 1.3% 2.4% 1.8% 3.6% 4.2% 2.6% 0.214*** diabetes 0.1% 0.0% 0.6% 0.2% 1.5% 0.5% 0.515*** difficulty with work and 5.8% 4.6% 4.5% 4.4% 5.4% 4.9% -0.043 household activities Poor self-assessed health 8.3% 7.6% 6.2% 4.9% 7.0% 6.8% -0.065 status 2003 1c obesity among non-pregnant 0.4% 0.3% 0.1% 0.9% 8.9% 2.4% 0.726*** women HiV positive 1.1% 2.1% 1.1% 1.4% 3.2% 1.8% 0.190*** inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2002-03 3 Smoking (all) 19.8% 19.0% 17.6% 17.8% 15.2% 17.9% -0.046** insufficient intake of fruit and 81.1% 80.1% 72.8% 81.6% 76.6% 78.4% -0.011** vegetables insufficient physical activity 0.2% 0.5% 0.9% 0.5% 0.5% 0.5% 0.032 drinking 16.3% 17.4% 17.4% 11.8% 10.7% 14.8% -0.090*** 2003 1c Smoking (women) 8.6% 7.7% 6.6% 5.4% 1.5% 5.7% -0.232*** concurrent partnerships 3.0% 2.9% 3.2% 5.0% 17.4% 6.7% 0.433*** condom usage (more than 32.0% 13.9% 23.6% 44.2% 64.5% 50.7% 0.208*** one partner) Mosquito net use by children 1.3% 0.7% 0.8% 1.6% 7.3% 2.0% 0.460*** Mosquito net use by pregnant 1.6% 0.9% 4.2% 2.0% 10.5% 3.7% 0.463*** women 2006 2 concurrent partnerships 1.7% 0.7% 2.1% 2.6% 3.2% 2.2% 0.232 Mosquito net use by children 0.7% 1.4% 0.9% 2.1% 2.0% 1.4% 0.212** 8 inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interVentionS1a,1b,1c,2 utilization 1993 1a Full immunization 18.1% 32.1% 29.1% 38.5% 58.5% 34.8% 0.220*** treatment of diarrhea 6.4% 8.4% 4.1% 12.4% 15.7% 9.0% 0.218*** Medical treatment of ari 6.6% 15.7% 19.0% 11.5% 39.8% 18.3% 0.237*** Skilled antenatal care (4+ visits) 5.4% 9.0% 8.9% 14.9% 31.8% 13.4% 0.348*** Skilled birth attendance 9.8% 9.7% 15.3% 28.0% 78.3% 26.5% 0.453*** 1998-99 1b Full immunization 18.3% 27 .8% 20.7% 34.6% 52.6% 30.0% 0.198*** treatment of diarrhea 5.5% 4.6% 7.4% 10.4% 16.0% 8.5% 0.240*** Medical treatment of ari 15.2% 25.1% 18.3% 28.6% 62.6% 29.0% 0.241*** Skilled antenatal care (4+ visits) 16.6% 21.0% 20.6% 28.2% 34.6% 23.6% 0.147*** Skilled birth attendance 14.6% 14.8% 19.3% 28.2% 73.2% 27 .6% 0.347*** 2003 1c Full immunization 34.0% 40.8% 40.4% 46.6% 62.1% 44.0% 0.110*** treatment of diarrhea 19.0% 21.1% 29.0% 24.4% 43.4% 26.5% 0.158*** Medical treatment of ari 25.1% 22.7% 37.1% 34.1% 77.2% 36.0% 0.218*** Skilled antenatal care (4+ visits) 12.0% 12.2% 15.5% 18.2% 33.3% 17.5% 0.225*** Skilled birth attendance 18.5% 25.0% 31.4% 45.0% 86.3% 38.5% 0.306*** contraceptive prevalence 33.7% 41.7% 46.3% 44.6% 52.3% 48.1% 0.063*** 2006 2 Full immunization 90.6% 85.3% 86.0% 94.1% 96.8% 90.6% 0.017** treatment of diarrhea 27 .1% 21.4% 21.7% 18.0% 34.2% 23.7% -0.008 contraceptive prevalence 7.5% 7.1% 10.0% 16.5% 30.8% 15.4% 0.329*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2002-03 3 tB screening 0.8% 1.2% 0.9% 1.5% 2.2% 1.3% 0.200** cervical cancer screening 51.1% 56.4% 30.2% 41.3% 39.1% 43.3% -0.089** Breast cancer screening 0.7% 6.2% 0.9% 0.2% 2.0% 2.2% -0.190 2006 2 Voluntary counseling and 68.6% 76.6% 83.8% 89.8% 93.8% 88.9% 0.042*** testing for HiV adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2002-03 3 inpatient or outpatient 27.1% 30.7% 27.6% 32.9% 44.4% 32.4% 0.091** (12 months) inpatient (12 months) 4.3% 5.5% 4.0% 4.3% 8.5% 5.3% 0.105*** inpatient (5 years) 8.2% 11.0% 8.8% 9.4% 15.8% 10.6% 0.103*** outpatient (12 months) 13.4% 16.4% 17.6% 20.9% 28.7% 19.1% 0.145 BeneFit utilization - PuBlic q1 q2 q3 q4 q5 total ci incidence FacilitieS3 analySiS 2002-03 3 outpatient health centre, 8.1% 10.3% 10.5% 14.3% 12.8% 11.2% 0.103** clinic or infirmary outpatient hospital 0.9% 0.7% 0.8% 0.8% 2.1% 1.1% 0.205* inpatient hospital 3.9% 5.4% 3.3% 4.6% 6.5% 4.7% 0.112 FeeS Paid at PuBlic q1 q2 q3 q4 q5 ci FacilitieS (SHareS)3 2002-03 3 outpatient health centre, 9.6 17.7 17.2 25.8 29.7 0.202** clinic or infirmary outpatient hospital 23.3 16.8 6.5 10.7 42.6 0.185 inpatient hospital 14.6 18.2 5.1 31.4 30.7 0.216** 9 BeneFit HealtH care SuBSidieS (SHareS)3,5 incidence 2004 3 analySiS total (cont.) constant unit cost Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient health centre, 16.4 21.3 18.9 25.0 18.4 2,954 0.038 32.0% clinic or infirmary outpatient hospital 25.5 7.2 21.7 15.9 29.8 34 0.097 6.6% inpatient hospital 13.5 25.3 17.9 21.2 22.2 10,862 0.095 61.4% total subsidies 15.2 22.8 18.4 22.0 21.5 13,850 0.077 100% total constant unit Subsidy Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient health centre, 14.5 18.4 18.8 25.5 22.8 2,954 0.103** 21.3% clinic or infirmary outpatient hospital 17.7 13.3 15.5 14.8 38.7 34 0.205* 0.2% inpatient hospital 16.3 22.7 14.1 19.5 27.3 10,862 0.112 78.4% total subsidies 15.9 21.8 15.1 20.8 26.4 13,850 0.111** 100% total Proportional cost Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient health centre, 9.6 17.7 17.2 25.8 29.7 2,954 0.202** 21.3% clinic or infirmary outpatient hospital 23.3 16.8 6.5 10.7 42.6 34 0.185 0.2% inpatient hospital 14.6 18.2 5.1 31.4 30.7 10,862 0.216** 78.4% total subsidies 13.6 18.1 7.7 30.1 30.5 13,850 0.213*** 100% threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3,4 2002-03 3 Headcount 40.0% 28.0% 19.4% 11.0% 5.6% concentration index 0.091*** 0.082*** 0.060** 0.063** 0.025 2003 4 Headcount 17.4% 8.8% 5.3% 2.1% 1.0% concentration index 0.189*** 0.248*** 0.432*** 0.521*** 0.570*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3,4 2002-03 3 Headcount 67.3% 63.0% 58.6% 51.7% 44.7% concentration index -0.011*** -0.044*** -0.065*** -0.115*** -0.154*** 2003 4 Headcount 25.2% 17.6% 12.8% 6.6% 2.3% concentration index 0.156*** 0.143*** 0.135*** 0.301*** 0.415*** 10 Financial iMPoVeriSHMent3,4 Protection Poverty line at uS$1.25 per consumption consumption change % change (cont.) capita per day including ooP excluding ooP 2002-03 3 Percentage in poverty 74.4% 77.9% 3.5% 4.8% average shortfall from the $0.46 $0.51 $0.05 10.1% poverty line average shortfall from the $0.62 $0.65 $0.03 5.1% poverty line, among the poor 2003 4 Percentage in poverty 61.8% 64.4% 2.6% 4.2% average shortfall from the $0.27 $0.28 $0.02 5.6% poverty line average shortfall from the $0.44 $0.44 $0.01 1.4% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2002-03 3 Percentage in poverty 88.4% 90.7% 2.3% 2.6% average shortfall from the $1.08 $1.15 $0.07 6.1% poverty line average shortfall from the $1.22 $1.26 $0.04 3.5% poverty line, among the poor 2003 4 Percentage in poverty 85.9% 87.4% 1.5% 1.7% average shortfall from the $0.85 $0.88 $0.03 3.6% poverty line average shortfall from the $0.99 $1.00 $0.02 1.9% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Burkina Faso’s consumer price index. data sources: 1a=1993 Burkina Faso demographic and Health Survey, 1b=1998-99 Burkina Faso demographic and Health Survey, 1c=2003 Burkina Faso demographic and Health Survey, 2=2006 Burkina Faso Multiple indicator cluster Survey, 3=2002-03 Burkina Faso World Health Survey, 4=2003 Burkina Faso Household living Standards Survey (eBcVM), 5=2003 Burkina Faso national Health accounts report. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Burkina Faso. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: ray Witlin 11 HealtH equity and Financial Protection dataSHeet BURUNDI the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2005 2 outcoMeS diarrhea 23.3% 21.1% 22.6% 18.9% 17.9% 20.8% -0.049*** acute respiratory infection 35.6% 35.2% 35.2% 30.0% 29.3% 33.1% -0.048*** Fever 33.9% 31.7% 32.5% 29.8% 24.5% 30.5% -0.053*** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2005 2 concurrent partnerships 1.4% 1.8% 2.7% 0.1% 1.2% 1.5% -0.145 Mosquito net use by children 3.6% 4.4% 4.5% 6.1% 14.9% 6.6% 0.307*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 2005 2 Full immunization 73.2% 89.6% 88.0% 83.2% 81.8% 83.3% 0.011 treatment of diarrhea 32.0% 35.0% 32.3% 43.0% 44.1% 36.7% 0.078*** Medical treatment of ari 49.9% 42.0% 37.7% 42.0% 48.6% 44.0% -0.014 contraceptive prevalence 3.8% 5.0% 4.6% 5.6% 8.1% 5.4% 0.156*** among women adult Preventive care2,3 q1 q2 q3 q4 q5 total ci 2005 2 voluntary counseling and 88.4% 90.0% 88.5% 88.9% 93.8% 90.9% 0.017*** testing for Hiv note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=n/a demographic and Health Survey, 2=2005 Burundi Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Burundi. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 12 HealtH equity and Financial Protection dataSHeet CAMEROON the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2004 1b outcoMeS infant mortality rate 116.4 102.9 93.6 70.0 55.6 92.4 -0.127*** under-five mortality rate 214.8 180.9 160.8 102.5 89.8 161.1 -0.170*** Stunting 45.9% 39.0% 39.9% 27 .8% 16.3% 35.8% -0.156*** underweight 23.8% 20.5% 13.4% 8.0% 3.5% 15.4% -0.280*** diarrhea 21.0% 20.6% 16.2% 13.2% 10.5% 17.0% -0.139*** acute respiratory infection 11.2% 12.9% 10.6% 12.0% 12.6% 11.8% 0.014 Fever 19.8% 26.6% 26.1% 29.1% 25.8% 25.1% 0.058*** 2006 2 Stunting 49.8% 42.8% 38.8% 25.2% 15.0% 36.6% -0.179*** underweight 31.8% 18.5% 13.9% 6.9% 4.3% 16.7% -0.337*** diarrhea 30.0% 18.6% 17.5% 13.2% 10.5% 18.9% -0.205*** acute respiratory infection 21.2% 21.9% 18.1% 18.4% 19.8% 20.0% -0.028 Fever 14.1% 18.9% 20.6% 17.5% 14.5% 17.2% 0.016 adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 1998 1b obesity among non-pregnant 0.9% 0.7% 2.0% 5.2% 9.4% 3.2% 0.499*** women 2004 1a obesity among non-pregnant 1.5% 2.6% 6.4% 12.3% 14.9% 8.2% 0.382*** women HiV positive 2.2% 3.2% 6.4% 7.1% 6.6% 5.3% 0.182*** inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2004 1b Smoking (women) 3.2% 2.7% 1.9% 0.9% 1.1% 1.9% -0.254*** concurrent partnerships 6.6% 14.4% 22.0% 28.9% 32.0% 21.4% 0.254*** condom usage (more than 16.9% 18.8% 26.9% 42.0% 48.8% 37.2% 0.187*** one partner) Mosquito net use by children 0.3% 0.9% 0.5% 2.3% 2.4% 1.1% 0.373*** Mosquito net use by pregnant 0.0% 0.7% 1.1% 4.6% 3.2% 1.6% 0.513*** women 2006 2 concurrent partnerships 2.4% 7.3% 7.4% 9.5% 8.8% 7.3% 0.157*** Mosquito net use by children 1.1% 1.9% 3.2% 3.4% 4.2% 2.6% 0.253*** 13 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 2004 1b Full immunization 37.0% 48.4% 50.9% 50.5% 61.3% 48.6% 0.095*** treatment of diarrhea 14.7% 20.6% 27.2% 34.7% 44.7% 24.3% 0.221*** Medical treatment of ari 30.6% 28.5% 53.3% 46.5% 52.7% 40.7% 0.131*** Skilled antenatal care (4+ visits) 39.6% 49.3% 63.8% 76.0% 88.4% 61.4% 0.167*** Skilled birth attendance 29.6% 45.9% 73.9% 88.4% 95.2% 62.6% 0.234*** contraceptive prevalence 28.6% 26.6% 27.3% 37.9% 39.7% 34.9% 0.092*** among women 2006 2 Full immunization 65.0% 76.8% 77.7% 92.6% 99.0% 80.8% 0.089*** treatment of diarrhea 10.2% 14.4% 24.0% 31.0% 47.2% 19.3% 0.297*** Medical treatment of ari 37.8% 55.3% 55.1% 68.7% 74.4% 54.5% 0.125*** contraceptive prevalence 5.0% 16.2% 24.7% 38.8% 44.0% 27.0% 0.308*** among women adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2006 2 Voluntary counseling and 75.0% 85.4% 90.5% 94.8% 96.9% 92.9% 0.028*** testing for HiV note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1998 cameroon demographic and Health Survey, 1b=2004 cameroon demographic and Health Survey, 2=2006 cameroon Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - cameroon. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 14 HealtH equity and Financial Protection dataSHeet CENTRAL AFRICAN REPUBLIC the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1994-95 1 outcoMeS infant mortality rate 137.9 124.4 110.0 94.2 59.3 107.4 -0.134*** under-five mortality rate 212.8 183.5 179.6 155.7 98.6 169.9 -0.115*** Stunting 48.3% 40.8% 38.2% 39.0% 30.1% 39.5% -0.089*** underweight 30.7% 23.8% 24.3% 19.7% 16.2% 23.1% -0.126*** diarrhea 28.7% 22.3% 19.8% 24.2% 19.7% 23.1% -0.063*** acute respiratory infection 27.1% 29.8% 29.0% 30.3% 28.4% 28.9% 0.014 Fever 32.0% 36.9% 33.1% 39.2% 37.3% 35.7% 0.027* 2006 2 Stunting 50.0% 47.1% 47.7% 42.6% 32.1% 44.4% -0.070*** underweight 29.2% 29.0% 29.5% 26.0% 19.6% 26.9% -0.066*** diarrhea 17.5% 17.1% 17.9% 20.3% 20.7% 18.6% 0.043*** acute respiratory infection 14.2% 14.8% 14.6% 17.9% 18.0% 15.8% 0.056*** Fever 20.0% 17.0% 19.2% 27.3% 25.7% 21.6% 0.084*** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 1994-95 1 concurrent partnerships 0.7% 1.7% 1.4% 1.2% 5.1% 1.9% 0.354*** 2006 2 concurrent partnerships 4.3% 5.7% 6.4% 10.4% 12.4% 8.0% 0.216*** condom usage (more than 29.4% 35.3% 52.5% 68.9% 72.4% 59.1% 0.143*** one partner) Mosquito net use by children 0.3% 0.8% 1.4% 1.7% 3.0% 1.4% 0.387*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 1994-95 1 Full immunization 18.2% 25.2% 29.0% 45.9% 63.5% 36.6% 0.262*** treatment of diarrhea 18.8% 22.1% 39.9% 28.5% 36.1% 27.7% 0.136*** Medical treatment of ari 30.3% 28.9% 44.8% 46.6% 56.7% 41.2% 0.143*** Skilled antenatal care (4+ visits) 11.8% 17.1% 25.3% 46.9% 53.9% 30.9% 0.318*** Skilled birth attendance 8.9% 14.9% 23.3% 57.9% 73.9% 35.8% 0.408*** 2006 2 Full immunization 20.3% 25.7% 31.2% 55.8% 60.4% 36.8% 0.262*** treatment of diarrhea 24.7% 28.0% 27.9% 42.3% 48.6% 34.3% 0.143*** Medical treatment of ari 36.4% 27.9% 42.2% 50.7% 54.4% 42.0% 0.120*** contraceptive prevalence 4.3% 6.9% 9.0% 16.6% 28.5% 13.1% 0.380*** among women 15 inequalitieS adult Preventive care2,3 q1 q2 q3 q4 q5 total ci in HealtH care 2006 2 utiliZation voluntary counseling and 73.9% 68.7% 76.1% 83.3% 86.9% 81.8% 0.042*** (cont.) testing for Hiv note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=1994-95 central african republic demographic and Health Survey, 2=2006 central african republic Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - central african republic. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 16 HealtH equity and Financial Protection dataSHeet chad the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 3 outcoMeS Malaria 37.3% 33.1% 31.4% 43.8% 50.2% 40.5% 0.082* 2004 1b infant mortality rate 120.4 132.4 135.3 139.2 109.7 128.0 -0.001 under-five mortality rate 192.9 220.6 264.0 227.9 197.8 221.2 0.020 Stunting 51.3% 44.9% 46.6% 41.9% 34.4% 43.9% -0.061*** underweight 45.7% 31.1% 34.5% 32.2% 25.8% 33.7% -0.088*** diarrhea 19.6% 32.1% 27 .9% 26.4% 27.3% 26.9% 0.030** acute respiratory infection 7.5% 11.0% 8.2% 9.7% 10.3% 9.3% 0.025 Fever 26.8% 37.6% 35.5% 38.1% 34.5% 34.8% 0.043*** adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 1996-97 1a obesity among non-pregnant 0.0% 0.0% 0.1% 1.8% 4.2% 1.1% 0.748*** women1a 2003 3 tuberculosis 15.0% 11.1% 13.3% 10.9% 8.3% 11.8% -0.097*** road traffic accident 1.0% 1.1% 2.8% 2.9% 3.3% 2.2% 0.235*** non-road traffic accident 2.9% 2.7% 3.0% 4.3% 5.0% 3.6% 0.130* angina 20.4% 19.6% 26.0% 21.9% 19.3% 21.5% 0.002 arthritis 37 .3% 32.1% 36.7% 30.9% 29.5% 33.4% -0.042*** asthma 5.2% 4.8% 4.4% 2.8% 3.1% 4.1% -0.114* depression 2.2% 1.8% 2.1% 3.1% 2.3% 2.3% 0.057 diabetes 1.3% 1.9% 2.7% 1.4% 1.5% 1.8% -0.009 difficulty with work and 7.1% 7.4% 5.7% 4.3% 4.5% 5.8% -0.125*** household activities Poor self-assessed health 13.9% 12.7% 14.3% 12.7% 11.2% 13.0% -0.037 status 2004 1b obesity among non-pregnant 1.0% 0.9% 0.5% 1.6% 5.3% 1.7% 0.462*** women inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 6.2% 13.1% 14.3% 13.2% 10.4% 11.4% 0.065* Smoking (women) 1.0% 3.6% 3.7% 3.0% 3.7% 3.0% 0.146 insufficient intake of fruit and 76.0% 65.3% 56.6% 58.0% 53.2% 61.8% -0.069*** vegetables insufficient physical activity 0.0% 0.0% 0.4% 0.3% 1.1% 0.4% 0.549*** drinking 12.0% 20.0% 21.2% 23.3% 21.6% 19.5% 0.092*** 2004 1b concurrent partnerships 0.8% 1.7% 1.9% 3.5% 7.0% 3.0% 0.397*** condom usage (more than 0.0% 0.0% 0.0% 4.1% 25.7% 13.0% 0.648*** one partner) 17 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 2004 1b Full immunization 1.1% 7.7% 11.1% 12.5% 23.7% 11.3% 0.348*** treatment of diarrhea 1.5% 14.1% 17 .1% 20.6% 32.5% 18.0% 0.289*** Medical treatment of ari 17 .3% 10.3% 13.7% 17.4% 38.6% 19.5% 0.302*** Skilled antenatal care (4+ visits) 1.2% 3.5% 4.4% 3.9% 9.4% 4.4% 0.319*** Skilled birth attendance 0.3% 1.0% 1.6% 2.1% 8.0% 2.5% 0.541*** contraceptive prevalence 54.0% 45.5% 49.9% 43.6% 45.4% 47 .4% -0.021 adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 0.9% 1.7% 1.7% 1.4% 1.2% 1.4% 0.028 cervical cancer screening 14.4% 51.9% 53.5% 64.9% 55.3% 50.6% 0.116*** Breast cancer screening 3.0% 2.7% 3.5% 7.7% 10.4% 4.8% 0.286* adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 14.9% 18.3% 18.8% 22.2% 34.6% 21.7% 0.177*** (12 months) inpatient (12 months) 3.0% 4.3% 5.0% 5.7% 9.7% 5.5% 0.240*** inpatient (5 years) 8.3% 9.3% 11.0% 13.1% 18.0% 11.9% 0.177*** outpatient (12 months) 8.7% 10.3% 9.4% 11.5% 18.8% 11.5% 0.158*** threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending 2003 3 Headcount 32.2% 24.9% 20.0% 14.1% 10.9% concentration index -0.014 -0.056** -0.103*** -0.250*** -0.392*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending 2003 3 Headcount 68.3% 67.2% 65.6% 62.7% 59.0% concentration index -0.040*** -0.046*** -0.056*** -0.069*** -0.092*** iMPoVeriSHMent Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 60.1% 62.9% 2.7 pp 4.6% average shortfall from the $0.39 $0.41 $0.03 6.9% poverty line average shortfall from the $0.61 $0.63 $0.01 2.2% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 77.2% 79.0% 1.8 pp 2.3% average shortfall from the $0.94 $0.98 $0.05 4.9% poverty line average shortfall from the $1.16 $1.18 $0.03 2.5% poverty line, among the poor 18 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using chad’s consumer price index. data sources: 1a=1996-97 chad demographic and Health Survey, 1b=2004 chad demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 chad World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - chad. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: un Photo/eskinder debebe 19 HealtH equity and Financial Protection dataSHeet comoros the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1996 1 outcoMeS infant mortality rate 95.7 114.0 88.4 62.9 60.8 87.4 -0.099*** under-five mortality rate 141.8 138.2 109.2 94.3 73.7 116.5 -0.118*** Stunting 49.4% 42.7% 37.5% 35.3% 27.7% 39.5% -0.113*** underweight 31.1% 27 .4% 16.5% 17.1% 13.9% 22.1% -0.176*** diarrhea 25.0% 25.5% 22.2% 20.1% 23.9% 23.4% -0.048 acute respiratory infection 26.3% 25.0% 19.8% 20.4% 20.4% 22.7% -0.061* Fever 44.9% 50.4% 49.5% 50.5% 49.0% 48.7% 0.016 2003 3 acute respiratory infection 26.6% 36.3% 29.4% 18.3% 25.9% 28.3% -0.054 Fever 86.0% 94.6% 86.6% 100.0% 96.5% 92.7% 0.020* Malaria 55.0% 56.4% 58.9% 63.8% 40.0% 53.2% -0.050 adult HealtH1,3 q1 q2 q3 q4 q5 total ci 1996 1 obesity among non-pregnant 0.7% 2.1% 2.9% 4.4% 10.8% 3.8% 0.459*** women 2003 3 tuberculosis 20.8% 20.4% 21.4% 20.6% 20.4% 20.7% -0.008 obesity among non-pregnant 5.5% 5.2% 5.5% 8.1% 3.2% 5.6% -0.015 women road traffic accident 1.8% 2.4% 1.5% 2.1% 3.7% 2.3% 0.107 non-road traffic accident 3.9% 4.7% 7.1% 5.0% 6.5% 5.5% 0.051 angina 3.4% 3.4% 5.1% 7.8% 3.9% 4.7% 0.082 arthritis 11.0% 14.9% 14.1% 13.6% 12.7% 13.3% 0.008 asthma 9.9% 5.4% 7.4% 5.5% 9.1% 7.5% -0.018 depression 1.0% 1.5% 1.4% 2.3% 1.5% 1.5% 0.062 diabetes 0.5% 1.3% 0.1% 1.6% 0.3% 0.7% 0.028 difficulty with work and 23.9% 17.1% 18.7% 17.4% 17.0% 18.8% -0.064** household activities Poor self-assessed health 18.3% 15.5% 15.8% 13.6% 10.3% 14.7% -0.107*** status inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 24.7% 26.4% 18.4% 21.5% 21.6% 22.5% -0.051* Smoking (women) 14.5% 14.2% 13.7% 11.6% 3.3% 11.6% -0.183*** insufficient intake of fruit and 72.7% 71.3% 65.3% 68.4% 69.7% 69.5% -0.011 vegetables insufficient physical activity 27.1% 27.6% 24.9% 22.1% 27.0% 25.7% -0.018 drinking 0.0% 0.0% 0.2% 0.2% 0.9% 0.3% 0.578*** concurrent partnerships 3.6% 2.4% 3.1% 6.9% 7.6% 4.5% 0.240 20 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 1996 1 Full immunization 40.7% 50.5% 52.8% 61.0% 81.6% 55.1% 0.131*** treatment of diarrhea 19.4% 30.0% 18.6% 47.6% 35.1% 29.1% 0.154*** Medical treatment of ari 36.9% 56.9% 55.3% 44.2% 58.1% 48.9% 0.073* Skilled antenatal care (4+ visits) 25.8% 39.1% 49.2% 61.0% 66.2% 46.3% 0.197*** Skilled birth attendance 20.9% 30.1% 44.7% 56.9% 75.5% 42.8% 0.259*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 0.5% 1.0% 1.7% 0.9% 1.2% 1.1% 0.084 cervical cancer screening 39.6% 19.6% 25.7% 45.3% 45.3% 33.2% 0.092 Breast cancer screening 2.2% 4.9% 5.6% 2.7% 0.4% 3.3% -0.004 adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 39.3% 43.8% 44.4% 49.3% 45.5% 44.4% 0.033* (12 months) inpatient (12 months) 9.5% 11.2% 12.2% 10.9% 12.0% 11.2% 0.045 inpatient (5 years) 18.9% 20.7% 23.3% 23.0% 24.1% 22.0% 0.050 outpatient (12 months) 31.7% 39.1% 37.3% 43.3% 38.0% 37.8% 0.034 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending 2003 3 Headcount 53.0% 42.3% 31.1% 17.4% 8.0% concentration index 0.031** 0.008 0.002 0.039 0.079 threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending 2003 3 Headcount 71.4% 68.9% 67.0% 60.3% 51.7% concentration index -0.019** -0.027*** -0.034*** -0.048*** -0.069*** iMPoVeriSHMent Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 9.3% 14.2% 4.9 pp 52.6% average shortfall from the $0.03 $0.06 $0.02 64.2% poverty line average shortfall from the $0.36 $0.39 $0.03 7.6% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 26.6% 35.0% 8.4 pp 31.8% average shortfall from the $0.16 $0.24 $0.08 47.5% poverty line average shortfall from the $0.61 $0.69 $0.07 11.9% poverty line, among the poor 21 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using comoros’s consumer price index. data sources: 1=1996 comoros demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 comoros World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - comoros. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 22 HealtH equity and Financial Protection dataSHeet CÔTE D´IVOIRE the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1994 1a outcoMeS infant mortality rate 124.5 103.8 92.5 81.5 64.8 96.2 -0.125*** under-five mortality rate 194.5 166.8 152.9 123.6 93.0 151.5 -0.133*** Stunting 41.0% 36.1% 29.2% 26.7% 16.1% 31.3% -0.152*** underweight 28.6% 20.9% 15.4% 10.6% 7.5% 17.9% -0.241*** diarrhea 25.3% 23.8% 23.0% 19.0% 20.8% 22.6% -0.046 acute respiratory infection 20.7% 15.4% 18.3% 16.4% 14.1% 17.4% -0.060* Fever 42.1% 42.8% 37.6% 34.4% 32.7% 38.5% -0.052*** 1998-99 1b infant mortality rate 168.3 122.0 125.0 102.2 56.6 122.7 -0.154*** under-five mortality rate 232.3 206.8 172.8 134.0 77.8 175.2 -0.170*** Stunting 39.8% 35.7% 33.2% 26.9% 16.6% 31.6% -0.133*** underweight 27 .8% 23.9% 21.8% 16.9% 11.2% 21.1% -0.152*** diarrhea 13.2% 14.1% 11.7% 15.4% 16.4% 14.0% 0.048*** acute respiratory infection 3.6% 6.7% 4.1% 8.2% 11.5% 6.4% 0.198*** Fever 46.3% 46.2% 45.1% 43.4% 37.3% 44.1% -0.033*** 2003 3 Malaria 50.2% 54.3% 59.7% 57.7% 55.9% 55.6% 0.022 2006 2 Stunting 46.9% 45.6% 40.6% 31.2% 25.4% 39.5% -0.116*** underweight 22.6% 20.3% 18.2% 12.0% 6.9% 17.0% -0.189*** diarrhea 19.7% 20.1% 16.3% 15.7% 12.2% 17.3% -0.090*** acute respiratory infection 18.6% 16.9% 12.9% 13.6% 10.5% 15.0% -0.103*** Fever 30.1% 29.4% 25.5% 21.3% 20.9% 26.1% -0.087*** adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 1994 1a obesity among non-pregnant 0.0% 2.4% 3.3% 7.2% 9.8% 5.1% 0.400*** women 1998-99 1b obesity among non-pregnant 0.9% 1.4% 2.1% 3.6% 9.0% 3.0% 0.444*** women 2003 3 tuberculosis 10.3% 7.1% 8.6% 6.7% 9.6% 8.5% -0.021 obesity among all women 0.0% 4.1% 1.4% 0.7% 5.8% 3.4% 0.233 road traffic accident 4.4% 3.6% 2.7% 3.4% 5.8% 4.0% 0.075 non-road traffic accident 9.6% 7.8% 7.5% 4.0% 9.5% 7.7% -0.036 angina 10.2% 8.4% 8.7% 5.2% 5.9% 7.7% -0.117** arthritis 15.6% 13.2% 12.6% 9.9% 10.7% 12.4% -0.074** asthma 4.3% 2.4% 3.3% 4.2% 6.8% 4.2% 0.164** depression 1.3% 1.7% 3.1% 1.0% 1.3% 1.7% -0.048 diabetes 2.3% 1.4% 0.3% 1.3% 1.3% 1.3% -0.121 difficulty with work and 7.4% 9.6% 7.0% 4.7% 4.1% 6.5% -0.129 household activities Poor self-assessed health 12.3% 13.5% 10.7% 7.2% 4.4% 9.6% -0.190 status 23 inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2003 3 Smoking (all) 15.6% 15.6% 11.7% 11.7% 12.1% 13.3% -0.059 Smoking (women) 0.5% 0.6% 0.2% 0.7% 0.1% 0.4% -0.119 insufficient intake of fruit and 61.9% 67.4% 72.3% 78.2% 79.3% 71.8% 0.052*** vegetables insufficient physical activity 2.5% 3.2% 2.3% 2.3% 3.3% 2.7% 0.014 drinking 8.1% 7.8% 9.3% 13.9% 11.4% 10.1% 0.109*** concurrent partnerships 0.4% 0.7% 0.4% 0.9% 0.4% 0.6% 0.052 2006 2 Mosquito net use by children 0.2% 1.1% 1.9% 1.5% 2.8% 1.4% 0.306 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1a,1b,2 utiliZation 1994 1a Full immunization 29.9% 47 .8% 41.6% 68.6% 85.1% 51.1% 0.212*** treatment of diarrhea 15.4% 28.5% 20.2% 27 .8% 34.7% 23.6% 0.148** Medical treatment of ari 33.3% 33.3% 24.9% 38.5% 58.8% 35.4% 0.100* Skilled antenatal care (4+ visits) 3.4% 3.5% 5.2% 5.4% 15.7% 6.0% 0.317*** Skilled birth attendance 2.2% 6.5% 4.0% 7.8% 11.1% 5.8% 0.281*** 1998-99 1b Full immunization 15.8% 27 .9% 32.3% 52.7% 65.3% 37 .4% 0.267*** treatment of diarrhea 5.6% 5.2% 4.5% 12.8% 12.7% 8.1% 0.231*** Skilled antenatal care (4+ visits) 12.8% 23.1% 26.2% 37.7% 53.3% 28.8% 0.261*** Skilled birth attendance 16.2% 31.0% 45.3% 66.7% 84.9% 45.7% 0.306*** 2006 2 Full immunization 56.4% 74.2% 85.0% 92.6% 97.4% 79.7% 0.105*** treatment of diarrhea 31.2% 35.7% 32.1% 29.3% 37.4% 32.9% 0.013 Medical treatment of ari 54.6% 54.2% 61.6% 72.3% 69.5% 59.2% 0.069** contraceptive prevalence 0.1% 0.0% 0.1% 0.0% 0.0% 0.1% -0.289 among women adult Preventive care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 1.8% 0.9% 3.0% 2.5% 4.4% 2.5% 0.218*** cervical cancer screening 26.3% 26.8% 16.1% 29.7% 24.9% 24.9% 0.024 Breast cancer screening 1.1% 0.0% 5.1% 1.8% 2.9% 2.0% 0.297** 2006 2 voluntary counseling and 77.4% 66.0% 81.4% 80.7% 85.5% 80.6% 0.038** testing for Hiv adult curative care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 38.7% 37.3% 44.6% 49.0% 58.5% 45.7% 0.095*** (12 months) inpatient (12 months) 3.3% 5.8% 5.6% 7.7% 8.6% 6.2% 0.180*** inpatient (5 years) 8.3% 12.8% 12.9% 16.7% 18.0% 13.8% 0.144*** outpatient (12 months) 30.9% 25.5% 32.9% 34.3% 45.3% 33.7% 0.097*** 24 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 45.6% 37.7% 30.4% 19.2% 12.2% concentration index 0.090*** 0.039** 0.016 -0.023 -0.091** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 56.3% 53.6% 49.9% 42.7% 34.5% concentration index 0.010 -0.016 -0.051*** -0.102*** -0.180*** iMPoveriSHMent3 Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 52.2% 57.7% 5.5 pp 10.4% average shortfall from the $0.34 $0.40 $0.06 16.7% poverty line average shortfall from the $0.63 $0.66 $0.04 5.6% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 70.3% 74.2% 3.9 pp 5.6% average shortfall from the $0.82 $0.92 $0.10 11.6% poverty line average shortfall from the $1.13 $1.19 $0.06 5.6% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using côte d´ivoire’s consumer price index. data sources: 1a=1994 côte d´ivoire demographic and Health Survey, 1b=1998-99 côte d´ivoire demographic and Health Survey, 2=2006 côte d´ivoire Multiple indicator cluster Survey, 3=2003 côte d´ivoire World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - côte d´ivoire. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: ami vitale, 2002 25 HealtH equity and Financial Protection dataSHeet DEMOCRATIC REPU BLIC OF THE CONGO the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2007 1 outcoMeS infant mortality rate 119.3 114.3 108.0 94.4 60.0 101.4 -0.107*** under-five mortality rate 183.9 172.4 178.7 147.7 105.6 160.6 -0.086*** Stunting 45.2% 48.3% 52.1% 48.4% 26.2% 45.0% -0.057*** underweight 27 .4% 29.6% 29.2% 23.7% 14.1% 25.4% -0.094*** diarrhea 17.4% 15.9% 16.8% 18.5% 14.8% 16.8% -0.004 acute respiratory infection 18.0% 15.3% 16.5% 17.8% 10.9% 15.9% -0.050** Fever 35.3% 29.2% 32.3% 33.6% 26.3% 31.6% -0.037*** adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2007 1 obesity among non-pregnant 0.9% 1.0% 1.2% 2.8% 6.3% 2.6% 0.419*** women HiV positive 0.0% 0.0% 0.0% 0.0% 1.8% 0.3% 0.882*** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2007 1 Smoking (women) 6.0% 4.8% 3.0% 0.9% 0.8% 3.0% -0.392*** concurrent partnerships 13.4% 12.0% 12.4% 13.2% 20.6% 14.6% 0.092*** condom usage (more than 7.4% 9.6% 13.9% 13.4% 22.1% 14.8% 0.236*** one partner) Mosquito net use by children 2.4% 4.6% 7.0% 6.1% 11.6% 6.1% 0.248*** Mosquito net use by pregnant 2.6% 4.6% 14.8% 9.5% 15.2% 8.5% 0.279*** women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2007 1 Full immunization 19.8% 27.1% 28.7% 33.6% 50.4% 30.8% 0.181*** treatment of diarrhea 41.2% 43.0% 45.1% 53.0% 42.8% 45.3% 0.029 Medical treatment of ari 38.4% 44.4% 36.5% 42.6% 53.9% 41.9% 0.045* Skilled antenatal care (4+ visits) 38.5% 41.5% 44.2% 43.2% 61.2% 45.4% 0.087*** Skilled birth attendance 50.5% 52.3% 65.0% 77.5% 91.3% 66.3% 0.133*** contraceptive prevalence 37.8% 38.2% 36.0% 30.7% 34.9% 34.7% -0.008 among women 26 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=2007 democratic republic of the congo demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - democratic republic of the congo. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 27 HealtH equity and Financial Protection dataSHeet E THIOPIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2000 1a outcoMeS infant mortality rate 106.9 128.5 144.9 132.5 95.2 122.5 -0.001 under-five mortality rate 172.7 238.4 237.3 224.2 154.8 207.1 -0.003 Stunting 59.2% 58.3% 59.7% 57.2% 47.5% 56.9% -0.031*** underweight 43.9% 44.5% 47.3% 39.3% 31.0% 41.9% -0.051*** diarrhea 23.3% 26.4% 25.0% 24.5% 20.5% 24.1% -0.016 acute respiratory infection 23.0% 25.0% 30.0% 25.1% 21.9% 25.2% 0.001 Fever 26.8% 29.0% 32.1% 28.6% 28.4% 29.0% 0.010 2003 3 Malaria 28.8% 24.2% 27.1% 26.5% 19.3% 25.3% -0.045 2005 1b infant mortality rate 94.7 98.2 97.4 98.6 68.3 92.9 -0.036** under-five mortality rate 145.1 156.0 143.1 153.3 93.5 140.8 -0.048*** Stunting 51.5% 53.6% 51.3% 48.5% 39.6% 49.6% -0.040*** underweight 37.5% 39.4% 33.8% 31.0% 25.1% 34.1% -0.074*** diarrhea 18.0% 20.1% 20.0% 16.8% 14.4% 18.1% -0.036** acute respiratory infection 12.5% 11.5% 14.7% 13.5% 10.6% 12.7% -0.005 Fever 19.2% 19.6% 20.0% 17.8% 17.1% 18.9% -0.025 2011 1c infant mortality rate 98.3 90.8 64.6 71.4 58.7 78.7 -0.110*** under-five mortality rate 155.6 137.2 100.7 117.5 86.0 122.6 -0.105*** Stunting 48.9% 47.9% 45.4% 45.8% 29.1% 44.5% -0.063*** underweight 36.1% 34.1% 28.8% 27.4% 15.3% 29.5% -0.126*** diarrhea 14.9% 12.7% 12.9% 15.0% 11.7% 13.5% -0.029 acute respiratory infection 13.1% 10.0% 13.3% 13.1% 8.7% 11.8% -0.024 Fever 18.6% 16.9% 17.6% 16.9% 15.7% 17.2% -0.025 28 inequalitieS adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci in HealtH 2000 1a outcoMeS obesity among non-pregnant 0.2% 0.1% 0.1% 0.1% 1.3% 0.4% 0.585*** (cont.) women 2003 3 tuberculosis 13.8% 10.0% 7.9% 7.7% 6.3% 9.1% -0.133*** road traffic accident 0.0% 0.0% 0.2% 0.2% 0.4% 0.2% 0.493*** non-road traffic accident 1.9% 1.2% 1.3% 1.7% 2.1% 1.7% 0.070 angina 17 .9% 14.3% 17 .2% 15.7% 9.1% 14.9% -0.079*** arthritis 24.7% 24.8% 25.0% 21.9% 17.3% 22.8% -0.051*** asthma 1.3% 1.1% 2.9% 2.4% 5.4% 2.6% 0.307*** depression 3.6% 4.3% 4.6% 4.9% 4.3% 4.3% 0.047 diabetes 0.5% 0.0% 0.3% 0.3% 0.8% 0.4% 0.289 difficulty with work and 8.9% 6.8% 6.0% 6.0% 5.9% 6.7% -0.060* household activities Poor self-assessed health 6.5% 5.5% 4.4% 4.7% 4.4% 5.1% -0.058 status 2005 1b obesity among non-pregnant 0.2% 0.4% 0.2% 0.1% 1.9% 0.7% 0.562*** women HiV positive 0.5% 0.6% 0.7% 0.5% 4.1% 1.3% 0.493*** 2011 1c obesity among non-pregnant 0.4% 0.4% 0.1% 0.3% 2.8% 1.0% 0.550*** women HiV positive 0.3% 0.4% 0.7% 1.0% 4.1% 1.4% 0.521*** inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 2.7% 5.6% 4.6% 3.7% 3.1% 3.9% -0.033 insufficient intake of fruit and 61.6% 56.8% 59.9% 57.9% 60.4% 59.2% -0.003 vegetables insufficient physical activity 0.5% 1.4% 2.9% 3.3% 1.9% 2.0% 0.195*** drinking 54.4% 35.6% 31.3% 20.1% 26.5% 33.6% -0.163*** 2005 1b Smoking (women) 3.0% 1.4% 1.5% 0.7% 0.7% 1.4% -0.312*** concurrent partnerships 1.6% 1.3% 1.1% 1.1% 3.2% 1.8% 0.193*** Mosquito net use by children 1.4% 0.8% 1.2% 1.7% 3.1% 1.5% 0.207*** Mosquito net use by pregnant 0.9% 0.3% 0.0% 1.2% 5.1% 1.1% 0.423** women 2011 1c Smoking (women) 1.4% 0.5% 0.9% 0.2% 0.7% 0.7% -0.145* concurrent partnerships 1.1% 1.0% 2.2% 2.0% 5.6% 2.6% 0.364*** condom usage (more than 1.5% 0.4% 7.0% 28.5% 37.6% 26.0% 0.316*** one partner) 29 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b.1c,2 utiliZation 2000 1a Full immunization 7.2% 8.3% 9.9% 16.9% 34.2% 14.3% 0.344*** treatment of diarrhea 11.1% 15.2% 13.7% 19.7% 43.7% 18.7% 0.242*** Medical treatment of ari 8.6% 13.7% 16.2% 14.6% 31.1% 15.8% 0.199*** Skilled antenatal care (4+ visits) 4.0% 5.0% 6.0% 7.2% 37.3% 10.7% 0.475*** Skilled birth attendance 0.9% 1.4% 2.1% 3.0% 26.6% 5.7% 0.675*** 2005 1b Full immunization 14.2% 17 .3% 21.5% 18.7% 36.1% 20.6% 0.183*** treatment of diarrhea 19.4% 22.3% 28.8% 29.1% 48.1% 27 .6% 0.147*** Medical treatment of ari 18.6% 12.2% 21.0% 13.5% 34.4% 18.8% 0.090* Skilled antenatal care (4+ visits) 3.5% 5.8% 8.3% 8.8% 40.3% 12.0% 0.479*** Skilled birth attendance 0.7% 1.2% 1.6% 4.6% 27.1% 5.7% 0.715*** contraceptive prevalence 48.4% 48.6% 54.0% 59.5% 57.3% 55.7% 0.022* 2011 1c Full immunization 16.4% 18.8% 17 .9% 25.3% 51.5% 24.3% 0.228*** treatment of diarrhea 21.7% 24.1% 34.8% 31.8% 52.8% 30.9% 0.148*** Medical treatment of ari 14.9% 21.9% 24.9% 29.4% 46.2% 25.1% 0.201*** Skilled antenatal care (4+ visits) 8.5% 11.7% 13.8% 21.6% 47.2% 19.2% 0.362*** Skilled birth attendance 2.5% 4.2% 3.3% 8.5% 47.8% 10.9% 0.607*** contraceptive prevalence 10.2% 16.5% 17.8% 19.9% 26.2% 18.7% 0.164*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 15.9% 12.9% 9.5% 20.6% 25.5% 15.9% 0.128 Breast cancer screening 0.3% 0.0% 0.8% 1.0% 1.2% 0.7% 0.406** adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 30.8% 33.4% 35.4% 33.2% 34.6% 33.5% 0.034** (12 months) inpatient (12 months) 0.9% 1.4% 2.4% 2.8% 3.4% 2.2% 0.243*** inpatient (5 years) 1.7% 2.9% 3.8% 4.7% 6.9% 4.0% 0.258*** outpatient (12 months) 29.8% 32.2% 32.0% 30.6% 32.5% 31.4% 0.028* threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 32.3% 27.0% 22.9% 19.6% 16.8% concentration index -0.248*** -0.367*** -0.475*** -0.584*** -0.726*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 35.8% 34.5% 32.1% 27.3% 22.7% concentration index -0.194*** -0.219*** -0.259*** -0.358*** -0.477*** 30 Financial iMPoVeriSHMent3 Protection Poverty line at uS$1.25 per consumption consumption change % change (cont.) capita per day including ooP excluding ooP 2003 3 Percentage in poverty 87.1% 88.4% 1.3 pp 1.5% average shortfall from the $0.63 $0.65 $0.02 3.5% poverty line average shortfall from the $0.72 $0.74 $0.01 2.0% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 96.3% 97.0% 0.7 pp 0.7% average shortfall from the $1.33 $1.36 $0.03 2.2% poverty line average shortfall from the $1.38 $1.40 $0.02 1.5% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using ethiopia’s consumer price index. data sources: 1a=2000 ethiopia demographic and Health Survey, 1b=2005 ethiopia demographic and Health Survey, 1c=2011 ethiopia demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 ethiopia World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - ethiopia. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: ray Witlin 31 HealtH equity and Financial Protection dataSHeet Gabon the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2000 1 outcoMeS infant mortality rate 62.0 73.2 71.6 77.1 43.2 66.4 -0.031 under-five mortality rate 94.9 118.1 115.8 105.7 49.3 99.0 -0.065** Stunting 40.6% 32.8% 21.2% 15.5% 15.1% 25.8% -0.218*** underweight 15.3% 9.9% 8.3% 4.9% 4.6% 8.9% -0.251*** diarrhea 16.9% 17.5% 17 .2% 17 .3% 16.9% 17.2% -0.003 acute respiratory infection 14.2% 13.2% 16.3% 13.7% 14.0% 14.3% -0.000 Fever 30.2% 29.9% 36.3% 31.2% 31.4% 31.8% 0.010 adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2000 1 obesity among non-pregnant 2.1% 4.8% 10.0% 10.4% 13.2% 8.0% 0.274*** women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 2000 1 Full immunization 5.5% 9.6% 18.1% 19.5% 23.6% 14.7% 0.249*** treatment of diarrhea 35.1% 40.2% 32.1% 36.9% 35.8% 36.1% -0.008 Medical treatment of ari 36.0% 52.0% 69.5% 79.7% 67.4% 60.7% 0.121 Skilled antenatal care (4+ visits) 42.5% 57 .0% 68.1% 74.0% 81.6% 64.5% 0.123*** Skilled birth attendance 69.5% 88.0% 93.3% 94.8% 97.0% 88.2% 0.060*** note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=2000 Gabon demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Gabon. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: un Photo/Gill Fickling 32 health eQUity aNd FiNaNCial PrOteCtiON dataSheet GHANA the health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and health Surveys (dhS), World health Surveys (WhS), Multiple indicator Cluster Surveys (MiCS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. iNeQUalitieS Child health1a,1b,1c,1d,2,3 Q1 Q2 Q3 Q4 Q5 total Ci iN health 1993 1a OUtCOMeS infant mortality rate 91.0 106.7 94.4 72.0 48.8 84.8 -0.099*** Under-five mortality rate 177 .1 183.9 156.0 112.2 80.9 146.0 -0.137*** Stunting 44.5% 34.7% 35.8% 28.9% 16.3% 32.6% -0.142*** Underweight 31.7% 30.9% 31.6% 19.5% 12.2% 25.8% -0.145*** diarrhea 11.1% 10.6% 11.8% 11.3% 10.1% 11.0% -0.002 acute respiratory infection 5.9% 5.8% 4.0% 2.7% 5.5% 4.8% -0.063 Fever 29.7% 31.1% 33.6% 22.4% 20.3% 27 .8% -0.070*** 1999 1b infant mortality rate 77.4 72.9 89.3 62.1 26.0 68.6 -0.100*** Under-five mortality rate 141.9 138.9 124.3 100.3 46.3 116.4 -0.145*** Stunting 39.4% 35.5% 35.1% 23.2% 16.8% 31.6% -0.133*** Underweight 28.2% 23.0% 20.2% 16.9% 8.6% 20.7% -0.164*** diarrhea 22.6% 19.5% 18.8% 16.1% 11.1% 18.4% -0.106*** acute respiratory infection 15.5% 15.5% 14.3% 12.5% 11.4% 14.1% -0.051*** Fever 30.4% 27.4% 28.1% 22.2% 28.3% 27 .5% -0.034*** 2003 1c infant mortality rate 80.2 66.3 75.4 67.9 62.3 71.3 -0.052* Under-five mortality rate 133.3 106.6 119.5 119.4 78.2 114.2 -0.065** Stunting 45.3% 36.0% 35.7% 25.9% 16.2% 33.8% -0.157*** Underweight 25.8% 20.0% 17.1% 13.4% 8.2% 18.1% -0.180*** diarrhea 20.0% 14.5% 14.4% 15.4% 11.2% 15.6% -0.097*** acute respiratory infection 11.7% 10.0% 10.6% 10.4% 7.9% 10.3% -0.047 Fever 22.1% 19.3% 22.8% 23.7% 22.0% 21.9% 0.025*** 2003 3 Malaria 57.2% 65.0% 61.8% 61.4% 76.4% 64.2% 0.044*** 2006 2 Underweight 19.3% 17.7% 13.1% 10.7% 4.3% 14.1% -0.214*** diarrhea 20.5% 15.5% 15.0% 12.1% 11.1% 15.4% -0.114*** acute respiratory infection 11.9% 11.7% 13.8% 9.3% 13.9% 12.1% 0.016 Fever 25.6% 24.6% 20.5% 22.8% 15.2% 22.4% -0.080*** 2008 1d infant mortality rate 71.5 47.1 76.7 55.8 52.9 61.7 -0.029 Under-five mortality rate 106.3 86.8 102.5 69.7 55.0 87.4 -0.093*** Stunting 32.8% 33.8% 27 .9% 22.3% 16.4% 27.8% -0.119*** Underweight 18.0% 18.4% 12.1% 9.8% 9.5% 14.3% -0.153*** diarrhea 25.6% 21.4% 21.5% 16.9% 10.0% 20.1% -0.133*** acute respiratory infection 11.1% 12.3% 9.5% 13.2% 6.8% 10.8% -0.057* Fever 19.9% 22.7% 21.8% 20.3% 14.0% 20.1% -0.045** 33 iNeQUalitieS adUlt health1a,1b,1c.1d,3 Q1 Q2 Q3 Q4 Q5 total Ci iN health 1993 1a OUtCOMeS Obesity among non-pregnant 0.4% 1.4% 2.7% 3.2% 10.1% 3.5% 0.510*** (CONt.) women 1999 1b Obesity among non-pregnant 1.5% 2.0% 3.0% 6.8% 17.0% 5.3% 0.493*** women 2003 1c Obesity among non-pregnant 1.4% 2.3% 4.3% 8.8% 18.0% 8.0% 0.442 women 2003 3 tuberculosis 4.3% 6.2% 3.7% 3.2% 3.0% 4.0% -0.087* road traffic accident 2.2% 2.3% 3.4% 2.7% 4.6% 3.0% 0.175*** Non-road traffic accident 7.2% 8.3% 8.3% 4.9% 3.7% 6.4% -0.123*** angina 5.2% 6.8% 6.2% 4.6% 4.0% 5.3% -0.069 arthritis 7.3% 10.4% 9.5% 7.6% 6.9% 8.3% -0.033 asthma 3.4% 5.2% 4.3% 5.9% 3.4% 4.4% 0.014 depression 2.7% 0.9% 2.0% 0.7% 1.5% 1.6% -0.144 diabetes 0.1% 0.8% 0.9% 1.4% 2.1% 1.1% 0.372*** difficulty with work and 5.2% 6.0% 5.7% 7.2% 5.1% 5.8% 0.003 household activities Poor self-assessed health 9.5% 6.6% 6.5% 6.5% 4.6% 6.7% -0.139*** status hiV-positive 1.3% 2.2% 3.1% 2.3% 2.0% 2.2% 0.049 2008 1d Obesity among non-pregnant 2.3% 3.3% 5.2% 12.4% 19.5% 9.4% 0.398*** women iNeQUalitieS iN riSk FaCtOrS1a,1b.1c.1d,2,3 Q1 Q2 Q3 Q4 Q5 total Ci riSky BehaViOr 2003 1c Smoking (women) 0.3% 0.3% 0.0% 0.0% 0.4% 0.2% 0.065 Concurrent partnerships 7.0% 12.2% 14.4% 19.2% 15.7% 14.1% 0.129*** Condom usage (more than 15.9% 17.2% 14.2% 30.3% 40.3% 26.8% 0.233*** one partner) Mosquito net use by children 6.9% 2.0% 3.1% 3.2% 5.9% 4.3% -0.105* Mosquito net use by pregnant 5.2% 3.0% 1.1% 2.1% 3.1% 2.9% -0.179 women 2003 3 Smoking (all) 10.4% 8.3% 2.7% 4.3% 3.8% 5.8% -0.244*** insufficient intake of fruit and 35.6% 30.3% 36.5% 41.0% 43.2% 37.4% 0.048*** vegetables insufficient physical activity 3.8% 4.2% 4.6% 6.6% 1.3% 4.1% -0.053 drinking 10.9% 8.0% 12.3% 11.2% 12.7% 11.0% 0.050 2006 2 Concurrent partnerships 0.7% 1.8% 1.9% 2.2% 1.9% 1.7% 0.170** Mosquito net use by children 15.4% 13.3% 9.9% 9.0% 4.9% 11.2% -0.164*** 2008 1d Smoking (women) 1.0% 0.3% 0.3% 0.2% 0.1% 0.3% -0.394*** Concurrent partnerships 7.8% 15.8% 19.5% 18.5% 16.3% 16.0% 0.088*** Condom usage (more than 22.0% 14.8% 20.0% 27.8% 36.5% 25.0% 0.173*** one partner) Mosquito net use by children 30.6% 33.9% 24.7% 32.3% 28.1% 30.2% -0.020 Mosquito net use by pregnant 37.6% 19.4% 22.2% 20.6% 13.8% 22.2% -0.165*** women 34 iNeQUalitieS MaterNal aNd Child health Q1 Q2 Q3 Q4 Q5 total Ci iN health Care iNterVeNtiONS1a,1b,1c,1d,2 UtilizatiON 1993 1a Full immunization 39.1% 55.9% 48.9% 58.1% 79.8% 56.0% 0.125*** treatment of diarrhea 19.7% 16.7% 21.3% 21.8% 18.0% 19.5% -0.003 Skilled antenatal care (4+ visits) 44.3% 45.6% 53.9% 73.3% 87.4% 59.7% 0.151*** Skilled birth attendance 26.0% 23.0% 32.8% 62.4% 85.9% 44.1% 0.283*** 1999 1b Full immunization 48.9% 56.1% 64.0% 69.0% 82.0% 62.2% 0.101*** Medical treatment of ari 20.7% 21.7% 22.4% 30.6% 50.5% 26.2% 0.144*** Skilled antenatal care (4+ visits) 41.9% 57.7% 64.2% 78.6% 90.5% 63.1% 0.149*** Skilled birth attendance 20.1% 27.7% 48.6% 67.1% 86.2% 45.2% 0.302*** 2003 1c Full immunization 53.9% 72.4% 74.2% 73.5% 80.7% 69.6% 0.074*** treatment of diarrhea 42.9% 45.2% 49.0% 47.8% 58.8% 47.0% 0.046* Medical treatment of ari 31.6% 40.2% 47.2% 50.8% 71.3% 44.4% 0.139*** Skilled antenatal care (4+ visits) 55.9% 63.2% 67.5% 84.9% 94.2% 71.0% 0.111*** Skilled birth attendance 20.5% 31.4% 43.8% 72.7% 92.4% 47.3% 0.314*** Contraceptive prevalence 31.4% 43.4% 40.0% 39.2% 40.5% 39.5% 0.023 2008 1d Full immunization 74.6% 77.6% 75.2% 85.4% 85.2% 79.0% 0.029** treatment of diarrhea 46.2% 57.1% 54.5% 55.4% 55.2% 52.6% 0.052** Medical treatment of ari 36.9% 40.7% 50.0% 58.9% 78.7% 48.7% 0.129*** Skilled antenatal care (4+ visits) 65.5% 74.3% 77.7% 91.9% 96.8% 79.8% 0.082*** Skilled birth attendance 24.6% 50.3% 65.1% 82.6% 95.4% 58.9% 0.248*** Contraceptive prevalence 32.8% 31.3% 30.7% 32.4% 32.2% 31.9% 0.003 2006 2 treatment of diarrhea 27.5% 30.6% 47.3% 46.8% 52.3% 37.3% 0.158*** Contraceptive prevalence 6.5% 13.4% 12.7% 16.0% 12.7% 12.5% 0.088*** adUlt PreVeNtiVe Care2,3 Q1 Q2 Q3 Q4 Q5 total Ci 2003 3 tB screening 1.2% 0.8% 1.3% 1.8% 0.4% 1.1% -0.044 Breast cancer screening 0.3% 1.0% 0.6% 3.6% 3.1% 1.7% 0.406*** 2006 2 Voluntary counseling and 57.5% 67.3% 62.5% 72.5% 80.5% 70.8% 0.065 testing for hiV adUlt CUratiVe Care3,4 Q1 Q2 Q3 Q4 Q5 total Ci 2003 3 inpatient or outpatient 43.7% 45.4% 50.8% 54.6% 54.5% 49.9% 0.054*** (12 months) inpatient (12 months) 5.4% 7.0% 8.0% 10.9% 10.3% 8.3% 0.143*** inpatient (5 years) 13.1% 12.6% 17.2% 18.5% 20.7% 16.5% 0.112*** Outpatient (12 months) 41.9% 40.0% 45.0% 46.5% 47.2% 44.1% 0.037** 2005-06 4 inpatient (2 weeks) 3.3% 4.6% 2.3% 3.1% 2.5% 3.2% -0.070 Outpatient (2 weeks) 11.2% 12.9% 13.3% 13.2% 13.5% 12.8% 0.036*** UtilizatiON3 Q1 Q2 Q3 Q4 Q5 total Ci 2003 3 Outpatient public health 6.3% 7.1% 7.0% 4.9% 3.3% 5.7% -0.103*** center/post Outpatient public hospital 8.6% 9.6% 11.2% 13.6% 14.1% 11.4% 0.106*** inpatient public hospital 3.9% 4.6% 4.4% 4.6% 6.3% 4.8% 0.089* Outpatient private hospital 1.9% 3.7% 2.3% 1.7% 2.7% 2.5% -0.033 inpatient private hospital 1.7% 1.9% 2.3% 2.3% 2.4% 2.1% 0.08 35 BeNeFit UtilizatiON - PUBliC Q1 Q2 Q3 Q4 Q5 total Ci iNCideNCe FaCilitieS3 aNalySiS 2003 3 Outpatient public health 6.3% 7.1% 7.0% 4.9% 3.3% 5.7% -0.103*** center/post Outpatient public hospital 8.6% 9.6% 11.2% 13.6% 14.1% 11.4% 0.106*** inpatient public hospital 3.9% 4.6% 4.4% 4.6% 6.3% 4.8% 0.089* Outpatient private hospital 1.9% 3.7% 2.3% 1.7% 2.7% 2.5% -0.033 inpatient private hospital 1.7% 1.9% 2.3% 2.3% 2.4% 2.1% 0.08 FeeS Paid at PUBliC Q1 Q2 Q3 Q4 Q5 Ci FaCilitieS (ShareS)3 2003 3 Outpatient public health 13.5 20.1 25.1 16.3 25.0 0.103 center/post Outpatient public hospital 16.4 12.5 18.9 23.5 28.8 0.153*** inpatient public hospital 7.1 16.8 16.3 39.8 20.1 0.231*** Outpatient private hospital 6.1 11.1 3.7 4.9 74.3 0.559*** inpatient private hospital 7.3 6.8 19.4 6.9 59.7 0.501** health Care SUBSidieS (ShareS)3,5 2003 3 total Constant Unit Cost Method Q1 Q2 Q3 Q4 Q5 Ci Share (lCU) Outpatient public health 22.7 25.2 24.4 17.1 10.6 130.7 -0.118*** 16.6% center/post Outpatient public hospital 15.0 17.5 19.6 24.0 23.9 207 .9 0.099*** 26.4% inpatient public hospital 17.9 19.2 18.2 17.2 27.6 325.1 0.069 41.3% Outpatient private hospital 16.1 31.2 20.3 13.8 18.6 48.1 -0.061 6.1% inpatient private hospital 16.7 18.9 20.9 24.1 19.5 75.3 0.056 9.6% total subsidies 17.6 20.5 20.0 19.4 22.4 787 .2 0.036 100% total Constant Unit Subsidy Method Q1 Q2 Q3 Q4 Q5 Ci Share (lCU) Outpatient public health 22.0 24.9 24.6 17.1 11.5 130.7 -0.103*** 16.6% center/post Outpatient public hospital 15.1 16.8 19.6 23.8 24.6 207 .9 0.106*** 26.4% inpatient public hospital 16.2 19.3 18.6 19.5 26.5 325.1 0.089* 41.3% Outpatient private hospital 15.8 30.4 18.6 13.4 21.9 48.1 -0.033 6.1% inpatient private hospital 16.1 17.7 22.0 21.9 22.3 75.3 0.080 9.6% total subsidies 16.8 20.1 20.2 20.1 22.8 787 .2 0.052** 100% total Proportional Cost Method Q1 Q2 Q3 Q4 Q5 Ci Share (lCU) Outpatient public health 13.5 20.1 25.1 16.3 25.0 130.7 0.103 16.6% center/post Outpatient public hospital 16.4 12.5 18.9 23.5 28.8 207 .9 0.153*** 26.4% inpatient public hospital 7.1 16.8 16.3 39.8 20.1 325.1 0.231*** 41.3% Outpatient private hospital 6.1 11.1 3.7 4.9 74.3 48.1 0.559*** 6.1% inpatient private hospital 7.3 6.8 19.4 6.9 59.7 75.3 0.501** 9.6% total subsidies 10.6 14.9 17.9 26.3 30.3 787 .2 0.235*** 100% health health iNSUraNCe Q1 Q2 Q3 Q4 Q5 total Ci iNSUraNCe COVerage4 COVerage 2005-06 4 district mutual 5.5% 12.0% 17.2% 19.2% 23.2% 15.4% 0.234*** Private mutual or company 0.0% 0.4% 0.1% 0.5% 1.6% 0.5% 0.527*** Other scheme 0.1% 0.5% 0.9% 1.0% 0.8% 0.6% 0.228*** any insurance 5.7% 12.9% 18.2% 20.6% 25.6% 16.6% 0.243*** 36 threshold share of total household consumption FiNaNCial CataStrOPhiC OUt-OF- 5% 10% 15% 25% 40% PrOteCtiON POCket SPeNdiNg3 2003 3 headcount 38.6% 23.6% 16.4% 8.8% 4.8% Concentration index 0.025* 0.027 0.072*** 0.148*** 0.249*** threshold share of nonfood consumption CataStrOPhiC OUt-OF- 5% 10% 15% 25% 40% POCket SPeNdiNg3 2003 3 headcount 56.2% 50.3% 44.6% 34.5% 22.8% Concentration index 0.020** 0.010 -0.003 -0.035** -0.043** iMPOVeriShMeNt3 Poverty line at US$1.25 per Consumption Consumption Change % change capita per day including OOP excluding OOP 2003 3 Percentage in poverty 49.6% 53.3% 3.7 pp 7.6% average shortfall from the $0.26 $0.29 $0.03 12.1% poverty line average shortfall from the $0.52 $0.54 $0.02 4.3% poverty line, among the poor Poverty line at US$2.00 per Consumption Consumption Change % change capita per day including OOP excluding OOP 2003 3 Percentage in poverty 72.2% 76.2% 4.0 pp 5.5% average shortfall from the $0.73 $0.80 $0.06 8.6% poverty line average shortfall from the $1.00 $1.03 $0.03 2.9% poverty line, among the poor PrOgreSSiVity PrOgreSSiVity OF health Q1 Q2 Q3 Q4 Q5 Ci/gini kakwani Share OF health SPeNdiNg (ShareS)4 FiNaNCiNg 2005-06 4 Consumption 4.3 8.8 13.6 20.5 52.7 0.476*** total taxes 3.9 8.1 12.9 20.2 54.8 0.498*** 0.022*** 53.3% Shi 2.7 7.3 13.5 19.4 57.1 0.521*** 0.046** 15.6% Voluntary insurance 1.7 8.3 4.0 17.8 68.1 0.590*** 0.115 0.2% Out-of-pocket spending 3.4 9.0 16.2 21.6 49.8 0.458*** -0.017 30.1% total payments 3.4 8.0 13.4 19.9 55.4 0.505*** 0.029 99.2% Note: the health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WhS, dhS and MiCS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. Q = quintile (where quintile 1 is the poorest) Ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using ghana’s consumer price index. data sources: 1a=1993 ghana demographic and health Survey, 1b=1999 ghana demographic and health Survey, 1c=2003 ghana demographic and health Survey, 1d=2008 ghana demographic and health Survey, 2=2006 ghana Multiple indicator Cluster Survey, 3=2003 ghana World health Survey, 4=2005/06 ghana living Standards Survey, 5=2002 ghana National health accounts report recommended citation: World Bank. 2012. health equity and Financial Protection datasheet - ghana. Washington, d.C.: World Bank. For more information and the latest versions of the health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Curt Carnemark 37 HealtH equity and Financial Protection dataSHeet Guine a the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1999 1a outcoMeS infant mortality rate 145.5 158.9 131.5 109.7 78.9 128.3 -0.104*** under-five mortality rate 233.4 234.4 199.7 183.8 130.0 201.1 -0.095*** Stunting 40.9% 38.1% 35.0% 31.7% 20.7% 34.0% -0.103*** underweight 24.0% 24.7% 21.6% 17.7% 15.1% 21.0% -0.093*** diarrhea 24.0% 22.3% 21.6% 20.2% 19.8% 21.8% -0.039** acute respiratory infection 18.7% 15.4% 15.2% 16.8% 15.2% 16.4% -0.031 Fever 45.4% 42.1% 43.0% 42.6% 44.3% 43.5% -0.005 2005 1b infant mortality rate 146.0 136.6 132.0 116.4 68.4 124.4 -0.096*** under-five mortality rate 241.7 252.0 234.6 174.8 125.5 213.3 -0.102*** Stunting 44.2% 44.1% 41.4% 35.1% 26.0% 39.3% -0.085*** underweight 26.5% 27 .1% 22.4% 20.2% 15.8% 23.0% -0.090*** diarrhea 18.4% 14.4% 16.3% 14.4% 17 .8% 16.3% -0.002 acute respiratory infection 9.9% 7.9% 7.8% 7.3% 8.0% 8.3% -0.047 Fever 38.9% 34.7% 34.4% 33.9% 29.1% 34.7% -0.044*** adult HealtH1,3 q1 q2 q3 q4 q5 total ci 1999 1a obesity among non-pregnant 1.2% 3.0% 2.4% 4.1% 9.5% 3.8% 0.356*** women 2005 1b obesity among non-pregnant 0.8% 0.9% 1.4% 3.9% 7.5% 3.0% 0.449*** women HiV positive 1.5% 0.6% 0.6% 2.2% 2.6% 1.5% 0.195*** inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2005 1b Smoking (women) 1.5% 1.1% 0.7% 0.8% 2.6% 1.4% 0.107 concurrent partnerships 6.0% 5.0% 9.4% 14.3% 18.2% 10.6% 0.265*** condom usage (more than 5.4% 10.4% 9.0% 21.8% 40.2% 23.0% 0.382*** one partner) Mosquito net use by children 0.5% 1.0% 0.6% 1.6% 4.3% 1.4% 0.435*** Mosquito net use by pregnant 0.5% 2.5% 0.4% 0.0% 5.7% 1.6% 0.368** women 38 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 1999 1a Full immunization 17.5% 23.8% 32.3% 39.4% 52.4% 32.4% 0.212*** treatment of diarrhea 34.9% 29.1% 45.9% 50.2% 48.6% 40.6% 0.109*** Medical treatment of ari 43.4% 42.9% 52.3% 67.8% 70.4% 53.9% 0.112*** Skilled antenatal care (4+ visits) 16.6% 17.1% 23.6% 24.9% 30.1% 21.8% 0.127*** Skilled birth attendance 4.4% 6.4% 8.1% 12.9% 19.7% 9.7% 0.312*** 2005 1b Full immunization 29.1% 31.8% 43.2% 43.9% 46.3% 37.7% 0.109*** treatment of diarrhea 22.4% 26.0% 34.6% 47.4% 65.6% 36.8% 0.231*** Medical treatment of ari 30.3% 45.0% 43.3% 47.5% 60.8% 43.2% 0.134*** Skilled antenatal care (4+ visits) 26.7% 30.4% 37.1% 53.3% 77.3% 42.2% 0.224*** Skilled birth attendance 8.0% 12.1% 20.9% 40.5% 85.4% 29.3% 0.461*** contraceptive prevalence 33.7% 37.0% 36.4% 40.2% 44.8% 40.4% 0.060*** note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1999 Guinea demographic and Health Survey, 1b=2005 Guinea demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Guinea. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: un Photo/ray Witlin 39 HealtH equity and Financial Protection dataSHeet Guine a- Bissau the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2006 2 outcoMeS Stunting 46.0% 51.5% 52.2% 44.3% 37.4% 47 .1% -0.032*** underweight 17 .9% 18.6% 21.1% 16.3% 11.2% 17 .6% -0.060*** diarrhea 13.0% 12.6% 12.0% 11.3% 13.9% 12.5% -0.006 acute respiratory infection 7.5% 7.8% 7.1% 5.7% 10.0% 7.5% 0.008 Fever 13.3% 13.6% 12.8% 13.8% 14.8% 13.6% 0.010 inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2006 2 concurrent partnerships 4.6% 6.2% 7.0% 8.6% 14.0% 9.0% 0.226*** Mosquito net use by children 38.9% 39.8% 42.0% 39.3% 25.0% 38.0% -0.041*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 2006 2 Full immunization 84.6% 91.5% 87 .8% 91.7% 98.2% 90.6% 0.021*** treatment of diarrhea 45.7% 42.5% 49.5% 35.7% 62.6% 46.6% 0.032 Medical treatment of ari 45.1% 52.2% 50.0% 71.6% 85.8% 61.2% 0.130*** contraceptive prevalence 5.8% 6.3% 9.1% 20.6% 36.7% 17.1% 0.395*** note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=n/a demographic and Health Survey, 2=2006 Guinea-Bissau Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Guinea-Bissau. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: 40 HealtH equity and Financial Protection dataSHeet K EN YA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1993 1a outcoMeS infant mortality rate 93.3 86.6 55.8 38.5 46.2 65.9 -0.185*** under-five mortality rate 129.1 132.0 78.0 56.1 61.5 94.0 -0.185*** Stunting 48.6% 43.3% 37.4% 41.7% 23.1% 39.8% -0.103*** underweight 28.3% 21.6% 18.7% 19.2% 9.8% 20.2% -0.164*** diarrhea 8.2% 10.7% 8.9% 7.9% 6.6% 8.6% -0.046* acute respiratory infection 5.9% 7.1% 5.8% 8.5% 6.7% 6.8% 0.043 Fever 44.5% 45.1% 41.5% 39.2% 41.4% 42.5% -0.022** 1998 1b infant mortality rate 102.6 87.6 67.2 59.2 50.4 76.8 -0.148*** under-five mortality rate 143.6 125.1 97.2 77.9 59.3 105.7 -0.172*** Stunting 49.1% 41.2% 35.5% 35.9% 21.0% 37.8% -0.134*** underweight 26.1% 21.8% 16.1% 14.7% 8.6% 18.3% -0.196*** diarrhea 19.4% 19.5% 17.0% 16.5% 13.0% 17.3% -0.074*** acute respiratory infection 23.1% 21.3% 19.5% 21.4% 15.2% 20.4% -0.065*** Fever 45.7% 43.9% 43.0% 41.8% 38.7% 42.9% -0.034** 2003 1c infant mortality rate 106.0 77.4 88.9 57.3 67 .7 81.7 -0.101*** under-five mortality rate 157.5 105.6 124.0 77.0 93.4 115.0 -0.117*** Stunting 44.0% 38.7% 34.4% 33.7% 25.2% 36.1% -0.103*** underweight 24.9% 15.8% 14.6% 14.1% 7.5% 16.1% -0.208*** diarrhea 18.3% 18.1% 14.9% 13.3% 16.4% 16.4% -0.051*** acute respiratory infection 18.3% 23.1% 18.0% 18.0% 16.8% 18.9% -0.030* Fever 38.5% 44.1% 42.0% 42.3% 42.3% 41.7% 0.020** 2008-09 1d infant mortality rate 73.1 78.1 69.3 45.4 60.7 66.2 -0.063** under-five mortality rate 97.1 113.4 98.2 60.1 67.6 89.0 -0.096*** Stunting 45.1% 40.0% 33.8% 28.9% 24.1% 35.5% -0.126*** underweight 24.6% 18.0% 13.7% 12.0% 9.1% 16.3% -0.221*** diarrhea 19.4% 16.1% 15.3% 20.2% 12.3% 16.8% -0.057*** acute respiratory infection 15.5% 13.6% 12.0% 12.2% 9.9% 12.9% -0.084*** Fever 26.0% 21.3% 25.5% 26.1% 21.4% 24.1% -0.025 2004 3 Malaria 66.1% 69.9% 59.9% 67.4% 48.8% 63.0% -0.050** 41 inequalitieS adult HealtH1a,1b,1c,1d,3 q1 q2 q3 q4 q5 total ci in HealtH 1993 1a outcoMeS obesity among non-pregnant 1.5% 1.7% 1.4% 3.6% 6.3% 2.9% 0.324*** (cont.) women 1998 1b obesity among non-pregnant 0.4% 1.8% 2.0% 2.6% 7.7% 2.7% 0.447*** women 2003 1c obesity among non-pregnant 1.7% 2.4% 4.9% 7.3% 12.8% 6.4% 0.388*** women HiV positive 4.1% 6.8% 5.1% 7.5% 10.2% 6.9% 0.144*** 2004 3 tuberculosis 10.3% 11.1% 6.5% 4.7% 4.1% 7.3% -0.222*** road traffic accident 1.7% 2.1% 2.0% 3.1% 2.2% 2.3% 0.096 non-road traffic accident 12.4% 12.1% 13.3% 9.6% 12.6% 12.0% -0.013 angina 2.9% 4.9% 1.2% 2.2% 3.3% 2.9% -0.047 arthritis 8.0% 6.4% 3.1% 5.1% 2.6% 5.0% -0.212*** asthma 3.7% 3.0% 1.6% 3.9% 2.4% 2.9% -0.030 depression 4.3% 7.2% 4.9% 4.8% 5.1% 5.3% -0.033 diabetes 0.1% 0.0% 1.0% 0.8% 3.8% 1.1% 0.531*** difficulty with work and 9.2% 6.6% 4.4% 4.4% 2.6% 5.4% -0.205*** household activities Poor self-assessed health 12.4% 6.5% 4.4% 3.0% 2.6% 5.8% -0.336*** status 2008-09 1d obesity among non-pregnant 1.6% 2.8% 6.1% 8.9% 13.3% 7.3% 0.349*** women HiV positive 4.8% 6.9% 5.8% 6.8% 7.8% 6.5% 0.071** inequalitieS in riSk FactorS1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 1c Smoking (women) 6.0% 2.9% 2.3% 0.8% 1.4% 2.5% -0.363*** concurrent partnerships 9.2% 10.4% 12.1% 12.3% 15.9% 12.3% 0.118*** condom usage (more than 9.8% 11.0% 14.4% 23.3% 33.9% 21.4% 0.283*** one partner) Mosquito net use by children 1.5% 3.6% 6.0% 7.7% 15.3% 6.3% 0.415*** Mosquito net use by pregnant 1.8% 5.8% 5.9% 8.4% 8.2% 5.8% 0.265*** women 2004 3 Smoking (all) 15.1% 14.3% 16.5% 14.6% 10.9% 14.3% -0.059*** insufficient intake of fruit and 86.7% 84.0% 85.8% 88.1% 85.3% 86.0% -0.001 vegetables insufficient physical activity 5.2% 5.0% 6.6% 6.5% 7.3% 6.1% 0.056 drinking 3.6% 4.7% 4.6% 5.2% 7.0% 5.0% 0.141 2008-09 1d Smoking (women) 5.4% 1.0% 0.6% 1.0% 0.8% 1.6% -0.445 concurrent partnerships 9.6% 10.9% 11.0% 12.9% 17.5% 12.8% 0.131*** condom usage (more than 13.9% 35.3% 29.7% 38.7% 39.3% 33.7% 0.109*** one partner) Mosquito net use by children 38.4% 45.2% 50.8% 50.7% 59.9% 48.0% 0.088 Mosquito net use by pregnant 49.1% 52.1% 48.6% 62.4% 45.9% 50.8% 0.004 women 42 inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interVentionS1a,1b,1c,1d,2 utilization 1993 1a Full immunization 65.3% 78.3% 78.8% 86.1% 87 .6% 78.8% 0.056*** treatment of diarrhea 11.0% 6.0% 5.2% 13.9% 5.8% 8.5% 0.021 Medical treatment of ari 45.1% 65.3% 42.5% 61.9% 58.0% 55.3% 0.031*** Skilled antenatal care (4+ visits) 60.1% 66.2% 64.7% 66.8% 76.3% 66.3% 0.039*** Skilled birth attendance 23.4% 33.5% 46.7% 57.9% 76.5% 45.9% 0.235*** 1998 1b Full immunization 48.3% 58.6% 72.0% 66.0% 59.4% 60.0% 0.056*** treatment of diarrhea 65.6% 66.8% 70.7% 76.5% 67.8% 69.0% 0.017 Medical treatment of ari 55.4% 54.6% 51.7% 55.9% 84.4% 58.3% 0.058*** Skilled antenatal care (4+ visits) 51.5% 59.3% 62.8% 67.3% 72.3% 61.6% 0.073*** Skilled birth attendance 22.9% 35.0% 42.9% 58.2% 79.8% 45.5% 0.251*** 2003 1c Full immunization 37.2% 51.1% 62.5% 56.4% 59.2% 52.0% 0.091*** treatment of diarrhea 29.6% 28.7% 24.8% 27.1% 36.3% 29.4% 0.025 Medical treatment of ari 44.0% 42.1% 45.7% 56.3% 64.9% 49.1% 0.082*** Skilled antenatal care (4+ visits) 40.4% 47.0% 51.9% 59.0% 70.6% 53.5% 0.118*** Skilled birth attendance 17.3% 33.7% 37.1% 56.1% 76.2% 41.9% 0.284*** contraceptive prevalence 43.2% 47.8% 51.1% 55.0% 55.4% 52.2% 0.048*** 2008-09 1d Full immunization 62.1% 66.8% 75.8% 69.8% 69.2% 68.3% 0.020 treatment of diarrhea 75.3% 70.8% 78.7% 62.3% 73.5% 72.0% -0.019 Medical treatment of ari 54.2% 45.9% 56.4% 50.1% 54.3% 52.1% -0.004 Skilled antenatal care (4+ visits) 35.5% 38.2% 42.1% 56.8% 65.3% 47.5% 0.140*** Skilled birth attendance 21.3% 30.9% 43.6% 54.0% 81.8% 44.2% 0.275*** contraceptive prevalence 44.2% 46.7% 54.3% 57.9% 51.8% 52.2% 0.027** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2004 3 tB screening 1.5% 1.4% 1.0% 2.0% 0.6% 1.3% -0.087 Voluntary counseling and 84.9% 97.9% 90.3% 91.4% 96.7% 93.1% 0.012 testing for HiV Breast cancer screening 1.3% 2.0% 3.0% 0.4% 0.4% 1.5% -0.147 adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2004 3 inpatient or outpatient 51.4% 58.2% 48.9% 58.9% 54.7% 54.4% 0.013 (12 months) inpatient (12 months) 6.2% 6.9% 5.3% 6.9% 5.5% 6.1% 0.005 inpatient (5 years) 13.1% 12.8% 14.1% 15.3% 15.8% 14.2% 0.057* outpatient (12 months) 53.0% 59.1% 50.7% 57 .8% 56.9% 55.5% 0.008 BeneFit utilization - PuBlic q1 q2 q3 q4 q5 total ci incidence FacilitieS3 analySiS 2004 3 outpatient clinic, health 18.8% 17.4% 15.7% 11.6% 8.6% 14.4% -0.161 center or dispensary outpatient hospital 6.5% 8.5% 8.8% 8.3% 8.4% 8.1% 0.040 inpatient hospital 2.6% 3.3% 5.6% 5.6% 3.3% 4.1% 0.097 43 BeneFit FeeS Paid at PuBlic q1 q2 q3 q4 q5 ci incidence FacilitieS (SHareS)3 analySiS 2004 3 (cont.) outpatient clinic, health 25.0 25.2 16.9 18.3 14.5 -0.129 center or dispensary outpatient hospital 10.1 24.2 29.5 15.4 20.7 0.078 inpatient hospital 7.9 6.2 38.5 21.9 25.6 0.235** HealtH care SuBSidieS (SHareS)3,4 2004 3 total constant unit cost Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient clinic, health 26.1 23.8 22.6 16.0 11.5 5,752.0 -0.164 8.6% center or dispensary outpatient hospital 16.4 20.8 21.2 20.8 20.7 9,527.8 0.036 57.0% inpatient hospital 13.7 17.6 25.8 27.6 15.3 1,445.3 0.081 34.4% total subsidies 16.3 20.0 22.9 22.7 18.1 16,725.1 0.034 100% total constant unit Subsidy Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient clinic, health 26.0 24.0 21.9 16.1 11.9 5,752.0 -0.161 8.6% center or dispensary outpatient hospital 16.1 20.9 21.7 20.4 20.8 9,527.8 0.040 57.0% inpatient hospital 13.0 16.0 27.7 27.2 16.1 1,445.3 0.097 34.4% total subsidies 15.9 19.5 23.8 22.4 18.4 16,725.1 0.042 100% total Proportional cost Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient clinic, health 25.0 25.2 16.9 18.3 14.5 5,752.0 -0.129 8.6% center or dispensary outpatient hospital 10.1 24.2 29.5 15.4 20.7 9,527.8 0.078 57.0% inpatient hospital 7.9 6.2 38.5 21.9 25.6 1,445.3 0.235** 34.4% total subsidies 10.6 18.1 31.5 17.9 21.8 16,725.1 0.114 100% threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2004 3 Headcount 28.1% 18.8% 13.8% 7.4% 3.4% concentration index 0.006 -0.016 0.014 0.089 0.226*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2004 3 Headcount 41.8% 35.3% 30.6% 23.4% 17.0% concentration index -0.033* -0.051*** -0.069*** -0.116*** -0.145*** 44 Financial iMPoVeriSHMent3 Protection Poverty line at uS$1.25 per consumption consumption change % change (cont.) capita per day including ooP excluding ooP 2004 3 Percentage in poverty 58.4% 61.3% 2.9 pp 5.0% average shortfall from the $0.36 $0.39 $0.03 7.5% poverty line average shortfall from the $0.62 $0.63 $0.01 2.4% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2004 3 Percentage in poverty 76.8% 78.6% 1.8 pp 2.4% average shortfall from the $0.88 $0.93 $0.05 5.3% poverty line average shortfall from the $1.14 $1.17 $0.03 2.8% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using kenya’s consumer price index. data sources: 1a=1993 kenya demographic and Health Survey, 1b=1998 kenya demographic and Health Survey, 1c=2003 kenya demographic and Health Survey, 1d=2008-09 kenya demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2004 kenya World Health Survey, 4=2005-06 kenya national Health accounts report. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - kenya. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: curt carnemark, 1996 45 HealtH equity and Financial Protection dataSHeet Lesotho the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2004 1a outcoMeS infant mortality rate 96.3 92.5 85.1 78.1 68.4 84.5 -0.074*** under-five mortality rate 121.4 104.7 83.8 77.5 69.9 91.6 -0.115*** Stunting 53.3% 48.4% 38.9% 37.6% 32.3% 43.4% -0.101*** underweight 23.2% 23.1% 12.6% 14.4% 9.9% 17.7% -0.156*** diarrhea 14.7% 18.6% 16.0% 12.1% 8.9% 14.5% -0.087*** acute respiratory infection 26.0% 21.8% 18.2% 18.1% 11.6% 19.7% -0.128*** Fever 29.5% 27.2% 27.7% 25.9% 22.5% 26.8% -0.035* 2009 1b infant mortality rate 88.6 93.6 86.2 82.1 67.0 83.5 -0.054* under-five mortality rate 92.4 108.9 87.0 102.4 70.4 91.7 -0.048 Stunting 45.0% 41.0% 40.2% 30.2% 28.1% 38.0% -0.094*** underweight 18.7% 11.9% 12.2% 13.6% 11.5% 14.0% -0.100** diarrhea 14.0% 11.9% 12.2% 9.7% 9.2% 11.6% -0.089*** acute respiratory infection 15.6% 14.2% 12.5% 10.8% 7.1% 12.3% -0.146*** Fever 18.3% 20.5% 18.1% 16.1% 16.3% 17.9% -0.036*** adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 2004 1a obesity among non-pregnant 7.5% 10.0% 14.7% 18.4% 23.8% 16.2% 0.219*** women HiV positive 18.8% 22.9% 24.3% 24.2% 24.1% 23.0% 0.046*** 2009 1b obesity among non-pregnant 7.0% 13.7% 13.4% 16.1% 30.3% 17.7% 0.262*** women HiV positive 18.7% 22.5% 22.2% 26.8% 23.1% 23.0% 0.039*** inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2004 1a Smoking (women) 25.0% 20.0% 13.8% 14.2% 7.6% 15.0% -0.221*** concurrent partnerships 24.4% 25.4% 24.4% 23.2% 27 .7% 25.2% 0.020 condom usage (more than 10.5% 12.3% 28.7% 37.3% 55.5% 32.7% 0.319*** one partner) 2009 1b Smoking (women) 18.8% 11.9% 12.8% 7.5% 2.7% 9.5% -0.327*** concurrent partnerships 19.7% 23.7% 24.6% 26.5% 27.5% 25.0% 0.056*** condom usage (more than 29.7% 42.9% 58.7% 61.6% 73.0% 58.0% 0.137*** one partner) 46 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 2004 1a Full immunization 65.8% 68.7% 69.6% 65.7% 69.8% 67.9% 0.012 treatment of diarrhea 66.5% 78.2% 70.0% 84.6% 80.8% 75.3% 0.036** Medical treatment of ari 47.9% 54.7% 67.4% 72.7% 69.0% 59.5% 0.094*** Skilled antenatal care (4+ visits) 61.7% 62.4% 73.6% 79.4% 86.4% 72.1% 0.078*** Skilled birth attendance 34.7% 42.8% 56.5% 72.0% 85.0% 56.1% 0.190*** contraceptive prevalence 34.1% 35.7% 44.4% 48.7% 57.6% 47.1% 0.113*** among women 2009 1b Full immunization 52.9% 59.1% 65.2% 62.1% 72.0% 61.9% 0.060*** Medical treatment of ari 51.7% 68.2% 58.6% 65.0% 65.6% 60.5% 0.047* Skilled antenatal care (4+ visits) 59.0% 66.4% 69.9% 78.2% 88.8% 72.5% 0.085*** Skilled birth attendance 35.6% 52.7% 62.4% 79.0% 90.3% 62.4% 0.186*** contraceptive prevalence 22.5% 28.5% 33.6% 37.0% 43.8% 34.8% 0.117*** among women note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=2004 lesotho demographic and Health Survey, 1b=2009 lesotho demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - lesotho. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: curt carnemark, 1988 47 HealtH equity and Financial Protection dataSHeet LI BERIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2007 1 outcoMeS infant mortality rate 110.1 115.7 94.3 108.0 76.6 103.4 -0.045** under-five mortality rate 142.8 188.3 148.7 179.3 128.9 160.4 -0.011 Stunting 42.6% 42.4% 39.4% 33.8% 26.9% 38.3% -0.078*** underweight 21.4% 19.0% 20.9% 16.3% 14.7% 18.9% -0.062*** diarrhea 20.5% 19.9% 22.8% 20.6% 19.8% 20.8% 0.015 acute respiratory infection 12.3% 15.2% 11.8% 13.5% 11.4% 13.0% -0.012 Fever 28.8% 33.9% 32.8% 34.9% 33.4% 32.6% 0.026* adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2007 1 obesity among non-pregnant 2.7% 3.0% 4.3% 8.6% 10.7% 6.2% 0.284*** women HiV positive 0.9% 0.8% 1.1% 2.2% 2.7% 1.6% 0.258*** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2007 1 Smoking (women) 6.7% 5.0% 2.7% 1.3% 1.0% 3.2% -0.379*** concurrent partnerships 16.9% 18.6% 25.7% 37.6% 39.2% 28.5% 0.176*** condom usage (more than 1.9% 3.7% 8.8% 15.6% 15.1% 11.4% 0.251*** one partner) inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2007 1 Full immunization 23.1% 31.6% 39.9% 52.6% 57.6% 39.2% 0.170*** treatment of diarrhea 54.1% 52.9% 60.9% 63.6% 67.1% 58.8% 0.054*** Medical treatment of ari 46.9% 50.4% 67.1% 65.4% 88.3% 60.2% 0.118*** Skilled antenatal care (4+ visits) 47.9% 54.9% 67.6% 83.0% 90.5% 66.7% 0.133*** Skilled birth attendance 25.9% 33.6% 42.1% 72.4% 82.1% 47.2% 0.241*** contraceptive prevalence 35.2% 34.3% 37.4% 34.9% 36.5% 35.9% 0.007 among women 48 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending4 2007 4 Headcount 11.2% 1.0% 0.1% 0.0% 0.0% concentration index -0.130*** -0.354*** -0.914*** -0.927*** 0.000 threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending4 2007 4 Headcount 43.0% 24.6% 14.0% 5.4% 0.9% concentration index -0.018*** -0.094*** -0.152*** -0.233*** -0.099** iMPoVeriSHMent4 Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2007 4 Percentage in poverty 57.2% 58.4% 1.2 pp 2.1% average shortfall from the $0.27 $0.27 $0.01 3.5% poverty line average shortfall from the $0.46 $0.47 $0.01 1.4% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2007 4 Percentage in poverty 83.2% 84.0% 0.8 pp 0.9% average shortfall from the $0.81 $0.82 $0.02 2.1% poverty line average shortfall from the $0.97 $0.98 $0.01 1.2% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using liberia’s consumer price index. data sources: 1=2007 liberia demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey, 4=2007 liberia core Welfare indicators questionnaire. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - liberia. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: curt carnemark 49 HealtH equity and Financial Protection dataSHeet MADAGASCAR the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1997 1a outcoMeS infant mortality rate 134.3 118.7 110.7 76.1 61.8 106.2 -0.120*** under-five mortality rate 101.1 103.1 67.0 59.5 32.6 78.2 -0.121*** Stunting 55.0% 53.3% 58.5% 57.8% 51.9% 55.5% 0.007 underweight 41.5% 33.9% 36.9% 35.5% 24.1% 35.7% -0.065*** diarrhea 29.4% 22.5% 26.5% 31.9% 25.6% 27.4% 0.019 acute respiratory infection 27.7% 26.7% 24.9% 21.4% 16.4% 24.3% -0.078*** Fever 33.5% 33.4% 34.8% 30.7% 29.6% 32.7% -0.009 2003-04 1b infant mortality rate 211.5 186.5 173.6 138.3 90.0 168.6 -0.116*** under-five mortality rate 156.6 174.5 106.4 94.4 40.4 123.4 -0.143*** Stunting 58.1% 57.0% 51.8% 46.2% 42.8% 52.2% -0.042*** underweight 40.8% 39.7% 39.8% 29.3% 24.4% 36.0% -0.064*** diarrhea 14.5% 9.8% 8.1% 7.8% 7.5% 10.1% -0.111*** acute respiratory infection 10.0% 9.8% 9.7% 6.4% 7.9% 8.9% -0.016 Fever 25.0% 21.0% 20.7% 17 .2% 19.7% 21.2% -0.032 2008-09 1c infant mortality rate 64.7 62.5 62.0 43.8 33.7 55.5 -0.104*** under-five mortality rate 119.7 96.2 97 .3 62.2 39.6 87.9 -0.164*** Stunting 46.4% 52.3% 51.4% 50.1% 43.3% 49.0% -0.008 diarrhea 8.0% 8.9% 7.7% 8.0% 10.3% 8.4% 0.024 acute respiratory infection 4.3% 5.7% 4.1% 4.8% 6.8% 5.0% 0.052* Fever 9.3% 9.5% 8.2% 9.8% 11.3% 9.5% 0.032 adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci 1997 1a obesity among non-pregnant 0.4% 0.3% 0.0% 0.3% 1.7% 0.5% 0.316 women 2003-04 1b obesity among non-pregnant 0.3% 0.7% 0.5% 1.4% 2.4% 1.2% 0.408*** women 2008-09 1c obesity among non-pregnant 0.3% 0.1% 0.3% 0.8% 3.6% 1.2% 0.594*** women 50 inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2003-04 1b Smoking (women) 6.8% 6.8% 8.0% 10.5% 7.1% 7.8% 0.055* concurrent partnerships 11.8% 13.6% 12.8% 12.6% 14.7% 13.1% 0.062*** condom usage (more than 0.1% 0.0% 1.7% 7.2% 9.1% 4.2% 0.585*** one partner) 2008-09 1c Smoking (women) 13.1% 13.9% 11.9% 9.0% 5.3% 10.3% -0.173*** concurrent partnerships 15.8% 12.9% 11.4% 12.8% 17.3% 14.2% 0.026** condom usage (more than 0.4% 0.4% 0.6% 3.0% 12.9% 4.6% 0.620*** one partner) Mosquito net use by children 47.8% 48.9% 38.6% 40.2% 56.1% 46.0% -0.003 Mosquito net use by pregnant 52.1% 53.6% 39.1% 40.4% 53.0% 48.2% -0.035* women inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interventionS1a,1b,1c,2 utiliZation 1997 1a Full immunization 22.2% 25.5% 27.9% 55.4% 67.1% 36.7% 0.252*** treatment of diarrhea 14.7% 19.1% 20.0% 28.1% 45.7% 23.1% 0.233*** Medical treatment of ari 35.5% 35.2% 33.2% 37.4% 59.3% 37.4% 0.070** Skilled antenatal care (4+ visits) 29.8% 32.2% 33.8% 45.4% 67.0% 38.7% 0.162*** Skilled birth attendance 30.4% 38.7% 42.7% 66.6% 90.0% 48.9% 0.230*** 2003-04 1b Full immunization 32.1% 44.5% 52.3% 71.5% 80.1% 53.1% 0.211*** treatment of diarrhea 44.3% 44.3% 37.6% 39.9% 54.5% 43.6% 0.040 Medical treatment of ari 50.0% 43.6% 39.3% 48.2% 64.9% 47.9% 0.054 Skilled antenatal care (4+ visits) 28.6% 31.3% 30.2% 49.0% 74.1% 40.6% 0.222*** Skilled birth attendance 23.1% 31.7% 42.4% 64.8% 92.9% 46.3% 0.304*** contraceptive prevalence 44.2% 44.9% 50.5% 43.2% 44.1% 45.0% -0.005 2008-09 1c Full immunization 41.7% 54.8% 65.2% 78.2% 82.3% 61.7% 0.142*** treatment of diarrhea 20.1% 23.1% 25.5% 34.5% 51.4% 29.5% 0.200*** Medical treatment of ari 31.6% 35.3% 37.7% 48.4% 63.7% 42.6% 0.153*** Skilled antenatal care (4+ visits) 32.8% 39.1% 46.2% 55.5% 76.6% 48.1% 0.171*** Skilled birth attendance 22.4% 28.7% 44.0% 60.0% 90.7% 44.3% 0.287*** contraceptive prevalence 15.5% 20.1% 22.9% 28.3% 26.3% 22.9% 0.100*** note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1997 Madagascar demographic and Health Survey, 1b=2003-04 Madagascar demographic and Health Survey, 1c=2008-09 Madagascar demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Madagascar. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: yosef Hadar 51 HealtH equity and Financial Protection dataSHeet MAL AWI the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1992 1a outcoMeS infant mortality rate 158.6 148.8 167.8 158.1 112.5 150.4 -0.042** under-five mortality rate 270.5 246.0 270.0 271.7 163.4 247.2 -0.051*** Stunting 61.4% 58.8% 54.8% 56.1% 42.0% 55.0% -0.055*** underweight 30.2% 28.1% 24.8% 20.1% 16.2% 24.1% -0.115*** diarrhea 13.9% 15.1% 15.2% 13.4% 15.9% 14.6% 0.013 acute respiratory infection 9.2% 8.4% 6.7% 6.8% 7.1% 7.6% -0.068* Fever 40.5% 40.3% 43.7% 40.2% 39.3% 40.9% -0.001 2000 1b infant mortality rate 144.0 116.7 122.6 138.2 92.2 124.6 -0.046*** under-five mortality rate 247.2 207 .7 206.2 227.4 153.8 211.9 -0.055*** Stunting 61.6% 57 .2% 52.7% 54.6% 41.7% 53.9% -0.062*** underweight 28.2% 23.5% 18.9% 21.1% 14.1% 21.4% -0.111*** diarrhea 19.2% 17.8% 17.6% 19.4% 15.0% 17.9% -0.027* acute respiratory infection 27.8% 27 .9% 26.7% 32.0% 20.6% 27.1% -0.028*** Fever 45.2% 41.9% 40.4% 45.3% 37.9% 42.3% -0.019** 2003 3 Malaria 62.5% 64.7% 61.8% 76.9% 78.1% 68.9% 0.054*** 2004 1c infant mortality rate 129.6 110.7 110.2 107.6 74.7 107.8 -0.078*** under-five mortality rate 223.3 191.7 194.5 167.6 122.9 181.9 -0.093*** Stunting 57.4% 56.3% 55.2% 48.9% 38.1% 51.9% -0.067*** underweight 25.5% 20.4% 19.3% 16.6% 8.5% 18.5% -0.157*** diarrhea 27.0% 24.3% 22.5% 20.0% 18.4% 22.6% -0.072*** acute respiratory infection 20.1% 20.2% 23.5% 17.8% 11.9% 19.1% -0.066*** Fever 41.0% 41.8% 38.1% 35.7% 30.3% 37.8% -0.059*** 2006 2 Stunting 57.1% 56.1% 53.7% 51.4% 43.6% 52.7% -0.049*** underweight 18.6% 15.8% 16.0% 14.5% 11.8% 15.5% -0.082*** diarrhea 25.7% 25.2% 25.1% 23.5% 20.1% 24.1% -0.041*** acute respiratory infection 28.6% 26.2% 27.9% 27.2% 20.6% 26.3% -0.047*** Fever 37.7% 35.5% 36.4% 36.4% 26.4% 34.7% -0.047*** 2010 1d infant mortality rate 78.6 83.5 80.9 83.9 70.0 79.8 -0.012 under-five mortality rate 142.8 140.1 136.1 120.3 107.3 130.2 -0.058*** Stunting 55.4% 51.1% 46.7% 47.6% 34.3% 47.1% -0.076*** underweight 17.3% 15.3% 13.0% 15.7% 8.1% 13.9% -0.107*** diarrhea 18.4% 17.6% 18.1% 16.5% 17.3% 17.7% -0.015 acute respiratory infection 15.3% 15.6% 17.5% 16.3% 12.5% 15.6% -0.018 Fever 35.5% 35.3% 37.6% 34.3% 29.4% 34.7% -0.026*** 52 inequalitieS adult HealtH1a,1b,1c,1d,3 q1 q2 q3 q4 q5 total ci in HealtH 1992 1a outcoMeS obesity among non-pregnant 0.3% 0.0% 0.7% 0.7% 3.8% 1.1% 0.597*** (cont.) women 2000 1b obesity among non-pregnant 0.8% 1.2% 2.0% 1.4% 5.4% 2.2% 0.408*** women 2003 3 tuberculosis 14.7% 12.1% 13.6% 9.2% 7.2% 11.4% -0.129*** road traffic accident 2.2% 3.4% 3.4% 3.5% 4.0% 3.3% 0.081 non-road traffic accident 9.2% 7.4% 11.4% 8.2% 7.9% 8.8% -0.016 angina 17 .3% 15.6% 13.3% 14.3% 11.7% 14.5% -0.076*** arthritis 33.6% 34.4% 34.9% 32.1% 26.5% 32.3% -0.045*** asthma 6.0% 5.3% 4.3% 4.8% 6.5% 5.4% 0.002 depression 1.0% 0.9% 1.6% 1.4% 1.7% 1.3% 0.107 diabetes 0.5% 0.0% 0.1% 0.3% 0.2% 0.2% -0.056 difficulty with work and 12.7% 12.6% 8.1% 7.3% 6.9% 9.5% -0.141*** household activities Poor self-assessed health 5.0% 7.9% 5.1% 5.7% 5.0% 5.8% -0.041 status 2004 1c obesity among non-pregnant 0.8% 0.6% 1.9% 2.2% 6.3% 2.6% 0.447*** women HiV positive 8.4% 7.7% 12.3% 13.9% 17.1% 12.0% 0.153*** 2010 1d obesity among non-pregnant 1.9% 3.1% 1.6% 2.6% 10.2% 4.3% 0.394*** women HiV positive 7.4% 7.9% 9.7% 11.4% 15.5% 10.8% 0.157*** inequalitieS in riSk FactorS1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 21.7% 18.4% 14.7% 12.1% 5.4% 14.6% -0.218*** insufficient intake of fruit and 41.9% 40.4% 39.5% 37.4% 38.5% 39.6% -0.020 vegetables insufficient physical activity 4.0% 2.6% 1.7% 2.0% 1.1% 2.3% -0.228*** drinking 3.2% 2.6% 3.4% 4.2% 4.2% 3.5% 0.083 2004 1c Smoking (women) 3.3% 2.1% 2.3% 1.3% 0.4% 1.8% -0.290*** concurrent partnerships 8.1% 4.3% 5.3% 4.5% 10.2% 6.5% 0.087*** condom usage (more than 15.2% 15.3% 23.0% 28.4% 43.5% 28.2% 0.245*** one partner) Mosquito net use by children 6.2% 9.1% 12.5% 17.7% 35.0% 15.2% 0.333*** Mosquito net use by pregnant 6.2% 10.2% 12.9% 17.3% 37.6% 15.4% 0.312*** women 2006 2 concurrent partnerships 1.3% 1.5% 1.1% 0.5% 0.8% 1.0% -0.188*** Mosquito net use by children 18.9% 23.4% 28.4% 29.3% 47.2% 28.8% 0.175*** 2010 1d Smoking (women) 1.5% 1.8% 1.1% 1.0% 0.4% 1.1% -0.232*** concurrent partnerships 5.9% 5.3% 5.0% 5.9% 10.1% 6.6% 0.130*** condom usage (more than 22.3% 36.6% 33.3% 48.7% 57.8% 43.3% 0.177*** one partner) Mosquito net use by children 30.0% 36.8% 43.1% 43.6% 55.5% 40.9% 0.115*** Mosquito net use by pregnant 24.4% 31.4% 40.8% 45.2% 53.4% 38.1% 0.155*** women 53 inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interVentionS1a,1b,1c,1d,2 utiliZation 1992 1a Full immunization 73.0% 79.4% 79.9% 87.2% 89.6% 81.9% 0.041*** treatment of diarrhea 30.3% 25.0% 28.2% 36.6% 42.4% 32.0% 0.083** Medical treatment of ari 48.3% 57.4% 52.8% 59.0% 65.8% 55.9% 0.059* Skilled antenatal care (4+ visits) 56.0% 54.6% 63.9% 70.4% 72.8% 63.3% 0.067*** Skilled birth attendance 45.3% 45.9% 51.9% 61.7% 80.5% 56.4% 0.127*** 2000 1b Full immunization 62.4% 65.6% 70.0% 75.2% 79.0% 70.1% 0.054** treatment of diarrhea 46.2% 46.9% 49.5% 46.8% 51.3% 47.9% 0.020 Medical treatment of ari 20.3% 23.0% 32.8% 22.9% 40.7% 26.7% 0.120** Skilled antenatal care (4+ visits) 50.2% 53.1% 56.1% 54.9% 63.5% 55.4% 0.050** Skilled birth attendance 42.2% 50.3% 56.2% 55.2% 78.2% 55.9% 0.121** 2004 1c Full immunization 51.6% 58.5% 65.8% 74.1% 77.7% 64.5% 0.083*** treatment of diarrhea 55.6% 63.7% 59.1% 64.1% 65.9% 61.2% 0.029** Medical treatment of ari 30.0% 34.5% 37.0% 41.6% 45.7% 36.7% 0.081*** Skilled antenatal care (4+ visits) 51.1% 51.0% 52.5% 59.7% 69.7% 56.3% 0.066*** Skilled birth attendance 47.0% 47.7% 52.8% 63.4% 85.3% 57.9% 0.123*** contraceptive prevalence 44.6% 47.5% 46.1% 51.5% 53.9% 49.2% 0.043*** 2006 2 treatment of diarrhea 52.5% 51.1% 54.6% 59.5% 62.3% 55.4% 0.044*** Medical treatment of ari 61.7% 58.0% 66.6% 58.9% 73.4% 63.0% 0.026 contraceptive prevalence 31.1% 34.1% 37.0% 35.2% 35.3% 34.6% 0.025*** 2010 1d Full immunization 78.1% 81.8% 80.8% 83.0% 81.8% 81.0% 0.009 Medical treatment of ari 61.0% 67.2% 70.6% 63.4% 71.1% 66.5% 0.018 Skilled antenatal care (4+ visits) 40.5% 44.9% 46.0% 45.7% 52.2% 45.6% 0.045*** Skilled birth attendance 65.3% 67.2% 70.4% 78.4% 89.8% 73.2% 0.063*** contraceptive prevalence 46.5% 53.5% 53.8% 56.0% 53.2% 52.8% 0.023*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 1.7% 1.3% 3.5% 2.3% 3.0% 2.3% 0.114* Breast cancer screening 0.8% 0.5% 4.4% 0.9% 3.0% 1.9% 0.257 2006 2 Voluntary counseling and 90.0% 89.9% 91.2% 91.1% 94.6% 91.9% 0.011*** testing for HiV adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 49.2% 56.1% 57.8% 59.0% 60.6% 56.4% 0.044*** (12 months) inpatient (12 months) 8.5% 8.8% 7.5% 10.9% 9.1% 8.9% 0.027 inpatient (5 years) 19.2% 15.8% 18.4% 20.2% 21.3% 18.9% 0.038* outpatient (12 months) 44.4% 50.7% 53.6% 53.3% 54.9% 51.2% 0.044*** BeneFit utiliZation - PuBlic q1 q2 q3 q4 q5 total ci incidence FacilitieS3 analySiS 2003 3 outpatient clinic, health center, 9.8% 12.9% 10.4% 10.7% 11.0% 10.9% 0.003 dispensary or maternity center outpatient hospital 9.6% 8.2% 10.6% 9.5% 11.7% 9.9% 0.039 inpatient hospital 4.6% 6.0% 6.5% 6.3% 6.0% 5.9% 0.043 54 BeneFit FeeS Paid at PuBlic q1 q2 q3 q4 q5 ci incidence FacilitieS (SHareS)3 analySiS 2003 3 (cont.) outpatient clinic, health center, 14.9 18.3 22.5 17.8 26.4 0.107** dispensary or maternity center outpatient hospital 21.8 7.8 21.0 15.3 34.1 0.167 inpatient hospital 0.4 0.6 3.8 0.8 94.4 0.788*** HealtH care SuBSidieS (SHareS)3,5 2003 3 total constant unit cost Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient clinic, health center, 17.9 23.6 18.9 19.5 20.1 1,026.1 0.003 32.0% dispensary or maternity center outpatient hospital 19.3 16.6 21.3 19.2 23.6 367.7 0.038 11.5% inpatient hospital 15.9 20.6 22.4 21.8 19.2 1,814.0 0.040 56.6% total subsidies 16.9 21.1 21.2 20.8 20.0 3,207.8 0.028 100% total constant unit Subsidy Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient clinic, health center, 17.9 23.6 18.9 19.5 20.1 1,026.1 0.003 32.0% dispensary or maternity center outpatient hospital 19.3 16.5 21.3 19.2 23.7 367.7 0.039 11.5% inpatient hospital 15.7 20.4 22.1 21.5 20.3 1,814.0 0.043 56.6% total subsidies 16.8 20.9 21.0 20.6 20.6 3,207.8 0.030 100% total Proportional cost Method q1 q2 q3 q4 q5 ci Share (lcu) outpatient clinic, health center, 14.9 18.3 22.5 17.8 26.4 1,026.1 0.107** 32.0% dispensary or maternity center outpatient hospital 21.8 7.8 21.0 15.3 34.1 367.7 0.167 11.5% inpatient hospital 0.4 0.6 3.8 0.8 94.4 1,814.0 0.788*** 56.6% total subsidies 7.5 7.1 11.8 7.9 65.7 3,207.8 0.316*** 100% threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3,4 2003 3 Headcount 19.6% 11.5% 8.2% 4.5% 2.6% concentration index 0.031 -0.037 -0.076* -0.222*** -0.391*** 2004 4 Headcount 17.3% 8.9% 5.6% 2.7% 1.0% concentration index 0.022*** 0.048*** 0.076*** 0.131*** 0.371*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3,4 2003 3 Headcount 45.2% 39.0% 34.3% 27.5% 20.8% concentration index -0.023** -0.063*** -0.087*** -0.142*** -0.228*** 2004 4 Headcount 44.5% 30.4% 23.2% 15.0% 8.4% concentration index -0.042*** -0.023*** -0.009* -0.010 0.017* 55 Financial iMPoVeriSHMent3,4 Protection Poverty line at uS$1.25 per consumption consumption change % change (cont.) capita per day including ooP excluding ooP 2003 3 Percentage in poverty 91.7% 92.1% 0.4 pp 0.4% average shortfall from the $0.81 $0.82 $0.01 1.7% poverty line average shortfall from the $0.88 $0.89 $0.01 1.2% poverty line, among the poor 2004 4 Percentage in poverty 69.6% 71.5% 1.9 pp 2.7% average shortfall from the $0.38 $0.40 $0.02 5.0% poverty line average shortfall from the $0.54 $0.55 $0.01 2.2% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 96.0% 96.1% 0.1pp 0.1% average shortfall from the $1.52 $1.54 $0.02 1.0% poverty line average shortfall from the $1.58 $1.59 $0.01 0.9% poverty line, among the poor 2004 4 Percentage in poverty 87.3% 88.0% 0.7pp 0.8% average shortfall from the $0.98 $1.01 $0.03 2.9% poverty line average shortfall from the $1.12 $1.14 $0.02 2.1% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Malawi’s consumer price index. data sources: 1a=1992 Malawi demographic and Health Survey, 1b=2000 Malawi demographic and Health Survey, 1c=2004 Malawi demographic and Health Survey, 1d=2010 Malawi demographic and Health Survey, 2=2006 Malawi Multiple indicator cluster Survey, 3=2003 Malawi World Health Survey, 4=2004 Malawi integrated Household Survey, 5=2002-03 Malawi national Health accounts report. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Malawi. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Francis dobbs, 1998 56 HealtH equity and Financial Protection dataSHeet Maldives the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2009 1 outcoMeS infant mortality rate 22.1 25.3 29.4 16.2 24.0 23.6 -0.020 under-five mortality rate 39.0 36.3 51.2 19.6 32.3 36.4 -0.059 Stunting 22.3% 23.9% 18.1% 16.4% 16.1% 19.4% -0.091*** underweight 25.2% 20.3% 18.7% 13.1% 10.2% 17.6% -0.170*** diarrhea 5.4% 5.1% 4.4% 5.2% 1.8% 4.4% -0.107** acute respiratory infection 13.4% 15.2% 12.4% 14.1% 14.4% 13.9% -0.000 Fever 29.9% 30.1% 28.0% 28.5% 27 .5% 28.8% -0.015 adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2009 1 obesity among non-pregnant 12.3% 13.3% 11.1% 14.2% 14.4% 13.0% 0.038 women inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2009 1 Smoking (women) 14.3% 10.7% 7.3% 6.5% 6.2% 8.9% -0.192*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2009 1 Full immunization 95.1% 96.6% 92.4% 90.3% 92.1% 93.3% -0.010 Medical treatment of ari 71.4% 87.1% 80.6% 84.4% 77.9% 80.6% 0.013 Skilled antenatal care (4+ visits) 95.9% 97.2% 97.7% 98.1% 99.1% 97.5% 0.006*** Skilled birth attendance 90.4% 93.7% 95.6% 99.0% 99.6% 95.6% 0.021*** contraceptive prevalence 26.7% 25.6% 25.9% 24.2% 25.0% 25.5% -0.012 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=2009 Maldives demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Maldives. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: un Photo/evan Schneider 57 HealtH equity and Financial Protection dataSHeet MALI the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 3 outcoMeS Malaria 37.5% 31.6% 26.6% 40.5% 42.7% 35.9% 0.032 2006 1c infant mortality rate 151.9 142.7 137.2 135.3 84.1 132.7 -0.080*** under-five mortality rate 260.0 258.6 249.0 240.2 138.5 235.7 -0.075*** Stunting 43.8% 43.1% 41.8% 34.5% 24.5% 38.0% -0.097*** underweight 32.4% 30.4% 31.2% 27 .1% 19.8% 28.4% -0.081*** diarrhea 14.3% 15.6% 15.0% 13.6% 8.6% 13.5% -0.069*** acute respiratory infection 5.7% 6.9% 5.1% 5.3% 6.2% 5.8% -0.002 Fever 18.5% 19.7% 17.9% 19.5% 15.5% 18.3% -0.024* adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci 1995-96 1a obesity among non-pregnant 0.3% 0.7% 0.3% 1.6% 6.7% 1.7% 0.587*** women 2001 1b obesity among non-pregnant 0.8% 1.3% 2.1% 3.1% 10.3% 3.8% 0.491*** women 2003 3 tuberculosis 6.4% 5.6% 8.3% 5.1% 2.7% 5.7% -0.103** road traffic accident 1.1% 2.6% 2.0% 2.0% 4.2% 2.3% 0.199 non-road traffic accident 3.1% 4.5% 3.7% 3.3% 2.2% 3.3% -0.055*** angina 11.8% 7.1% 9.8% 9.0% 9.0% 9.6% -0.055 arthritis 18.2% 18.3% 15.5% 16.5% 16.0% 17.0% -0.045* asthma 2.7% 3.0% 2.5% 1.9% 3.9% 2.8% 0.025 depression 1.6% 1.1% 1.5% 0.7% 1.1% 1.2% -0.097 diabetes 0.3% 0.0% 0.3% 0.8% 0.6% 0.4% 0.255* difficulty with work and 6.5% 2.8% 3.1% 4.6% 4.4% 4.3% -0.065 household activities Poor self-assessed health status 8.2% 6.2% 8.2% 8.6% 5.0% 7.3% -0.075* 2006 1c obesity among non-pregnant 0.9% 1.8% 3.0% 6.7% 12.1% 5.3% 0.468*** women HiV positive 1.3% 1.1% 0.9% 1.3% 2.0% 1.3% 0.108 58 inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 17.4% 17.8% 18.0% 17.5% 19.1% 17.9% 0.009 insufficient intake of fruit and 65.6% 64.9% 61.8% 53.6% 62.2% 61.8% -0.026** vegetables insufficient physical activity 0.1% 0.0% 0.1% 0.1% 0.3% 0.1% 0.368 drinking 4.7% 3.0% 4.6% 1.0% 1.0% 3.0% -0.259*** 2006 1c Smoking (women) 2.9% 3.4% 3.6% 1.5% 0.5% 2.3% -0.250*** concurrent partnerships 2.7% 2.0% 2.5% 6.4% 10.5% 5.0% 0.357*** condom usage (more than 2.9% 9.1% 10.4% 8.7% 21.7% 14.5% 0.298*** one partner) Mosquito net use by children 27.4% 26.9% 23.7% 27.2% 34.8% 27.8% 0.041 Mosquito net use by pregnant 33.8% 37.9% 31.8% 34.9% 31.7% 34.2% -0.019 women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,1c,2 utiliZation 2006 1c Full immunization 48.7% 45.3% 48.2% 45.7% 56.8% 48.8% 0.027* treatment of diarrhea 18.3% 23.0% 22.6% 25.3% 41.5% 24.5% 0.129*** Medical treatment of ari 27 .4% 31.1% 30.5% 43.9% 59.2% 38.1% 0.165*** Skilled antenatal care (4+ visits) 9.9% 10.7% 12.7% 21.9% 59.5% 22.4% 0.403*** Skilled birth attendance 9.0% 12.3% 16.2% 31.9% 74.6% 27.8% 0.433*** contraceptive prevalence 26.3% 34.5% 30.4% 31.5% 41.4% 35.4% 0.081*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 1.0% 1.0% 0.9% 1.0% 0.8% 1.0% 0.035 cervical cancer screening 31.6% 33.8% 28.9% 25.4% 40.5% 32.9% 0.076 Breast cancer screening 1.2% 2.4% 0.0% 0.6% 3.1% 1.5% 0.123 adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 13.8% 16.7% 16.5% 18.4% 23.7% 17.5% 0.097*** (12 months) inpatient (12 months) 1.1% 1.5% 1.3% 1.2% 2.5% 1.5% 0.137 inpatient (5 years) 3.7% 4.3% 3.0% 5.0% 5.9% 4.3% 0.088 outpatient (12 months) 3.4% 1.4% 4.9% 5.9% 6.7% 4.4% 0.156 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 42.9% 36.9% 32.4% 25.5% 22.0% concentration index -0.035** -0.111*** -0.188*** -0.273*** -0.469*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 80.1% 79.3% 78.2% 74.2% 71.4% concentration index -0.018*** -0.023*** -0.031*** -0.027*** -0.039*** 59 Financial iMPoVeriSHMent3 Protection Poverty line at uS$1.25 per consumption consumption change % change (cont.) capita per day including ooP excluding ooP 2003 3 Percentage in poverty 64.0% 66.4% 2.4 pp 3.8% average shortfall from the $0.54 $0.58 $0.03 6.2% poverty line average shortfall from the $0.73 $0.75 $0.02 2.3% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 74.9% 76.2% 1.3 pp 1.7% average shortfall from the $1.16 $1.21 $0.05 4.3% poverty line average shortfall from the $1.33 $1.36 $0.03 2.5% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Mali’s consumer price index. data sources: 1=1995-96 Mali demographic and Health Survey, 1b=2001 Mali demographic and Health Survey, 1c=2006 Mali demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 Mali World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Mali. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: curt carnemark, 1989 60 HealtH equity and Financial Protection dataSHeet MAURITANIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 3 outcoMeS diarrhea 52.8% 34.4% 35.3% 58.4% 42.7% 45.7% -0.017 acute respiratory infection 15.3% 7.0% 22.9% 16.9% 16.3% 15.4% 0.039 Fever 94.2% 98.8% 96.8% 85.3% 83.7% 90.9% -0.031** Malaria 28.3% 22.9% 24.5% 24.5% 23.0% 24.4% -0.051 2007 2 Stunting 33.2% 32.4% 28.4% 20.9% 17.6% 27.3% -0.125*** underweight 29.8% 29.5% 22.9% 13.9% 9.4% 22.2% -0.203*** diarrhea 24.9% 22.8% 21.8% 19.9% 18.9% 21.9% -0.054*** acute respiratory infection 10.2% 8.4% 9.1% 10.7% 11.1% 9.8% 0.030 Fever 22.8% 17.6% 16.5% 14.5% 14.1% 17.5% -0.102*** adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2003 3 tuberculosis 14.9% 10.3% 9.9% 6.7% 9.1% 10.2% -0.120*** obesity among non-pregnant 8.6% 17.9% 20.4% 14.1% 22.8% 16.5% 0.127*** women road traffic accident 1.4% 1.0% 1.8% 2.5% 2.0% 1.7% 0.107 non-road traffic accident 1.6% 2.0% 1.4% 5.1% 3.2% 2.7% 0.193** angina 9.6% 10.6% 6.4% 7.4% 6.1% 8.0% -0.089** arthritis 32.5% 31.6% 23.6% 16.6% 12.7% 23.3% -0.191*** asthma 12.2% 6.9% 8.1% 8.5% 5.9% 8.3% -0.111*** depression 3.2% 2.7% 4.3% 1.8% 2.8% 3.0% -0.049 diabetes 1.2% 3.1% 1.7% 1.2% 2.9% 2.0% 0.069 difficulty with work and 6.1% 11.5% 7.0% 6.0% 5.1% 7.1% -0.075** household activities Poor self-assessed health 4.9% 5.4% 4.0% 4.1% 2.3% 4.1% -0.097* status inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 10.4% 9.7% 10.9% 18.0% 21.4% 14.1% 0.189*** Smoking (women) 1.6% 3.4% 4.4% 6.8% 7.1% 4.6% 0.271*** insufficient intake of fruit and 99.2% 99.1% 99.0% 96.8% 95.5% 97.9% -0.008*** vegetables insufficient physical activity 2.6% 2.1% 1.5% 1.6% 1.6% 1.9% -0.116 drinking 1.1% 1.3% 2.3% 2.0% 3.7% 2.1% 0.240*** concurrent partnerships 1.1% 4.3% 0.6% 0.0% 3.9% 1.8% 0.144 61 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2007 2 Full immunization 61.8% 72.2% 69.0% 53.5% 56.9% 64.6% -0.014 treatment of diarrhea 23.2% 28.2% 31.4% 36.8% 43.4% 31.0% 0.126*** Medical treatment of ari 32.8% 33.6% 45.8% 60.4% 68.0% 47.2% 0.168*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 2.7% 2.6% 2.7% 2.7% 2.5% 2.6% 0.003 cervical cancer screening 16.0% 11.1% 27.4% 31.0% 24.4% 24.1% 0.091 Breast cancer screening 1.2% 3.8% 4.4% 3.1% 2.2% 2.9% 0.134 2007 2 Voluntary counseling and 71.6% 75.9% 83.7% 84.0% 88.5% 84.8% 0.030*** testing for HiV adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 24.7% 27.8% 30.4% 40.9% 46.2% 34.0% 0.140*** (12 months) inpatient (12 months) 5.6% 5.8% 6.2% 8.5% 10.2% 7.3% 0.161*** inpatient (5 years) 13.4% 15.5% 17.1% 21.1% 24.6% 18.4% 0.148*** outpatient (12 months) 14.8% 13.0% 16.7% 34.2% 41.9% 23.1% 0.250*** threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending 2003 3 Headcount 23.2% 17.5% 13.3% 9.3% 6.8% concentration index 0.133*** 0.086*** 0.047 0.022 -0.121 threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending 2003 3 Headcount 58.7% 56.7% 54.5% 50.1% 46.1% concentration index -0.069*** -0.090*** -0.111*** -0.138*** -0.176*** iMPoVeriSHMent Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 23.6% 24.9% 1.4 pp 5.9% average shortfall from the $0.16 $0.16 $0.01 3.8% poverty line average shortfall from the $0.65 $0.63 -$0.01 -2.0% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 42.5% 45.3% 2.8 pp 6.6% average shortfall from the $0.42 $0.44 $0.02 5.0% poverty line average shortfall from the $0.95 $0.94 -$0.01 -1.5% poverty line, among the poor 62 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Mauritania’s consumer price index. data sources: 1=n/a demographic and Health Survey, 2=2007 Multiple indicator cluster Survey, 3=2003 Mauritania World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Mauritania. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Scott Wallace 63 HealtH equity and Financial Protection dataSHeet Mauritius the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 3 outcoMeS diarrhea 22.6% 34.7% 17.4% 25.4% 17.5% 24.0% -0.043 acute respiratory infection 18.5% 29.3% 27.3% 41.2% 28.2% 29.5% 0.086 Fever 88.4% 95.5% 93.2% 91.9% 92.8% 92.4% 0.000 adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2003 3 tuberculosis 12.0% 9.3% 8.8% 9.2% 6.0% 9.1% -0.112*** obesity among non-pregnant 15.0% 19.7% 12.3% 7.4% 8.9% 12.0% -0.166*** women road traffic accident 1.2% 1.4% 1.2% 1.7% 2.1% 1.5% 0.097 non-road traffic accident 8.1% 6.4% 5.0% 5.3% 4.9% 6.0% -0.098** angina 5.2% 4.5% 4.5% 3.9% 3.5% 4.3% -0.061 arthritis 9.1% 7.1% 7.7% 6.9% 6.3% 7.4% -0.065* asthma 6.8% 3.8% 3.4% 4.3% 5.0% 4.6% -0.059 depression 8.8% 7.1% 6.6% 6.3% 3.1% 6.4% -0.135*** diabetes 10.4% 9.2% 8.1% 9.0% 10.1% 9.4% -0.004 difficulty with work and 14.4% 9.3% 9.5% 6.2% 2.9% 8.5% -0.254*** household activities Poor self-assessed health 21.1% 17.3% 11.1% 9.7% 5.4% 13.1% -0.242*** status riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci inequalitieS in 2003 3 riSky BeHaVior Smoking (all) 26.8% 24.5% 23.0% 17.9% 20.6% 22.6% -0.078*** Smoking (women) 2.4% 2.9% 1.0% 4.1% 5.7% 3.2% 0.170* insufficient intake of fruit and 93.7% 91.1% 89.0% 87.6% 84.1% 89.2% -0.021*** vegetables insufficient physical activity 0.3% 0.1% 0.1% 0.4% 0.0% 0.2% -0.193 drinking 5.5% 5.4% 5.8% 5.7% 3.2% 5.2% -0.061 concurrent partnerships 0.4% 0.0% 0.4% 0.0% 0.0% 0.2% -0.536* inequalitieS adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci in HealtH care 2003 3 utiliZation tB screening 0.4% 0.8% 0.7% 0.8% 0.5% 0.6% 0.048 cervical cancer screening 38.4% 27.3% 36.5% 34.0% 44.0% 36.3% 0.047 Breast cancer screening 16.6% 10.3% 14.5% 13.0% 17.2% 14.3% 0.012 64 inequalitieS adult curatiVe care3 q1 q2 q3 q4 q5 total ci in HealtH care 2003 3 utiliZation inpatient or outpatient (cont.) 67.1% 64.1% 61.9% 65.7% 58.1% 63.5% -0.016** (12 months) inpatient (12 months) 16.2% 15.5% 12.0% 12.5% 9.6% 13.2% -0.091*** inpatient (5 years) 36.0% 37.5% 29.3% 30.2% 26.2% 31.9% -0.063*** outpatient (12 months) 63.7% 63.6% 60.7% 62.3% 52.9% 60.6% -0.026** threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending 2003 3 Headcount 42.5% 25.0% 14.7% 6.5% 2.4% concentration index 0.053*** 0.078*** 0.111*** 0.233*** 0.446*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending 2003 3 Headcount 53.6% 41.3% 31.9% 17.6% 8.8% concentration index 0.044*** 0.024** 0.025* 0.061*** 0.122*** iMPoVeriSHMent Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 0.5% 0.9% 0.4 pp 75.6% average shortfall from the $0.00 $0.00 $0.00 59.3% poverty line average shortfall from the $0.18 $0.16 -$0.02 -9.3% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 4.3% 6.2% 1.9 pp 44.2% average shortfall from the $0.01 $0.02 $0.01 44.8% poverty line average shortfall from the $0.35 $0.35 $0.00 0.4% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Mauritius’s consumer price index. data sources: 1=n/a demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 Mauritius World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Mauritius. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Francis dobbs 65 HealtH equity and Financial Protection dataSHeet MOZ AM BIQUE the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1997 1a outcoMeS infant mortality rate 207.6 157.4 170.0 138.4 101.7 163.4 -0.110*** under-five mortality rate 331.8 213.5 258.8 189.5 132.5 246.5 -0.142*** Stunting 52.3% 53.6% 46.8% 41.5% 29.3% 44.8% -0.107*** underweight 41.5% 38.8% 29.4% 20.4% 10.0% 28.4% -0.231*** diarrhea 20.7% 26.8% 19.8% 20.2% 19.2% 20.9% -0.016 acute respiratory infection 12.1% 11.3% 10.9% 10.5% 16.5% 12.2% 0.062 Fever 44.7% 47.6% 47.2% 42.3% 43.1% 44.8% -0.010 2003 1b infant mortality rate 157.4 161.6 141.5 115.2 76.3 135.8 -0.092*** under-five mortality rate 226.8 231.8 228.2 175.1 112.2 203.2 -0.077*** Stunting 54.1% 53.2% 52.3% 41.1% 26.2% 47.0% -0.094*** underweight 29.7% 25.8% 22.0% 16.9% 7.3% 21.6% -0.171*** diarrhea 15.5% 12.8% 14.6% 13.8% 15.6% 14.5% 0.018 acute respiratory infection 7.8% 11.5% 8.0% 10.4% 14.8% 10.1% 0.109*** Fever 26.2% 26.8% 28.7% 29.9% 25.2% 27.3% 0.019 2008 2 Stunting 50.6% 51.9% 46.2% 37.7% 25.2% 43.4% -0.118*** underweight 23.5% 23.4% 20.1% 13.3% 7.7% 18.3% -0.180*** diarrhea 18.3% 16.7% 19.4% 16.9% 16.2% 17.6% -0.016 acute respiratory infection 8.5% 13.0% 12.4% 17.3% 16.3% 13.3% 0.132*** Fever 23.7% 22.9% 24.1% 25.5% 20.6% 23.5% -0.005 adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 1997 1a obesity among non-pregnant 0.9% 0.6% 0.6% 2.1% 5.3% 1.9% 0.449*** women 2003 1b obesity among non-pregnant 0.6% 0.7% 0.7% 3.2% 12.3% 3.7% 0.637*** women inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 1b Smoking (women) 12.9% 10.7% 7.1% 3.4% 1.9% 7.3% -0.317*** concurrent partnerships 8.5% 13.0% 10.6% 23.7% 35.1% 18.2% 0.307*** condom usage (more than 2.7% 6.0% 4.4% 14.4% 36.9% 20.2% 0.447*** one partner) 2008 2 concurrent partnerships 3.1% 4.6% 4.7% 7.4% 8.6% 6.0% 0.199*** Mosquito net use by children 22.2% 27.9% 31.0% 28.6% 31.5% 27.9% 0.058*** 66 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 1997 1a Full immunization 20.3% 27.9% 35.4% 69.6% 86.9% 47.5% 0.297*** treatment of diarrhea 30.3% 30.2% 37.4% 46.5% 74.0% 42.2% 0.187*** Medical treatment of ari 19.0% 27.8% 43.6% 59.4% 47.4% 39.3% 0.187*** Skilled antenatal care (4+ visits) 19.8% 28.9% 36.2% 57.8% 75.2% 41.6% 0.275*** Skilled birth attendance 16.8% 27.6% 28.1% 60.8% 80.5% 41.5% 0.329*** 2003 1b Full immunization 44.7% 54.4% 61.0% 80.0% 91.7% 63.7% 0.156*** treatment of diarrhea 40.1% 43.5% 58.5% 70.6% 69.6% 54.6% 0.141*** Medical treatment of ari 43.0% 52.8% 52.8% 66.0% 62.9% 55.4% 0.091*** Skilled antenatal care (4+ visits) 17 .7% 22.3% 24.2% 45.4% 70.6% 34.0% 0.303*** Skilled birth attendance 7.6% 9.2% 13.5% 31.6% 49.5% 20.0% 0.415*** contraceptive prevalence 39.6% 40.3% 42.9% 41.0% 54.6% 45.2% 0.082*** 2008 2 Full immunization 92.2% 92.4% 97.3% 98.3% 99.0% 96.0% 0.016*** treatment of diarrhea 48.9% 52.2% 56.1% 59.4% 59.2% 54.7% 0.045*** Medical treatment of ari 61.1% 66.8% 72.1% 66.3% 72.5% 67.9% 0.023* contraceptive prevalence 9.7% 8.3% 12.2% 20.4% 36.5% 18.3% 0.321*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2008 2 Voluntary counseling and 89.3% 89.7% 90.5% 93.3% 96.8% 93.4% 0.020*** testing for HiV note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1997 Mozambique demographic and Health Survey, 1b=2003 Mozambique demographic and Health Survey, 2=2008 Mozambique Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Mozambique. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: eric Miller, 2002 67 HealtH equity and Financial Protection dataSHeet Nami bia the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1992 1a outcoMeS infant mortality rate 73.6 66.1 56.8 76.8 62.4 61.8 0.068 under-five mortality rate 111.8 90.0 94.8 115.5 73.9 73.3 0.099 Stunting 45.5% 39.4% 37 .7% 29.3% 22.1% 35.4% -0.120*** underweight 30.8% 25.5% 23.7% 18.2% 9.1% 21.9% -0.177*** diarrhea 15.9% 18.1% 15.2% 10.7% 8.5% 13.9% -0.123*** acute respiratory infection 9.0% 8.7% 7.2% 4.0% 4.7% 6.8% -0.155*** Fever 42.5% 45.5% 37 .4% 28.2% 33.1% 37 .6% -0.076*** 2000 1b infant mortality rate 48.1 58.7 48.2 33.5 25.5 43.0 -0.116*** under-five mortality rate 65.3 78.3 61.1 46.9 33.3 57.0 -0.120*** Stunting 35.1% 31.8% 28.4% 24.5% 17.0% 28.3% -0.122*** underweight 26.8% 24.7% 16.8% 14.6% 8.2% 19.1% -0.195*** diarrhea 14.2% 11.9% 11.8% 17.7% 11.1% 13.4% -0.005 acute respiratory infection 19.8% 23.2% 26.0% 15.6% 14.5% 20.1% -0.072*** Fever 20.3% 18.2% 23.7% 26.3% 20.9% 21.9% 0.035 2003 3 Malaria 43.8% 48.1% 48.2% 31.8% 24.3% 41.3% -0.074** 2006-07 1c infant mortality rate 66.2 63.5 50.3 62.8 24.6 55.2 -0.100*** under-five mortality rate 98.0 74.8 58.3 86.4 20.1 70.7 -0.151*** Stunting 39.0% 36.2% 28.2% 24.9% 15.0% 29.8% -0.161*** underweight 22.2% 22.3% 17.3% 16.6% 6.5% 17.6% -0.160*** diarrhea 13.9% 12.7% 14.7% 13.2% 12.2% 13.4% -0.026 acute respiratory infection 10.9% 10.7% 9.0% 6.6% 3.8% 8.4% -0.173*** Fever 21.1% 17.7% 18.1% 18.0% 16.2% 18.4% -0.044* adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci 1992 1a obesity among non-pregnant 2.6% 4.2% 3.8% 10.7% 17.0% 8.2% 0.370*** women 2003 3 tuberculosis 25.7% 22.4% 18.1% 19.2% 9.7% 19.0% -0.169*** road traffic accident 2.8% 1.5% 1.8% 2.5% 3.2% 2.4% 0.047 non-road traffic accident 3.6% 2.6% 4.6% 5.1% 6.3% 4.5% 0.146** angina 13.2% 7.4% 6.1% 7.3% 5.1% 7.8% -0.183*** arthritis 12.1% 11.8% 8.4% 11.4% 7.9% 10.3% -0.069** asthma 3.3% 2.8% 2.7% 5.2% 4.4% 3.7% 0.109* depression 9.7% 9.9% 6.6% 6.0% 6.6% 7.7% -0.116*** diabetes 2.1% 1.7% 1.9% 1.5% 2.9% 2.1% 0.033 difficulty with work and 12.8% 11.1% 9.5% 5.3% 4.0% 8.5% -0.236** household activities Poor self-assessed health status 8.4% 6.0% 7.8% 5.0% 4.2% 6.3% -0.141** 2006-07 1c obesity among non-pregnant 2.4% 5.1% 11.1% 16.0% 20.3% 11.7% 0.330*** women 68 riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci inequalitieS in 2003 3 riSky BeHavior Smoking (all) 23.8% 18.6% 19.4% 17.6% 18.0% 19.5% -0.055** insufficient intake of fruit and 94.6% 92.7% 91.3% 86.8% 73.9% 87.7% -0.046*** vegetables insufficient physical activity 4.7% 5.6% 6.0% 4.0% 4.1% 4.9% -0.045 drinking 13.6% 10.0% 8.9% 10.3% 10.2% 10.6% -0.070* 2006-07 1c Smoking (women) 7.3% 5.6% 6.5% 9.5% 10.8% 8.1% 0.114*** concurrent partnerships 28.8% 30.2% 34.2% 40.0% 30.9% 33.1% 0.027*** condom usage (more than 43.6% 55.4% 57.8% 69.0% 72.0% 61.2% 0.090*** one partner) Mosquito net use by children 16.1% 14.6% 11.6% 10.1% 4.3% 11.8% -0.179*** Mosquito net use by pregnant 11.6% 13.6% 11.9% 3.9% 2.7% 9.0% -0.200*** women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1a,1b,1c,2 utiliZation 1992 1a Full immunization 54.3% 61.5% 57.9% 58.6% 65.0% 59.2% 0.027 treatment of diarrhea 10.0% 7.7% 11.6% 9.2% 16.2% 10.1% 0.082 Skilled antenatal care (4+ visits) 49.9% 58.7% 61.0% 62.1% 72.6% 60.7% 0.068*** Skilled birth attendance 50.9% 60.1% 66.5% 76.2% 94.1% 69.1% 0.121*** 2000 1b Full immunization 56.8% 66.1% 63.4% 73.2% 67.6% 65.2% 0.044** treatment of diarrhea 51.3% 60.3% 61.6% 64.7% 71.7% 61.2% 0.062** Medical treatment of ari 49.3% 47.5% 56.4% 58.0% 75.0% 55.3% 0.074*** Skilled antenatal care (4+ visits) 63.0% 71.0% 76.9% 78.0% 85.6% 75.0% 0.060*** Skilled birth attendance 54.6% 65.6% 81.2% 87.7% 97.2% 76.7% 0.117*** 2006-07 1c Full immunization 60.0% 67.5% 65.3% 76.4% 81.3% 68.9% 0.058*** treatment of diarrhea 55.8% 78.1% 77.9% 73.0% 63.6% 69.7% 0.023 Skilled antenatal care (4+ visits) 72.6% 76.1% 76.8% 81.6% 87.0% 78.6% 0.036*** Skilled birth attendance 60.1% 73.7% 87.0% 94.6% 98.3% 81.8% 0.099*** contraceptive prevalence 28.9% 37.0% 44.0% 57.5% 54.4% 45.5% 0.127*** adult Preventive care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 7.0% 4.5% 5.3% 6.4% 5.6% 5.8% -0.031 voluntary counseling and 80.0% 85.7% 98.2% 87.9% 91.4% 89.7% 0.020 testing for Hiv cervical cancer screening 73.0% 69.0% 61.3% 73.5% 80.7% 74.4% 0.042* Breast cancer screening 7.5% 2.7% 9.8% 14.4% 21.4% 10.8% 0.283*** adult curative care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 43.7% 38.1% 37.2% 40.8% 39.6% 40.0% -0.010 (12 months) inpatient (12 months) 12.5% 13.0% 12.0% 14.3% 9.4% 12.2% -0.037 inpatient (5 years) 23.9% 24.7% 26.2% 28.4% 29.0% 26.4% 0.041** outpatient (12 months) 22.6% 21.6% 20.5% 22.7% 27 .4% 23.0% 0.043 69 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending 2003 3 Headcount 16.6% 11.1% 8.3% 6.0% 4.8% concentration index -0.140*** -0.192*** -0.305*** -0.419*** -0.554*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending 2003 3 Headcount 35.4% 31.6% 28.4% 24.2% 21.5% concentration index -0.195*** -0.238*** -0.276*** -0.330*** -0.355*** iMPoveriSHMent Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 68.4% 69.3% 0.8 pp 1.2% average shortfall from the $0.54 $0.55 $0.01 1.4% poverty line average shortfall from the $0.78 $0.78 $0.00 0.3% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 78.6% 79.0% 0.5 pp 0.6% average shortfall from the $1.11 $1.12 $0.01 1.1% poverty line average shortfall from the $1.39 $1.39 $0.01 0.5% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using namibia’s consumer price index. data sources: 1a=1992 namibia demographic and Health Survey, 1b=2000 namibia demographic and Health Survey, 1c=2006-07 namibia demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 namibia World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - namibia. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: un Photo/eskinder debebe 70 HealtH equity and Financial Protection dataSHeet NIGER the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2006 1b outcoMeS infant mortality rate 125.1 137.6 140.0 139.3 85.8 126.9 -0.031** under-five mortality rate 218.3 267.7 271.8 269.1 176.9 242.9 -0.007 Stunting 56.6% 58.6% 57.3% 58.8% 41.1% 54.7% -0.045*** underweight 43.7% 43.9% 42.7% 41.8% 26.4% 40.0% -0.072*** diarrhea 22.3% 23.3% 23.5% 19.5% 17.9% 21.3% -0.036*** acute respiratory infection 15.1% 14.4% 14.1% 15.0% 12.5% 14.3% -0.021 Fever 29.4% 28.3% 28.2% 27.9% 23.2% 27.5% -0.029** adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 1998 1a obesity among non-pregnant 0.7% 0.3% 0.0% 0.4% 8.0% 1.7% 0.653*** women 2006 1b obesity among non-pregnant 0.6% 1.0% 1.1% 1.8% 10.3% 3.2% 0.578*** women HiV positive 0.3% 0.6% 0.5% 0.5% 1.4% 0.7% 0.235*** inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2006 1b Smoking (women) 6.0% 2.2% 1.6% 1.6% 1.2% 2.5% -0.334*** concurrent partnerships 0.3% 0.3% 0.3% 0.9% 2.1% 0.8% 0.422*** Mosquito net use by children 5.1% 6.7% 6.1% 6.1% 13.6% 7.4% 0.183*** Mosquito net use by pregnant 3.7% 7.6% 5.1% 7.8% 16.9% 7.9% 0.242*** women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 2006 1b Full immunization 20.4% 24.8% 24.0% 28.8% 49.4% 29.2% 0.177*** treatment of diarrhea 22.6% 21.0% 26.5% 24.9% 42.0% 26.5% 0.119*** Medical treatment of ari 39.6% 44.1% 41.3% 49.1% 66.1% 47.2% 0.106*** Skilled antenatal care (4+ visits) 8.4% 10.7% 9.7% 12.8% 35.0% 14.9% 0.309*** Skilled birth attendance 4.9% 7.7% 7.7% 13.9% 61.4% 18.4% 0.528*** contraceptive prevalence 51.6% 50.4% 41.8% 48.8% 46.2% 47.4% -0.008 among women 71 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1998 niger demographic and Health Survey, 1b=2006 niger demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - niger. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 72 HealtH equity and Financial Protection dataSHeet NIGERIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 1a outcoMeS infant mortality rate 153.9 160.5 128.7 95.9 54.2 125.2 -0.154*** under-five mortality rate 266.5 296.8 234.4 191.1 83.1 229.3 -0.139*** Stunting 53.7% 53.2% 48.7% 34.2% 22.6% 42.8% -0.155*** underweight 33.8% 33.7% 28.6% 24.0% 13.8% 27.1% -0.152*** diarrhea 22.2% 24.4% 19.4% 19.8% 8.9% 19.2% -0.134*** acute respiratory infection 11.3% 13.1% 12.4% 9.3% 6.5% 10.7% -0.098*** Fever 34.0% 36.1% 35.1% 31.0% 22.0% 31.9% -0.080*** 2007 2 Stunting 51.3% 51.2% 45.7% 36.2% 25.8% 42.6% -0.125*** underweight 33.4% 32.5% 26.2% 19.3% 16.1% 25.9% -0.149*** diarrhea 11.8% 11.2% 10.0% 8.2% 6.4% 9.6% -0.116*** acute respiratory infection 6.2% 7.1% 6.2% 6.3% 5.4% 6.3% -0.032* Fever 10.8% 13.6% 13.0% 14.0% 11.7% 12.7% 0.018 2008 1b infant mortality rate 126.9 130.0 105.6 86.4 64.5 106.8 -0.123*** under-five mortality rate 237.4 236.1 171.9 136.2 94.9 186.6 -0.160*** Stunting 50.4% 48.3% 41.5% 34.2% 24.8% 40.5% -0.129*** underweight 41.1% 33.5% 25.1% 18.2% 11.6% 26.9% -0.229*** diarrhea 14.6% 13.2% 9.4% 7.8% 4.8% 10.3% -0.204*** acute respiratory infection 5.4% 5.6% 4.8% 4.3% 3.2% 4.7% -0.102*** Fever 18.1% 17.5% 16.4% 15.1% 13.0% 16.2% -0.061*** adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 2003 1a obesity among non-pregnant 2.1% 2.8% 4.6% 5.8% 11.8% 5.8% 0.352*** women 2008 1b obesity among non-pregnant 2.2% 2.7% 4.5% 7.1% 13.2% 6.4% 0.372*** women 73 inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2003 1a Smoking (women) 1.9% 1.0% 1.3% 1.0% 0.3% 1.0% -0.256*** concurrent partnerships 6.4% 6.6% 8.6% 14.6% 16.6% 10.8% 0.230*** condom usage (more than 12.4% 11.5% 12.4% 25.8% 32.2% 22.8% 0.234*** one partner) Mosquito net use by children 1.8% 0.5% 1.4% 0.9% 0.7% 1.1% -0.139 Mosquito net use by pregnant 1.0% 0.4% 2.1% 2.8% 0.4% 1.3% 0.084 women 2007 2 concurrent partnerships 2.1% 2.3% 4.6% 5.8% 6.9% 4.1% 0.258*** condom usage (more than 17.4% 30.8% 55.6% 56.0% 71.1% 52.5% 0.186*** one partner) Mosquito net use by children 0.1% 0.2% 0.6% 0.9% 1.2% 0.6% 0.409*** 2008 1b Smoking (women) 1.3% 0.9% 0.6% 0.5% 0.1% 0.7% -0.355*** concurrent partnerships 4.1% 6.0% 10.3% 15.1% 14.7% 10.3% 0.239*** condom usage (more than 6.1% 18.5% 26.1% 35.0% 42.9% 32.0% 0.199*** one partner) Mosquito net use by children 2.5% 4.6% 6.7% 7.5% 8.2% 5.7% 0.225*** Mosquito net use by pregnant 2.5% 5.1% 7.3% 6.4% 5.2% 5.2% 0.111*** women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1a,1b,2 utiliZation 2003 1a Full immunization 3.5% 3.6% 9.8% 10.6% 41.2% 13.0% 0.501*** treatment of diarrhea 17.4% 24.8% 38.6% 33.5% 50.2% 29.6% 0.184*** Medical treatment of ari 19.8% 26.4% 35.3% 44.6% 61.2% 34.0% 0.200*** Skilled antenatal care (4+ visits) 22.4% 27 .8% 43.6% 63.6% 90.5% 47.4% 0.289*** Skilled birth attendance 14.0% 20.3% 29.0% 52.0% 85.0% 38.4% 0.364*** contraceptive prevalence 37 .5% 36.2% 36.8% 36.6% 43.0% 39.4% 0.040* 2008 1b Full immunization 4.9% 11.8% 20.0% 33.9% 53.2% 22.8% 0.416*** treatment of diarrhea 19.7% 26.3% 43.3% 43.3% 60.1% 32.1% 0.224*** Medical treatment of ari 34.4% 42.0% 54.1% 68.6% 68.2% 49.8% 0.157*** Skilled antenatal care (4+ visits) 14.2% 27.3% 49.6% 71.7% 89.3% 46.5% 0.345*** Skilled birth attendance 8.4% 17.7% 38.3% 64.4% 86.3% 40.1% 0.409*** contraceptive prevalence 36.5% 40.0% 43.2% 47.6% 46.8% 45.2% 0.034*** 2007 2 Full immunization 8.2% 10.3% 9.3% 32.4% 61.5% 23.7% 0.428*** treatment of diarrhea 18.0% 27.4% 31.4% 38.1% 52.6% 30.6% 0.197*** Medical treatment of ari 45.7% 60.0% 55.7% 78.9% 82.1% 64.5% 0.103*** contraceptive prevalence 2.8% 5.9% 10.2% 17.9% 22.8% 12.1% 0.358*** among women adult Preventive care2,3 q1 q2 q3 q4 q5 total ci 2007 2 voluntary counseling and 57.2% 71.2% 77.1% 79.0% 88.8% 82.1% 0.056*** testing for Hiv 74 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=2003 nigeria demographic and Health Survey, 1b=2008 nigeria demographic and Health Survey, 2=2007 nigeria Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - nigeria. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: yosef Hadar, 1980 75 HealtH equity and Financial Protection dataSHeet REPU BLIC OF THE CONGO the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 3 outcoMeS Malaria 11.5% 13.1% 11.2% 17.8% 27.3% 16.3% 0.144 2005 1 infant mortality rate 97 .1 106.2 77 .4 86.9 54.1 87.0 -0.100*** under-five mortality rate 150.0 135.3 160.8 141.8 90.5 138.1 -0.058** Stunting 36.1% 30.6% 28.7% 28.3% 24.8% 30.4% -0.063*** underweight 15.9% 13.4% 12.1% 9.2% 6.0% 12.0% -0.146*** diarrhea 14.9% 13.6% 14.5% 16.1% 11.8% 14.3% -0.027 acute respiratory infection 7.6% 6.9% 7.6% 11.3% 7.5% 8.1% 0.048 Fever 25.0% 25.3% 23.4% 24.9% 21.5% 24.2% -0.025 adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2003 3 tuberculosis 11.6% 9.2% 11.4% 9.3% 5.9% 9.2% -0.110 road traffic accident 3.6% 1.6% 1.4% 1.5% 0.9% 1.6% -0.245** non-road traffic accident 1.7% 3.0% 2.1% 2.1% 3.2% 2.5% 0.051 angina 13.0% 8.7% 12.6% 8.9% 3.8% 8.9% -0.172*** arthritis 20.3% 20.0% 21.7% 11.5% 15.4% 17.4% -0.093** asthma 7.8% 8.9% 5.9% 2.3% 2.5% 5.2% -0.306*** depression 7.1% 8.5% 6.5% 7.3% 1.8% 6.0% -0.210*** diabetes 1.5% 1.5% 3.1% 1.9% 1.3% 1.8% -0.023 difficulty with work and 4.1% 2.5% 4.2% 3.2% 4.4% 3.7% 0.012 household activities Poor self-assessed health 20.6% 13.5% 18.4% 9.2% 7.0% 13.0% -0.196*** status 2005 1 obesity among non-pregnant 1.9% 4.3% 5.3% 8.8% 15.0% 7.5% 0.351*** women inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 12.7% 9.8% 12.2% 5.1% 5.5% 8.7% -0.173*** insufficient intake of fruit and 52.9% 64.2% 68.8% 58.3% 58.9% 60.9% 0.004 vegetables insufficient physical activity 0.3% 2.5% 1.8% 2.9% 3.3% 2.2% 0.232** drinking 31.0% 26.3% 33.0% 26.4% 21.4% 27.1% -0.058 2005 1 Smoking (women) 8.6% 7.7% 6.6% 5.4% 1.5% 5.7% -0.232 concurrent partnerships 59.1% 64.1% 67.7% 69.1% 60.1% 64.0% 0.003 condom usage (more than 7.0% 8.0% 12.3% 15.3% 17.4% 12.3% 0.189*** one partner) Mosquito net use by children 4.4% 6.6% 5.8% 5.1% 9.1% 6.0% 0.102** Mosquito net use by pregnant 14.6% 6.7% 8.9% 9.7% 12.6% 10.7% -0.027 women 76 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2005 1 Full immunization 30.4% 46.1% 59.8% 61.3% 76.3% 52.5% 0.164*** treatment of diarrhea 25.3% 21.4% 25.8% 40.6% 22.3% 27.1% 0.078* Medical treatment of ari 33.6% 48.8% 53.5% 49.1% 57.2% 47.5% 0.100** Skilled antenatal care (4+ visits) 31.3% 31.8% 21.3% 13.9% 23.2% 24.8% -0.120*** Skilled birth attendance 70.6% 80.4% 94.2% 97.9% 98.4% 86.5% 0.076*** contraceptive prevalence 21.7% 18.7% 20.8% 23.6% 28.1% 23.1% 0.081*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 3.6% 2.1% 2.6% 3.5% 1.6% 2.6% -0.058 cervical cancer screening 31.9% 27 .1% 45.2% 44.4% 42.4% 39.0% 0.070 Breast cancer screening 18.8% 7.0% 9.7% 10.2% 20.9% 14.2% 0.146 adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 38.6% 39.4% 50.9% 48.4% 47.7% 45.5% 0.040 (12 months) inpatient (12 months) 10.4% 9.1% 8.3% 12.8% 10.5% 10.3% -0.001 inpatient (5 years) 20.7% 15.7% 20.6% 24.1% 16.3% 19.3% -0.008 outpatient (12 months) 34.9% 30.2% 43.5% 42.5% 51.4% 40.9% 0.106*** threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 46.7% 41.4% 34.7% 27.3% 21.6% concentration index 0.050* 0.030 -0.027 -0.097* -0.151* threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 60.2% 59.0% 57.0% 51.5% 45.2% concentration index -0.027 -0.039* -0.043** -0.088*** -0.160*** iMPoVeriSHMent3 Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 21.6% 27.9% 6.3 pp 29.4% average shortfall from the $0.13 $0.19 $0.05 39.4% poverty line average shortfall from the $0.55 $0.59 $0.04 7.7% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 41.2% 46.7% 5.6 pp 13.5% average shortfall from the $0.40 $0.51 $0.10 25.9% poverty line average shortfall from the $0.87 $0.96 $0.09 10.9% poverty line, among the poor 77 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using republic of the congo’s consumer price index. data sources: 1=2005 republic of the congo demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 republic of the congo World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - republic of the congo. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 78 HealtH equity and Financial Protection dataSHeet RWANDA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2005 1a outcoMeS infant mortality rate 125.9 117.0 108.8 132.1 82.9 114.3 -0.034*** under-five mortality rate 231.8 218.5 203.0 225.6 144.0 207.2 -0.052*** Stunting 60.8% 54.6% 51.5% 50.3% 34.6% 51.0% -0.075*** underweight 25.0% 20.4% 16.9% 19.3% 7.5% 18.2% -0.128*** diarrhea 16.2% 14.4% 13.7% 16.2% 11.1% 14.4% -0.033** acute respiratory infection 18.7% 16.8% 17.5% 17.2% 18.1% 17.7% 0.013 Fever 28.4% 25.2% 26.1% 27.8% 25.9% 26.6% 0.003 2010 1b infant mortality rate 77.4 61.8 63.8 67.5 58.2 66.0 0.966** under-five mortality rate 127 .8 109.8 121.2 113.6 86.9 112.1 0.948*** Stunting 53.7% 50.6% 45.4% 39.4% 25.4% 44.0% -0.124*** underweight 14.8% 16.1% 11.2% 9.6% 5.0% 11.8% -0.178*** diarrhea 16.2% 13.5% 12.4% 11.7% 11.6% 13.3% -0.078*** acute respiratory infection 12.8% 11.1% 9.1% 7.3% 9.2% 10.1% -0.093*** Fever 17 .9% 16.8% 15.6% 12.2% 16.3% 15.9% -0.052*** adult HealtH1a,1b,3 q1 q2 q3 q4 q5 total ci 2005 1a obesity among non-pregnant 0.4% 0.4% 0.7% 0.4% 3.0% 1.0% 0.456*** women HiV positive 2.0% 1.9% 2.9% 2.7% 5.3% 3.0% 0.220*** 2010 1b obesity among non-pregnant 0.5% 0.4% 1.1% 2.4% 6.0% 2.2% 0.556*** women HiV positive 2.8% 2.7% 2.1% 2.2% 5.2% 3.1% 0.130*** inequalitieS in riSk FactorS1a,1b,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2005 1a Smoking (women) 6.4% 6.4% 5.0% 3.7% 1.3% 4.6% -0.218*** concurrent partnerships 4.1% 3.9% 3.6% 4.0% 5.7% 4.2% 0.075*** condom usage (more than 6.1% 13.2% 16.2% 15.2% 37.1% 19.1% 0.358*** one partner) Mosquito net use by children 4.4% 10.0% 8.1% 13.4% 31.1% 13.0% 0.355*** Mosquito net use by pregnant 8.2% 16.1% 12.3% 19.3% 38.6% 17.7% 0.274*** women 2010 1b Smoking (women) 7.0% 4.3% 3.6% 2.2% 1.0% 3.6% -0.337*** concurrent partnerships 6.0% 5.1% 4.7% 3.9% 6.5% 5.3% 0.013 condom usage (more than 21.0% 29.3% 23.9% 42.4% 50.9% 34.2% 0.190*** one partner) Mosquito net use by children 63.4% 66.6% 72.3% 75.5% 78.1% 70.5% 0.049*** Mosquito net use by pregnant 67.1% 66.5% 76.4% 76.2% 76.6% 72.4% 0.034*** women 79 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,2 utiliZation 2005 1a Full immunization 75.0% 74.3% 75.3% 79.5% 74.3% 75.7% 0.009 treatment of diarrhea 13.8% 15.1% 15.2% 24.4% 28.0% 18.7% 0.166*** Medical treatment of ari 23.7% 26.2% 24.4% 22.9% 44.0% 28.0% 0.116*** Skilled antenatal care (4+ visits) 11.1% 11.8% 11.6% 14.6% 20.5% 13.7% 0.145*** Skilled birth attendance 15.8% 20.0% 23.6% 29.1% 60.7% 29.2% 0.284*** contraceptive prevalence 29.7% 32.7% 37.1% 34.8% 44.0% 37.1% 0.085*** among women 2010 1b Full immunization 86.4% 87.5% 91.7% 92.0% 95.7% 90.1% 0.022*** treatment of diarrhea 27.1% 34.0% 36.3% 37.6% 44.2% 34.5% 0.089*** Medical treatment of ari 30.1% 37.1% 38.0% 44.5% 57.2% 39.2% 0.117*** Skilled antenatal care (4+ visits) 34.4% 34.9% 32.8% 34.8% 42.6% 35.7% 0.036*** Skilled birth attendance 61.7% 64.4% 67.9% 72.6% 85.9% 69.6% 0.065*** contraceptive prevalence 23.0% 23.8% 25.9% 28.0% 24.0% 24.9% 0.019** among women note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=2005 rwanda demographic and Health Survey, 1b=2010 rwanda demographic and Health Survey 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - rwanda. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: arne Hoel 80 HealtH equity and Financial Protection dataSHeet São Tomé and PrínciPe the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2008-09 1 outcoMeS infant mortality rate 54.3 45.6 46.1 66.0 25.8 48.2 -0.052 Stunting 38.5% 35.5% 32.7% 21.9% 23.5% 30.9% -0.113*** underweight 18.7% 14.0% 17.4% 14.3% 8.9% 15.0% -0.099** diarrhea 14.4% 12.9% 15.7% 21.7% 16.1% 16.1% 0.058 acute respiratory infection 18.0% 15.9% 11.2% 21.7% 11.2% 15.6% -0.027 Fever 15.5% 16.1% 15.4% 18.4% 22.2% 17.3% 0.070* adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2008-09 1 obesity among non-pregnant 10.5% 10.2% 7.8% 15.7% 13.9% 12.0% 0.105** women HiV positive 2.2% 1.4% 1.3% 1.2% 1.3% 1.5% -0.079*** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2008-09 1 Smoking (women) 3.5% 1.1% 1.1% 1.4% 0.3% 1.4% -0.361*** concurrent partnerships 9.2% 7.1% 9.1% 12.6% 15.2% 10.9% 0.140*** condom usage (more than 40.6% 28.6% 42.1% 56.2% 54.9% 47.8% 0.090* one partner) Mosquito net use by children 44.3% 51.3% 63.6% 64.1% 67.5% 57.8% 0.087*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2008-09 1 Full immunization 68.1% 72.9% 80.1% 83.4% 81.6% 76.6% 0.044** treatment of diarrhea 73.2% 61.3% 47.5% 51.1% 64.6% 58.5% -0.045 Skilled antenatal care (4+ visits) 63.0% 72.2% 77.1% 85.5% 93.1% 77.8% 0.077*** Skilled birth attendance 71.8% 74.1% 84.2% 87.0% 94.3% 81.7% 0.057*** contraceptive prevalence 41.3% 42.2% 46.3% 46.6% 45.2% 44.4% 0.019 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=2008-09 São tomé and Príncipe demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - São tomé and Príncipe. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 81 HealtH equity and Financial Protection dataSHeet SENEGAL the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1997 1a outcoMeS infant mortality rate 101.0 97.7 87.4 66.2 50.8 82.6 -0.119*** under-five mortality rate 187.0 192.7 162.2 101.8 68.8 147.1 -0.171*** diarrhea 10.6% 11.2% 8.4% 8.0% 8.9% 9.5% -0.050* 2003 3 Malaria 44.4% 48.0% 22.6% 21.1% 27.2% 34.5% -0.173*** 2005 1b infant mortality rate 111.0 105.2 85.3 58.7 45.2 85.6 -0.162*** under-five mortality rate 214.5 190.1 155.0 102.6 75.5 158.2 -0.182*** Stunting 30.6% 24.3% 19.2% 12.3% 9.3% 20.4% -0.225*** underweight 22.3% 16.8% 15.9% 5.5% 6.5% 14.4% -0.253*** diarrhea 24.8% 24.0% 22.0% 20.8% 25.0% 23.3% -0.014 acute respiratory infection 10.5% 11.9% 14.4% 17.6% 16.7% 13.9% 0.113*** Fever 30.6% 32.3% 28.3% 32.9% 31.7% 31.1% 0.009 2010-11 1c infant mortality rate 71.9 58.5 54.0 53.7 44.0 57.9 -0.091*** under-five mortality rate 127.2 104.2 84.6 75.5 71.7 96.6 -0.125*** Stunting 37.4% 32.7% 27.6% 23.1% 14.8% 28.1% -0.161*** underweight 25.4% 22.8% 18.8% 14.8% 9.2% 18.9% -0.173*** diarrhea 20.7% 18.7% 20.1% 26.3% 20.0% 21.1% 0.025* acute respiratory infection 10.6% 8.4% 12.2% 17.2% 18.6% 13.0% 0.146*** Fever 20.3% 16.7% 21.5% 30.6% 29.2% 23.2% 0.108*** adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci 2003 3 tuberculosis 12.4% 7.2% 9.7% 6.7% 6.0% 8.5% -0.155 road traffic accident 1.4% 2.0% 3.2% 3.0% 1.9% 2.2% 0.090 non-road traffic accident 3.1% 1.8% 5.8% 1.6% 4.5% 3.4% 0.101 angina 13.0% 5.2% 8.7% 7.7% 8.6% 8.8% -0.063 arthritis 21.2% 17 .1% 21.5% 19.3% 18.6% 19.6% -0.040 asthma 3.3% 1.5% 3.9% 3.8% 5.5% 3.7% 0.124 depression 1.5% 1.4% 2.9% 1.3% 1.6% 1.7% 0.023 diabetes 0.4% 1.1% 0.4% 2.3% 3.5% 1.6% 0.382*** difficulty with work and 8.2% 5.9% 4.5% 4.6% 5.5% 5.7% -0.088 household activities Poor self-assessed health 7.8% 9.1% 7.2% 7.3% 7.9% 7.8% -0.013 status 2005 1b obesity among non-pregnant 2.3% 2.9% 7.1% 10.5% 11.8% 7.7% 0.290*** women HiV positive 0.7% 1.0% 0.8% 0.7% 0.5% 0.7% -0.068*** 2010-11 1c obesity among non-pregnant 2.6% 3.2% 5.4% 5.9% 9.0% 5.6% 0.230*** women HiV positive 1.0% 1.2% 0.6% 0.5% 0.5% 0.7% -0.185** 82 inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 17.8% 10.7% 13.1% 10.7% 15.1% 13.7% -0.044 insufficient intake of fruit and 87.8% 77.3% 82.5% 81.0% 78.7% 81.4% -0.016* vegetables insufficient physical activity 2.3% 1.6% 2.9% 2.7% 1.9% 2.3% 0.012 drinking 2.9% 2.9% 1.7% 2.2% 2.8% 2.5% -0.006 2005 1b Smoking (women) 0.6% 0.6% 0.2% 0.3% 0.9% 0.5% 0.117 concurrent partnerships 2.6% 4.3% 4.0% 3.5% 4.9% 3.9% 0.088*** condom usage (more than 14.0% 27.4% 32.3% 38.1% 28.2% 29.1% 0.063 one partner) Mosquito net use by children 3.7% 7.6% 11.7% 8.7% 5.6% 7.4% 0.090*** Mosquito net use by pregnant 2.8% 9.7% 14.8% 11.5% 8.3% 9.0% 0.171*** women 2010-11 1c Smoking (women) 1.2% 0.3% 0.2% 0.3% 0.2% 0.4% -0.354*** concurrent partnerships 2.6% 3.1% 4.3% 4.7% 3.2% 3.6% 0.068** condom usage (more than 30.9% 39.6% 33.5% 47.3% 44.0% 40.2% 0.077** one partner) Mosquito net use by children 40.1% 41.8% 42.7% 28.7% 22.2% 36.0% -0.100*** Mosquito net use by pregnant 44.5% 43.6% 47.1% 32.2% 19.4% 38.4% -0.122*** women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,1c,2 utiliZation 1997 1a treatment of diarrhea 11.4% 12.1% 14.0% 11.7% 12.3% 12.3% -0.004 Skilled antenatal care (4+ visits) 11.5% 12.2% 16.5% 17.1% 30.1% 16.8% 0.200*** Skilled birth attendance 21.0% 26.0% 45.7% 70.2% 87.2% 47.7% 0.296*** 2005 1b Full immunization 59.2% 57.3% 59.5% 55.8% 65.2% 59.1% 0.009 treatment of diarrhea 21.4% 21.9% 26.2% 39.3% 29.7% 26.7% 0.101*** Medical treatment of ari 34.7% 37.9% 42.5% 58.6% 60.7% 47.4% 0.125*** Skilled antenatal care (4+ visits) 12.4% 14.8% 26.1% 41.3% 58.3% 29.0% 0.324*** Skilled birth attendance 13.6% 21.8% 45.6% 77.4% 87.9% 45.4% 0.362*** contraceptive prevalence 35.7% 34.0% 38.3% 36.8% 41.8% 38.5% 0.042** 2010-11 1c Full immunization 56.2% 63.0% 63.6% 65.5% 69.1% 62.9% 0.036*** treatment of diarrhea 24.7% 22.3% 27 .9% 24.0% 37.0% 26.5% 0.072** Medical treatment of ari 26.6% 34.1% 50.8% 41.8% 53.0% 42.0% 0.120*** Skilled antenatal care (4+ visits) 34.8% 43.1% 53.6% 61.7% 73.1% 52.7% 0.152*** Skilled birth attendance 29.8% 51.7% 75.2% 88.4% 95.4% 65.3% 0.218*** contraceptive prevalence 4.3% 5.6% 9.1% 10.2% 13.2% 8.8% 0.205*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 2.1% 0.8% 1.9% 1.2% 2.3% 1.7% 0.024 cervical cancer screening 56.0% 31.9% 32.2% 49.6% 41.1% 42.3% 0.018 Breast cancer screening 2.1% 0.0% 1.5% 6.6% 7.7% 4.0% 0.392*** adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 22.9% 38.1% 28.8% 35.0% 34.6% 31.6% 0.063** (12 months) inpatient (12 months) 2.1% 3.1% 3.6% 4.8% 4.2% 3.5% 0.146** inpatient (5 years) 11.1% 8.5% 11.8% 12.5% 13.1% 11.5% 0.060 outpatient (12 months) 32.4% 53.1% 20.0% 33.4% 32.8% 34.7% -0.032 83 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 37.8% 29.4% 23.5% 17.5% 13.3% concentration index 0.070*** 0.015 -0.048 -0.142*** -0.262*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 56.9% 53.4% 50.0% 44.3% 39.1% concentration index -0.064*** -0.094*** -0.130*** -0.194*** -0.268*** iMPoVeriSHMent3 Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 50.6% 53.8% 3.2 pp 6.3% average shortfall from the $0.34 $0.37 $0.03 9.8% poverty line average shortfall from the $0.62 $0.64 $0.02 3.3% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 68.9% 71.5% 2.6 pp 3.8% average shortfall from the $0.83 $0.89 $0.06 6.8% poverty line average shortfall from the $1.12 $1.15 $0.03 2.8% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Senegal’s consumer price index. data sources: 1a=1997 Senegal demographic and Health Survey, 1b=2005 Senegal demographic and Health Survey, 1c=2010-11 Senegal demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 Senegal World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Senegal. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Scott Wallace 84 HealtH equity and Financial Protection dataSHeet SIERRA LEONE the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2005 2 outcoMeS Stunting 49.3% 52.2% 49.3% 46.6% 34.3% 46.9% -0.057*** underweight 31.7% 29.4% 29.0% 27.3% 20.0% 27.8% -0.069*** diarrhea 14.3% 14.1% 14.8% 15.7% 13.0% 14.4% -0.002 acute respiratory infection 21.5% 20.6% 19.4% 22.4% 19.1% 20.6% -0.011 Fever 33.8% 31.9% 36.9% 37.4% 35.2% 35.0% 0.020* 2008 1 infant mortality rate 160.0 121.4 115.7 116.0 96.5 124.5 -0.079*** under-five mortality rate 240.6 185.0 173.0 184.8 154.5 190.9 -0.070*** Stunting 38.0% 44.7% 39.2% 36.2% 23.8% 37.5% -0.059*** underweight 22.7% 25.3% 23.6% 19.9% 11.4% 21.4% -0.079*** diarrhea 13.2% 15.2% 14.6% 13.9% 9.8% 13.6% -0.045* acute respiratory infection 11.4% 11.2% 13.5% 9.9% 7.9% 11.1% -0.051** Fever 24.5% 25.4% 24.5% 26.3% 30.5% 25.9% 0.035** adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2008 1 obesity among non-pregnant 10.2% 6.5% 6.0% 9.8% 13.9% 9.4% 0.116*** women HiV positive 0.4% 1.3% 1.0% 2.0% 2.6% 1.5% 0.281*** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2005 2 concurrent partnerships 3.1% 3.1% 5.1% 6.0% 6.5% 5.1% 0.167*** Mosquito net use by children 2.0% 1.8% 2.6% 3.2% 2.5% 2.4% 0.097** 2008 1 Smoking (women) 15.0% 13.4% 10.8% 9.3% 4.7% 10.4% -0.203*** concurrent partnerships 7.3% 9.1% 11.4% 19.7% 30.1% 16.1% 0.305*** condom usage (more than 0.9% 3.9% 1.4% 5.0% 9.5% 6.0% 0.317*** one partner) Mosquito net use by children 25.8% 24.8% 29.8% 35.1% 31.4% 29.0% 0.065*** Mosquito net use by pregnant 19.9% 38.2% 27.1% 34.5% 17.1% 27.8% 0.004 women 85 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2005 2 Full immunization 55.0% 65.2% 72.9% 74.8% 78.9% 70.2% 0.062*** treatment of diarrhea 54.2% 49.4% 55.5% 69.7% 79.3% 60.5% 0.094*** Medical treatment of ari 51.6% 47.0% 58.1% 57.8% 65.6% 54.8% 0.051** contraceptive prevalence 3.4% 1.9% 3.2% 8.8% 22.5% 8.9% 0.473*** among women 2008 1 Full immunization 39.6% 41.1% 40.1% 40.2% 40.2% 40.2% 0.009 treatment of diarrhea 64.0% 74.6% 76.8% 81.3% 79.4% 74.7% 0.037** Medical treatment of ari 44.2% 52.9% 50.9% 53.5% 56.3% 50.8% 0.031 Skilled antenatal care (4+ visits) 30.5% 36.5% 41.9% 50.3% 76.7% 45.3% 0.179*** Skilled birth attendance 15.8% 23.9% 27.4% 38.2% 62.9% 31.3% 0.264*** contraceptive prevalence 3.4% 3.0% 3.9% 9.9% 18.6% 8.1% 0.405*** among women threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending4 2003 4 Headcount 53.0% 37.4% 28.0% 16.0% 6.5% concentration index 0.115*** 0.166*** 0.200*** 0.316*** 0.403*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending4 2003 4 Headcount 64.2% 57.2% 48.1% 35.9% 22.4% concentration index 0.070*** 0.077*** 0.075*** 0.101*** 0.164*** iMPoVeriSHMent4 Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2003 4 Percentage in poverty 39.2% 46.9% 7.8 pp 19.8% average shortfall from the $0.15 $0.20 $0.04 28.6% poverty line average shortfall from the $0.39 $0.42 $0.03 7.4% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 4 Percentage in poverty 65.5% 72.8% 7.3 pp 11.1% average shortfall from the $0.56 $0.66 $0.10 17.4% poverty line average shortfall from the $0.86 $0.91 $0.05 5.7% poverty line, among the poor 86 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=2008 Sierra leone demographic and Health Survey, 2=2005 Sierra leone Multiple indicator cluster Survey, 3=n/a World Health Survey, 4=2003 Sierra leone integrated Household Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Sierra leone. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 87 HealtH equity and Financial Protection dataSHeet Somalia the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2006 2 outcoMeS Stunting 52.9% 50.0% 46.7% 31.9% 25.6% 41.8% -0.141*** underweight 44.1% 40.7% 36.3% 23.9% 14.3% 32.4% -0.189*** diarrhea 25.7% 26.1% 23.1% 16.5% 13.4% 21.2% -0.129*** acute respiratory infection 26.4% 26.0% 22.5% 20.5% 18.9% 23.0% -0.073*** Fever 26.9% 26.3% 25.3% 16.4% 13.5% 21.9% -0.138*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 2006 2 Full immunization 2.8% 3.3% 13.9% 11.3% 17.8% 10.3% 0.294*** treatment of diarrhea 9.4% 10.6% 22.6% 39.8% 39.8% 20.8% 0.327*** Medical treatment of ari 11.5% 17.4% 31.1% 48.6% 51.8% 29.4% 0.308*** note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=n/a demographic and Health Survey, 2=2006 Somalia Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Somalia. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: un Photo/Stuart Price 88 HealtH equity and Financial Protection dataSHeet SOuth AfricA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1998 1 outcoMeS infant mortality rate 69.2 60.5 41.2 32.7 16.1 47.1 -0.236*** under-five mortality rate 78.3 81.0 43.4 33.7 16.4 54.3 -0.259*** diarrhea 17.5% 15.7% 14.5% 10.1% 9.0% 13.9% -0.129*** acute respiratory infection 20.6% 21.1% 19.9% 18.8% 21.6% 20.4% -0.005 adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2002-03 3 tuberculosis 12.9% 15.4% 10.6% 12.9% 5.2% 11.3% -0.112** obesity among non-pregnant 40.1% 42.9% 38.4% 37.3% 30.8% 37.3% -0.070** women road traffic accident 2.9% 4.3% 4.2% 2.6% 6.0% 4.0% 0.092 non-road traffic accident 4.0% 6.7% 6.6% 3.6% 2.5% 4.7% -0.121** angina 4.9% 3.9% 4.3% 5.3% 4.0% 4.5% -0.003 arthritis 11.9% 8.1% 9.1% 11.9% 7.4% 9.6% -0.031 asthma 4.3% 6.6% 7.8% 6.3% 7.2% 6.5% 0.053 depression 10.7% 7.2% 10.6% 13.1% 7.2% 9.7% 0.007 diabetes 7.8% 8.0% 8.1% 9.2% 10.2% 8.7% 0.053 difficulty with work and 12.0% 6.2% 6.4% 6.3% 3.4% 6.9% -0.206** household activities Poor self-assessed health 13.8% 9.7% 8.3% 5.7% 2.6% 7.8% -0.278** status riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci inequalitieS in 2002-03 3 riSky BeHaVior Smoking (all) 25.5% 26.3% 23.1% 23.6% 28.3% 25.4% 0.005 Smoking (women) 6.8% 10.8% 11.5% 14.5% 17.0% 12.3% 0.143*** insufficient intake of fruit and 82.3% 79.2% 64.8% 62.5% 60.7% 69.4% -0.076*** vegetables insufficient physical activity 33.6% 41.2% 31.4% 30.7% 28.8% 33.1% -0.054*** drinking 8.0% 11.8% 10.9% 9.8% 13.0% 10.8% 0.059* concurrent partnerships 4.2% 11.1% 9.8% 2.3% 4.8% 6.3% -0.140* inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 1998 1 Full immunization 52.2% 65.8% 74.0% 75.2% 71.4% 66.4% 0.071*** treatment of diarrhea 52.7% 55.3% 51.6% 45.9% 45.0% 51.5% -0.028 Medical treatment of ari 76.3% 73.4% 77.3% 76.3% 75.2% 75.6% 0.004 Skilled antenatal care (4+ visits) 72.9% 79.5% 80.5% 81.7% 88.1% 79.9% 0.033*** Skilled birth attendance 69.1% 83.6% 89.9% 96.9% 98.6% 86.0% 0.073*** 89 inequalitieS adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci in HealtH care 2002-03 3 utiliZation tB screening 5.6% 7.5% 5.2% 6.2% 2.6% 5.4% -0.071 (cont.) Voluntary counseling and 69.3% 81.8% 77.5% 75.1% 83.4% 78.7% 0.019 testing for HiV cervical cancer screening 30.2% 42.8% 54.5% 50.7% 70.9% 53.9% 0.159*** Breast cancer screening 2.3% 1.8% 5.5% 6.9% 17.8% 7.1% 0.423*** adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2002-03 3 inpatient or outpatient 31.0% 38.2% 35.8% 37.1% 38.3% 36.2% 0.032* (12 months) inpatient (12 months) 9.0% 8.8% 10.3% 12.8% 8.1% 9.8% 0.035 inpatient (5 years) 21.7% 19.9% 25.9% 23.3% 24.7% 23.2% 0.042 outpatient (12 months) 20.5% 25.8% 22.3% 29.7% 26.9% 25.2% 0.059* threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending 2002-03 3 Headcount 27.1% 20.4% 16.3% 10.8% 9.4% concentration index -0.055** -0.184*** -0.302*** -0.629*** -0.833*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending 2002-03 3 Headcount 36.1% 32.3% 28.8% 23.4% 19.1% concentration index -0.115*** -0.187*** -0.247*** -0.370*** -0.518*** iMPoVeriSHMent Poverty line at uS$1.25 per consumption consumption change % change capita per day including ooP excluding ooP 2002-03 3 Percentage in poverty 36.8% 37.5% 0.7 pp 2.0% average shortfall from the $0.25 $0.26 $0.01 2.4% poverty line average shortfall from the $0.67 $0.67 $0.00 0.5% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2002-03 3 Percentage in poverty 52.1% 52.7% 0.6 pp 1.1% average shortfall from the $0.60 $0.62 $0.02 2.6% poverty line average shortfall from the $1.12 $1.13 $0.02 1.5% poverty line, among the poor 90 note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using South africa’s consumer price index. data sources: 1=1998 South africa demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2002-03 South africa World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - South africa. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: trevor Samson 91 HealtH equity and Financial Protection dataSHeet SWA ZIL AND the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2003 3 outcoMeS Malaria 0.0% 0.0% 2.6% 0.9% 0.0% 0.7% -0.252*** 2006-07 1 infant mortality rate 88.4 76.0 74.7 91.4 88.4 83.6 0.016 under-five mortality rate 114.8 101.5 86.0 108.4 92.0 100.4 -0.023 Stunting 36.5% 30.1% 27 .2% 25.2% 16.4% 28.0% -0.128*** underweight 7.1% 5.5% 6.1% 6.1% 2.8% 5.7% -0.096* diarrhea 23.3% 11.8% 13.5% 11.3% 9.6% 14.1% -0.168*** acute respiratory infection 18.2% 18.1% 11.8% 13.1% 12.4% 14.9% -0.116*** Fever 34.2% 32.8% 26.7% 25.1% 24.1% 28.9% -0.093*** adult HealtH1,3 q1 q2 q3 q4 q5 total ci 2003 3 tuberculosis 25.0% 14.1% 17 .7% 17 .1% 18.1% 18.1% -0.024 road traffic accident 2.8% 1.2% 1.4% 1.9% 4.0% 2.3% 0.228 non-road traffic accident 2.2% 2.2% 3.0% 3.3% 1.9% 2.6% -0.021 angina 17.2% 6.9% 11.8% 11.1% 17 .9% 13.2% 0.055 arthritis 14.6% 10.8% 9.3% 8.3% 15.4% 11.5% 0.011 asthma 17 .2% 10.6% 13.7% 8.4% 6.6% 10.7% -0.167*** depression 35.7% 26.1% 25.3% 22.4% 17 .5% 24.2% -0.113*** diabetes 4.0% 3.7% 7.5% 6.6% 13.4% 7.8% 0.176 difficulty with work and 18.4% 13.2% 23.5% 16.0% 13.5% 16.9% -0.041 household activities Poor self-assessed health 57.5% 40.6% 39.3% 41.5% 35.7% 41.5% -0.067*** status 2006-07 1 obesity among non-pregnant 13.1% 18.9% 22.1% 24.5% 32.2% 23.0% 0.159*** women HiV positive 18.1% 19.5% 18.8% 22.3% 21.5% 20.0% 0.039*** 92 inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 13.9% 8.4% 7.0% 10.6% 8.2% 9.2% -0.027 insufficient intake of fruit and 71.6% 71.5% 72.2% 60.2% 51.6% 64.1% -0.073*** vegetables insufficient physical activity 1.9% 1.5% 2.6% 1.6% 0.8% 1.7% -0.099 drinking 11.3% 3.5% 4.1% 2.1% 4.0% 4.5% -0.192** 2006-07 1 Smoking (women) 3.2% 2.4% 1.9% 1.8% 1.9% 2.2% -0.077 concurrent partnerships 29.2% 28.0% 33.4% 32.0% 29.0% 30.4% 0.004 condom usage (more than 34.3% 48.0% 51.1% 58.8% 66.9% 53.3% 0.117*** one partner) Mosquito net use by children 0.8% 0.4% 0.6% 0.5% 1.3% 0.7% 0.118 Mosquito net use by pregnant 1.9% 0.0% 0.0% 2.3% 0.4% 1.0% -0.075 women inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1,2 utiliZation 2006-07 1 Full immunization 83.0% 80.0% 81.5% 85.8% 78.2% 81.7% -0.006 treatment of diarrhea 18.3% 21.6% 28.1% 19.1% 7.8% 19.7% -0.046 Medical treatment of ari 51.9% 54.2% 74.6% 51.7% 61.2% 57.4% 0.034 Skilled antenatal care (4+ visits) 75.5% 78.9% 80.9% 83.6% 88.5% 81.5% 0.030*** Skilled birth attendance 51.7% 66.1% 76.8% 87.9% 92.2% 74.1% 0.115*** contraceptive prevalence 40.4% 45.9% 54.3% 53.7% 59.7% 51.9% 0.072*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 3.2% 6.7% 5.6% 8.0% 4.4% 5.7% 0.033 Breast cancer screening 4.3% 5.9% 2.7% 5.8% 5.4% 4.7% 0.110 adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 7.0% 12.4% 18.1% 16.4% 16.9% 15.2% 0.114*** (12 months) inpatient (12 months) 1.5% 1.0% 1.5% 3.0% 2.1% 1.9% 0.163* inpatient (5 years) 5.5% 8.5% 9.9% 11.7% 15.5% 10.9% 0.184*** threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 23.2% 18.5% 15.6% 10.9% 9.2% concentration index -0.182*** -0.244*** -0.315*** -0.388*** -0.505*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 38.5% 35.0% 32.6% 29.0% 25.2% concentration index -0.262*** -0.308*** -0.340*** -0.377*** -0.427*** 93 Financial iMPoVeriSHMent3 Protection Poverty line at uS$1.25 per consumption consumption (cont.) change % change capita per day including ooP excluding ooP Percentage in poverty 57.7% 59.4% 1.7 pp 2.9% average shortfall from the $0.44 $0.46 $0.02 4.1% poverty line average shortfall from the $0.75 $0.75 $0.01 1.2% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP Percentage in poverty 71.3% 72.6% 1.3 pp 1.9% average shortfall from the $0.95 $0.98 $0.03 3.2% poverty line average shortfall from the $1.29 $1.31 $0.02 1.3% poverty line, among the poor note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Swaziland’s consumer price index. data sources: 1=2006-07 Swaziland demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 Swaziland World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - Swaziland. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: curt carnemark, 2001 94 HealtH equity and Financial Protection dataSHeet TANZ ANIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1996 1a outcoMeS infant mortality rate 100.0 137.5 104.5 111.8 66.1 104.6 -0.045*** under-five mortality rate 152.8 192.4 159.8 173.0 97.4 156.4 -0.045*** Stunting 55.9% 51.8% 52.6% 46.6% 34.8% 49.0% -0.073*** underweight 34.2% 28.3% 29.4% 24.1% 14.1% 26.7% -0.129*** diarrhea 14.0% 12.4% 15.0% 16.4% 13.0% 14.2% 0.027 acute respiratory infection 12.0% 13.5% 14.6% 14.9% 12.9% 13.6% 0.036* Fever 30.0% 29.5% 32.8% 36.4% 30.0% 31.8% 0.025** 1999 1b infant mortality rate 127.3 119.2 127.2 122.6 83.6 117.0 -0.033 under-five mortality rate 197.7 154.9 189.1 194.1 109.9 170.4 -0.041 Stunting 53.1% 56.6% 52.6% 44.1% 30.3% 48.4% -0.090** underweight 27.9% 32.1% 24.2% 22.6% 16.0% 25.2% -0.087** diarrhea 12.4% 12.4% 14.6% 15.8% 9.3% 13.0% 0.009 acute respiratory infection 14.8% 12.9% 12.4% 19.0% 14.6% 14.7% 0.049 Fever 37.3% 39.0% 33.6% 37.9% 36.5% 37.0% -0.001 2004-05 1c infant mortality rate 96.7 109.9 100.2 80.5 64.2 92.0 -0.070*** under-five mortality rate 166.4 166.0 161.1 137.3 89.0 147.4 -0.084*** Stunting 50.4% 48.9% 46.0% 43.4% 23.2% 43.8% -0.095*** underweight 19.5% 20.3% 16.3% 14.3% 8.5% 16.3% -0.128*** diarrhea 13.7% 15.0% 12.2% 13.6% 9.8% 13.1% -0.051*** acute respiratory infection 9.2% 8.0% 8.6% 8.6% 7.8% 8.5% -0.029 Fever 26.6% 26.9% 24.4% 25.2% 23.2% 25.4% -0.028** 2010 1d infant mortality rate 63.3 57.2 62.2 63.8 63.1 61.9 0.007 under-five mortality rate 113.7 102.3 98.0 101.8 82.2 101.2 -0.042* Stunting 48.0% 44.7% 43.2% 39.6% 27.4% 41.7% -0.078*** underweight 21.9% 18.2% 15.2% 12.5% 10.1% 16.1% -0.143*** diarrhea 14.8% 13.3% 14.5% 16.3% 16.4% 14.9% 0.034* acute respiratory infection 7.8% 5.6% 8.4% 9.4% 9.0% 7.9% 0.075*** Fever 23.6% 19.6% 21.4% 28.6% 26.1% 23.6% 0.050*** adult HealtH1a,1b,1c,1d,3 q1 q2 q3 q4 q5 total ci 1996 1a obesity among non-pregnant 1.6% 1.8% 1.9% 3.4% 9.1% 3.6% 0.400*** women 2004-05 1c obesity among non-pregnant 0.8% 1.0% 1.8% 3.4% 12.0% 4.5% 0.561*** women 2010 1d obesity among non-pregnant 0.9% 1.8% 2.5% 5.9% 15.6% 6.4% 0.510*** women 95 inequalitieS in riSk FactorS1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2004-05 1c Smoking (women) 3.7% 1.8% 1.7% 0.3% 0.3% 1.5% -0.474*** concurrent partnerships 16.9% 14.6% 16.2% 17.7% 25.1% 18.5% 0.097*** condom usage (more than 9.8% 12.6% 13.2% 21.4% 40.4% 23.1% 0.303*** one partner) Mosquito net use by children 3.8% 6.4% 12.4% 19.0% 50.7% 16.1% 0.483*** Mosquito net use by pregnant 3.7% 8.2% 16.0% 20.5% 63.1% 18.9% 0.511*** women 2010 1d Smoking (women) 3.3% 1.9% 1.3% 0.6% 0.3% 1.4% -0.413*** concurrent partnerships 17.1% 15.8% 14.9% 19.8% 20.5% 17.9% 0.060*** condom usage (more than 19.2% 21.8% 26.6% 42.7% 51.5% 35.5% 0.219*** one partner) Mosquito net use by children 62.6% 65.3% 62.7% 66.3% 65.9% 64.4% 0.012* Mosquito net use by pregnant 59.7% 66.6% 58.6% 66.0% 72.5% 63.9% 0.026 women inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interVentionS1a,1b,1c,1d,2 utiliZation 1996 1a Full immunization 58.5% 69.4% 67.2% 79.5% 82.7% 71.0% 0.070*** Medical treatment of ari 62.1% 64.8% 74.8% 70.3% 76.5% 69.6% 0.050*** Skilled antenatal care (4+ visits) 57.6% 70.4% 65.1% 70.9% 81.8% 68.4% 0.064*** Skilled birth attendance 26.6% 40.2% 41.5% 52.9% 81.3% 47.1% 0.218*** 1999 1b Full immunization 53.8% 73.2% 59.4% 82.0% 78.7% 68.4% 0.083*** treatment of diarrhea 45.8% 57.0% 47.1% 68.2% 58.7% 55.1% 0.052 Medical treatment of ari 71.2% 85.1% 65.2% 93.6% 86.8% 81.0% 0.038** Skilled antenatal care (4+ visits) 58.2% 69.8% 65.5% 71.9% 84.7% 69.8% 0.068*** Skilled birth attendance 29.4% 35.1% 36.3% 47.8% 82.7% 44.5% 0.215*** 2004-05 1c Full immunization 26.8% 30.9% 30.0% 31.8% 30.4% 29.8% 0.029 treatment of diarrhea 59.9% 64.2% 65.7% 54.5% 71.3% 62.2% 0.008 Medical treatment of ari 53.0% 59.9% 66.2% 56.0% 66.3% 59.6% 0.036 Skilled antenatal care (4+ visits) 40.3% 48.0% 49.8% 52.0% 65.1% 50.5% 0.090*** Skilled birth attendance 26.4% 32.1% 35.8% 51.1% 86.4% 43.6% 0.234*** contraceptive prevalence 44.1% 42.5% 43.6% 46.3% 52.9% 47.5% 0.045*** among women 2010 1d Full immunization 69.3% 73.7% 72.6% 78.3% 85.3% 75.2% 0.043*** treatment of diarrhea 49.2% 58.6% 58.4% 69.0% 66.1% 59.9% 0.060*** Medical treatment of ari 55.2% 67.7% 58.7% 57.7% 82.6% 63.2% 0.059** Skilled antenatal care (4+ visits) 35.8% 33.0% 38.9% 46.4% 58.5% 42.1% 0.119*** Skilled birth attendance 32.5% 36.2% 45.9% 61.8% 90.8% 50.6% 0.216*** contraceptive prevalence 18.7% 19.4% 20.5% 29.1% 29.1% 24.0% 0.109*** among women note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1996 tanzania demographic and Health Survey, 1b=1999 tanzania demographic and Health Survey, 1c=2004-05 tanzania demographic and Health Survey, 1d=2010 tanzania demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - tanzania. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Scott Wallace 96 HealtH equity and Financial Protection dataSHeet The GAM BIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 2005-06 2 outcoMeS Stunting 36.7% 32.5% 27.0% 24.2% 15.0% 27.9% -0.151*** underweight 21.7% 17.7% 16.2% 12.3% 10.8% 16.2% -0.143*** diarrhea 21.1% 20.0% 20.2% 18.3% 14.8% 19.1% -0.059*** acute respiratory infection 10.3% 9.9% 12.3% 9.9% 9.9% 10.5% -0.001 Fever 7.6% 8.1% 8.6% 7.5% 10.6% 8.4% 0.051** inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2005-06 2 concurrent partnerships 0.7% 2.2% 1.6% 0.7% 3.4% 1.7% 0.143 Mosquito net use by children 10.8% 11.1% 8.8% 7.7% 3.1% 8.6% -0.177*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 2005-06 2 Full immunization 99.6% 97.3% 98.6% 97.7% 98.1% 98.3% -0.003 treatment of diarrhea 48.5% 56.6% 42.4% 44.5% 50.0% 48.5% -0.016 Medical treatment of ari 71.1% 80.9% 79.1% 76.5% 77.2% 76.8% 0.010 adult Preventive care2,3 q1 q2 q3 q4 q5 total ci 2005-06 2 voluntary counseling and 88.7% 92.9% 87.4% 89.0% 87.7% 89.0% -0.007 testing for Hiv note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=n/a demographic and Health Survey, 2=2005-06 the Gambia Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - the Gambia. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 97 HealtH equity and Financial Protection dataSHeet TOGO the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1998 1 outcoMeS infant mortality rate 92.3 95.5 94.4 80.8 69.6 88.3 -0.054*** under-five mortality rate 176.0 174.5 153.3 125.6 99.6 151.1 -0.108*** Stunting 37.5% 34.3% 30.8% 26.8% 17.0% 30.7% -0.122*** underweight 26.9% 28.6% 23.5% 21.5% 11.1% 23.4% -0.113*** diarrhea 32.9% 32.6% 31.4% 35.3% 21.7% 31.3% -0.040*** acute respiratory infection 22.1% 20.0% 19.6% 22.1% 18.2% 20.5% -0.017 Fever 38.0% 40.5% 35.8% 37.4% 35.9% 37.7% -0.016 2006 2 Stunting 39.3% 37.9% 34.1% 21.1% 18.9% 31.3% -0.151*** underweight 35.0% 32.7% 26.4% 13.8% 14.2% 25.5% -0.200*** diarrhea 14.6% 19.6% 15.6% 12.4% 9.4% 14.6% -0.092*** acute respiratory infection 12.6% 12.4% 10.0% 14.5% 17.3% 13.2% 0.057** Fever 19.4% 24.0% 20.9% 17.6% 13.9% 19.4% -0.053*** adult HealtH1,3 q1 q2 q3 q4 q5 total ci 1998 1 obesity among non-pregnant 0.9% 0.6% 2.0% 4.0% 10.2% 3.0% 0.515*** women inequalitieS in riSk FactorS1,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2006 2 concurrent partnerships 3.2% 4.9% 4.0% 6.0% 3.6% 4.4% 0.018 condom usage (more than 13.4% 35.4% 34.1% 65.4% 80.6% 50.2% 0.234*** one partner) Mosquito net use by children 0.3% 0.8% 1.4% 1.4% 1.4% 1.0% 0.265*** inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interventionS1,2 utiliZation 1998 1 Full immunization 22.0% 26.1% 33.7% 28.7% 53.6% 31.0% 0.155*** treatment of diarrhea 12.6% 15.7% 12.8% 23.7% 30.0% 17.2% 0.151*** Medical treatment of ari 18.1% 18.1% 22.9% 37.2% 48.1% 26.3% 0.214*** Medical treatment of ari 11.3% 17.7% 22.3% 38.6% 62.5% 27.0% 0.338*** Skilled antenatal care (4+ visits) 9.5% 14.8% 27.3% 49.0% 77.9% 30.9% 0.416*** 2006 2 Full immunization 71.5% 62.8% 76.1% 85.2% 84.4% 76.0% 0.060*** treatment of diarrhea 18.8% 16.7% 21.0% 24.8% 31.3% 20.9% 0.119** Medical treatment of ari 28.2% 31.9% 35.3% 28.4% 37.0% 32.0% 0.051 contraceptive prevalence 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% -0.371*** among women 98 inequalitieS adult Preventive care2,3 q1 q2 q3 q4 q5 total ci in HealtH care 2006 2 utiliZation voluntary counseling and 82.5% 89.3% 85.0% 94.6% 93.7% 91.8% 0.020** (cont.) testing for Hiv note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1=1998 togo demographic and Health Survey, 2=2006 togo Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - togo. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. 99 HealtH equity and Financial Protection dataSHeet UGANDA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1995 1a outcoMeS infant mortality rate 120.3 91.7 102.7 93.4 70.5 96.6 -0.083*** under-five mortality rate 207.8 167.4 176.9 146.0 115.7 164.6 -0.096*** Stunting 50.3% 50.0% 45.5% 45.4% 32.1% 45.1% -0.074*** underweight 26.2% 25.0% 20.7% 21.0% 13.9% 21.7% -0.111*** diarrhea 30.7% 22.7% 23.3% 26.7% 17.4% 24.4% -0.073*** acute respiratory infection 32.9% 29.9% 27.7% 30.2% 19.2% 28.3% -0.076*** Fever 56.2% 46.6% 48.5% 48.8% 39.9% 48.3% -0.051*** 2000-01 1b infant mortality rate 116.5 107.8 101.8 86.8 68.8 97.9 -0.099*** under-five mortality rate 193.7 186.4 177.7 123.8 115.0 161.3 -0.118*** Stunting 48.9% 46.5% 48.2% 44.3% 30.3% 44.6% -0.062*** underweight 22.7% 23.0% 20.7% 15.1% 10.1% 19.0% -0.138*** diarrhea 26.4% 24.1% 17.4% 17.4% 15.5% 20.6% -0.114*** acute respiratory infection 24.5% 26.7% 21.6% 24.9% 20.0% 23.7% -0.033** Fever 49.7% 51.4% 41.9% 47.1% 38.8% 46.2% -0.044*** 2006 1c infant mortality rate 109.9 97.9 95.0 82.9 69.8 92.8 -0.085*** under-five mortality rate 194.4 166.6 170.0 147.3 119.1 162.4 -0.090*** Stunting 42.5% 37.7% 44.4% 36.9% 25.1% 38.0% -0.067*** underweight 21.0% 15.9% 16.9% 17.0% 9.5% 16.4% -0.107*** diarrhea 34.1% 28.2% 24.3% 24.2% 19.6% 26.7% -0.101*** acute respiratory infection 27.9% 25.5% 22.4% 20.7% 18.1% 23.4% -0.088*** Fever 49.3% 46.2% 37.6% 41.2% 34.3% 42.4% -0.069*** adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci 1995 1a obesity among non-pregnant 0.7% 0.9% 2.0% 1.7% 5.4% 2.1% 0.393*** women 2000-01 1b obesity among non-pregnant 1.0% 1.0% 1.0% 3.1% 7.0% 2.8% 0.468*** women 2006 1c obesity among non-pregnant 0.0% 0.3% 2.0% 4.1% 11.0% 4.2% 0.597*** women 100 inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHavior 2006 1c Smoking (women) 10.2% 3.7% 3.5% 1.8% 0.7% 3.8% -0.485*** concurrent partnerships 14.3% 15.7% 19.0% 21.2% 28.6% 20.3% 0.149*** condom usage (more than 8.0% 11.9% 13.1% 16.0% 32.4% 19.4% 0.289*** one partner) Mosquito net use by children 11.2% 9.8% 5.4% 10.1% 16.1% 10.2% 0.047* Mosquito net use by pregnant 8.0% 10.1% 9.3% 12.0% 25.6% 11.7% 0.200*** women inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interventionS1a,1b,1c,2 utiliZation 1995 1a Full immunization 34.2% 46.0% 49.3% 46.1% 65.1% 47.5% 0.107*** treatment of diarrhea 46.5% 47.2% 47.0% 50.3% 51.6% 48.2% 0.024 Medical treatment of ari 49.1% 58.1% 64.3% 69.1% 75.8% 61.4% 0.080*** Skilled antenatal care (4+ visits) 37.8% 39.4% 46.1% 48.6% 66.3% 47.0% 0.112*** Skilled birth attendance 21.6% 26.9% 29.4% 37.8% 68.6% 36.0% 0.234*** 2000-01 1b Full immunization 26.8% 37.7% 40.2% 39.9% 42.5% 36.9% 0.088*** treatment of diarrhea 38.9% 40.4% 43.7% 45.2% 56.9% 43.3% 0.055*** Medical treatment of ari 61.4% 68.9% 56.8% 68.1% 83.7% 66.7% 0.040*** Skilled antenatal care (4+ visits) 31.3% 35.4% 37.9% 45.9% 67.9% 42.7% 0.156*** Skilled birth attendance 20.0% 27.6% 32.7% 47.6% 78.5% 39.1% 0.272*** 2006 1c Full immunization 6.8% 8.3% 7.7% 7.5% 11.4% 8.1% 0.062 treatment of diarrhea 49.1% 41.0% 38.5% 42.7% 43.9% 43.5% -0.032** Medical treatment of ari 76.8% 69.6% 70.7% 71.6% 81.6% 73.5% -0.003 Skilled antenatal care (4+ visits) 44.9% 41.4% 41.4% 45.0% 65.9% 47 .1% 0.074*** Skilled birth attendance 29.0% 33.0% 35.2% 50.8% 78.2% 43.0% 0.209*** contraceptive prevalence 6.4% 10.0% 11.4% 17 .5% 28.4% 15.5% 0.290*** note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. data sources: 1a=1995 uganda demographic and Health Survey, 1b=2000-01 uganda demographic and Health Survey, 1c=2006 uganda demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=n/a World Health Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - uganda. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: yosef Hadar 101 HealtH equity and Financial Protection dataSHeet Z AM BIA the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1996 1a outcoMeS infant mortality rate 135.8 148.0 111.7 117.6 84.2 120.5 -0.073*** under-five mortality rate 220.2 240.4 197.3 175.5 122.9 193.6 -0.097*** Stunting 57.6% 56.1% 51.0% 43.8% 31.8% 48.5% -0.104*** underweight 25.8% 25.6% 19.2% 16.0% 10.2% 19.7% -0.158*** diarrhea 26.0% 23.5% 23.0% 28.4% 20.1% 24.4% -0.011 acute respiratory infection 14.1% 12.1% 12.0% 16.2% 10.8% 13.1% -0.010 Fever 45.0% 42.2% 42.0% 43.7% 33.8% 41.6% -0.035*** 2001-02 1b infant mortality rate 132.1 107.2 126.9 88.5 60.3 105.3 -0.110*** under-five mortality rate 201.7 192.2 202.5 141.6 84.1 166.3 -0.130*** Stunting 59.6% 58.5% 55.3% 48.5% 36.4% 52.8% -0.076 underweight 27.9% 25.6% 24.7% 21.3% 15.4% 23.5% -0.090*** diarrhea 23.0% 22.2% 21.9% 23.5% 16.6% 21.7% -0.022 acute respiratory infection 15.9% 15.2% 17.9% 14.9% 9.5% 15.0% -0.035* Fever 49.4% 48.0% 50.2% 40.6% 26.8% 44.2% -0.075*** 2007 1c infant mortality rate 83.8 104.4 103.0 85.8 78.0 92.0 -0.010 under-five mortality rate 139.4 164.2 174.4 149.0 101.2 148.6 -0.030 Stunting 47 .4% 51.2% 47 .8% 43.5% 33.6% 45.8% -0.051*** underweight 16.5% 15.6% 16.1% 12.5% 10.2% 14.7% -0.081*** diarrhea 14.6% 16.7% 14.0% 18.8% 16.0% 15.9% 0.038** acute respiratory infection 7.7% 11.3% 8.6% 10.4% 9.1% 9.4% 0.021 Fever 17 .4% 19.4% 19.1% 20.0% 13.4% 18.2% -0.015 2003 3 Malaria 70.3% 71.8% 78.4% 71.2% 61.2% 70.4% -0.023* 102 inequalitieS adult HealtH1a,1b,1c,3 q1 q2 q3 q4 q5 total ci in HealtH 1996 1a outcoMeS obesity among non-pregnant 1.2% 1.3% 1.9% 3.6% 5.9% 2.7% 0.350*** (cont.) women 2001-02 1b obesity among non-pregnant 0.3% 0.5% 1.4% 3.2% 8.2% 3.1% 0.563*** women 2003 3 tuberculosis 18.5% 15.7% 15.4% 9.4% 10.7% 14.0% -0.138*** road traffic accident 0.6% 1.8% 0.8% 1.8% 2.7% 1.5% 0.256** non-road traffic accident 6.2% 4.3% 4.4% 4.0% 6.3% 5.1% -0.029 angina 3.3% 1.8% 2.7% 2.7% 3.2% 2.7% 0.036 arthritis 4.5% 5.9% 4.4% 1.8% 3.2% 4.0% -0.151*** asthma 4.1% 2.2% 4.7% 1.7% 2.5% 3.0% -0.098 depression 2.6% 0.9% 1.0% 3.0% 2.8% 2.1% 0.079 diabetes 0.7% 0.7% 0.5% 0.4% 0.5% 0.6% -0.146 difficulty with work and 5.4% 4.6% 3.5% 4.1% 1.5% 3.8% -0.181*** household activities Poor self-assessed health 8.4% 8.5% 6.1% 7.3% 2.6% 6.6% -0.164*** status 2007 1c obesity among non-pregnant 0.9% 0.7% 2.5% 6.1% 13.2% 5.5% 0.503*** women HiV positive 8.0% 9.4% 12.1% 20.3% 18.1% 14.0% 0.185*** inequalitieS in riSk FactorS1a,1b,1c,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2001-02 1b Smoking (women) 7.3% 3.8% 1.8% 1.4% 0.2% 2.7% -0.468 concurrent partnerships 16.7% 10.3% 11.7% 15.2% 12.4% 13.2% 0.000 condom usage (more than 12.0% 17.2% 30.8% 42.6% 42.5% 30.1% 0.249*** one partner) Mosquito net use by children 2.8% 4.8% 8.6% 10.3% 14.3% 7.7% 0.295*** Mosquito net use by pregnant 1.9% 7.8% 10.6% 15.7% 16.1% 9.8% 0.279*** women 2003 3 Smoking (all) 20.4% 14.5% 14.4% 12.8% 7.9% 14.1% -0.164*** insufficient intake of fruit and 82.0% 75.3% 73.8% 76.1% 80.0% 77.6% -0.005 vegetables insufficient physical activity 31.0% 27.3% 25.7% 18.7% 13.8% 23.3% -0.156*** drinking 6.5% 4.9% 6.1% 7.6% 9.5% 6.9% 0.103*** 2007 1c Smoking (women) 3.1% 3.9% 1.3% 0.7% 0.5% 1.8% -0.395*** concurrent partnerships 8.2% 11.4% 10.3% 15.6% 15.7% 12.6% 0.131*** condom usage (more than 21.5% 17.7% 27.6% 37.7% 52.0% 35.3% 0.204*** one partner) Mosquito net use by children 20.5% 32.3% 33.5% 30.1% 33.2% 29.4% 0.085 Mosquito net use by pregnant 29.4% 37.3% 40.4% 29.1% 35.1% 34.4% 0.022 women 103 inequalitieS Maternal and cHild q1 q2 q3 q4 q5 total ci in HealtH care HealtH interVentionS1a,1b,1c,2 utilization 1996 1a Full immunization 72.2% 74.5% 80.7% 80.1% 86.3% 78.3% 0.038*** Medical treatment of ari 70.5% 78.5% 79.3% 84.3% 88.9% 79.5% 0.046*** Skilled antenatal care (4+ visits) 63.6% 66.0% 71.3% 78.5% 88.4% 73.0% 0.072*** Skilled birth attendance 19.9% 24.8% 38.0% 68.5% 90.6% 47.2% 0.327*** 2001-02 1b Full immunization 64.1% 65.9% 66.1% 79.1% 80.6% 70.3% 0.059*** treatment of diarrhea 48.5% 51.8% 52.8% 58.9% 56.4% 53.3% 0.050*** Medical treatment of ari 62.5% 67.3% 71.2% 75.2% 72.9% 69.3% 0.050*** Skilled antenatal care (4+ visits) 60.5% 66.5% 68.6% 81.8% 87.4% 72.4% 0.082*** Skilled birth attendance 19.5% 23.5% 34.2% 69.4% 91.5% 44.0% 0.337*** contraceptive prevalence 28.7% 32.5% 36.4% 41.5% 53.1% 41.3% 0.121*** 2007 1c Full immunization 15.9% 11.1% 15.9% 12.0% 19.1% 14.6% 0.026 treatment of diarrhea 67.5% 69.5% 63.8% 69.8% 66.8% 67.7% -0.004 Medical treatment of ari 64.5% 62.1% 65.3% 71.1% 59.8% 64.7% 0.014 Skilled antenatal care (4+ visits) 55.9% 58.0% 59.5% 57.8% 63.9% 58.7% 0.028*** Skilled birth attendance 27.5% 27.9% 36.3% 73.0% 91.6% 46.4% 0.275*** contraceptive prevalence 25.1% 20.5% 19.0% 27.4% 29.0% 24.6% 0.055*** adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 2.3% 2.2% 2.4% 2.5% 4.7% 2.8% 0.136 Breast cancer screening 2.1% 0.0% 2.6% 3.6% 1.3% 1.9% 0.158 adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 63.9% 68.3% 67.7% 59.5% 59.5% 63.7% -0.022** (12 months) inpatient (12 months) 8.7% 7.5% 7.1% 8.8% 9.1% 8.3% 0.021 inpatient (5 years) 15.5% 14.3% 13.6% 15.9% 19.1% 15.7% 0.041 outpatient (12 months) 64.9% 69.8% 70.7% 57 .4% 56.2% 63.9% -0.038*** utilization - PuBlic q1 q2 q3 q4 q5 total ci FacilitieS4 2006 4 outpatient health center and 35.5% 32.3% 31.0% 29.1% 20.9% 29.8% -0.085*** health post outpatient hospital 9.0% 7.9% 7.9% 5.4% 7.1% 7.4% -0.074 inpatient hospital 7.1% 5.6% 5.1% 6.3% 6.7% 6.2% -0.012 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 9.5% 5.3% 3.6% 1.9% 1.1% concentration index -0.064* -0.061 -0.131* -0.344*** -0.635*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 35.8% 32.5% 30.3% 26.3% 23.7% concentration index -0.176*** -0.209*** -0.234*** -0.261*** -0.301*** 104 Financial iMPoVeriSHMent3 Protection Poverty line at uS$1.25 per consumption consumption change % change (cont.) capita per day including ooP excluding ooP 2003 3 Percentage in poverty 86.1% 86.3% 0.2 pp 0.2% average shortfall from the $0.68 $0.69 $0.01 1.0% poverty line average shortfall from the $0.79 $0.80 $0.01 0.7% poverty line, among the poor Poverty line at uS$2.00 per consumption consumption change % change capita per day including ooP excluding ooP 2003 3 Percentage in poverty 93.1% 93.4% 0.4 pp 0.4% average shortfall from the $1.36 $1.37 $0.01 0.7% poverty line average shortfall from the $1.46 $1.46 $0.00 0.3% poverty line, among the poor ProgreSSiVity ProgreSSiVity oF HealtH q1 q2 q3 q4 q5 ci/gini kakwani Share oF HealtH SPending (SHareS)3 Financing 2003 3 consumption 3.0 6.2 10.3 18.3 62.2 0.577*** taxes 1.1 2.7 5.7 13.8 76.8 0.724*** 0.147*** 42.4% Pre-payment schemes 0.9 1.3 4.4 14.2 79.1 0.746*** 0.169*** 9.4% employer 0.3 0.9 3.7 11.4 83.7 0.786*** 0.209*** 0.9% out-of-pocket spending 3.7 5.5 9.5 19.1 62.2 0.586*** 0.009 47.3% total payments 2.2 3.9 7.3 16.1 70.5 0.665*** 0.088*** 100.0% note: the Health equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, dHS and MicS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. q = quintile (where quintile 1 is the poorest) ci = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using zambia’s consumer price index. data sources: 1a=1996 zambia demographic and Health Survey, 1b=2001-02 zambia demographic and Health Survey, 1c=2007 zambia demographic and Health Survey, 2=n/a Multiple indicator cluster Survey, 3=2003 zambia World Health Survey, 4=2006 zambia living conditions Monitoring Survey. recommended citation: World Bank. 2012. Health equity and Financial Protection datasheet - zambia. Washington, d.c.: World Bank. For more information and the latest versions of the Health equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: edwin Huffman 105 HealtH equity and Financial Protection dataSHeet ZIM BABWE the Health equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. data are drawn from the demographic and Health Surveys (dHS), World Health Surveys (WHS), Multiple indicator cluster Surveys (MicS), living Standards and Measurement Surveys (lSMS), as well as other household surveys where available. the datasheets use a common set of health indicators for all countries. all analyses are conducted using the health modules of the adePt software. inequalitieS cHild HealtH1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci in HealtH 1994 1a outcoMeS infant mortality rate 54.5 50.3 53.8 68.0 39.4 53.6 -0.012 under-five mortality rate 70.9 83.2 52.8 88.0 45.3 68.7 -0.045 Stunting 30.9% 32.7% 31.4% 26.2% 20.2% 28.6% -0.076*** underweight 14.5% 16.0% 12.1% 9.0% 6.7% 11.9% -0.145*** diarrhea 29.5% 24.2% 25.7% 22.3% 17.7% 24.3% -0.087*** acute respiratory infection 35.5% 29.5% 25.2% 21.3% 16.7% 26.3% -0.151*** Fever 44.7% 41.8% 39.4% 42.9% 35.6% 41.2% -0.042*** 1999 1b infant mortality rate 76.4 67.9 80.5 69.2 42.0 68.2 -0.076*** under-five mortality rate 107.3 91.9 106.7 78.7 48.0 88.5 -0.111*** Stunting 38.2% 30.5% 36.8% 28.1% 24.8% 31.9% -0.070*** underweight 14.5% 12.2% 13.1% 8.9% 5.4% 10.9% -0.174*** diarrhea 14.3% 14.0% 18.4% 15.1% 11.7% 14.7% -0.028 acute respiratory infection 18.9% 19.3% 19.9% 14.6% 12.5% 17.0% -0.088*** Fever 26.5% 30.2% 32.1% 26.3% 22.9% 27.5% -0.027 2003 3 Malaria 35.5% 32.3% 37.5% 27.3% 24.1% 32.8% -0.041 2005-06 1c infant mortality rate 52.3 67 .3 50.5 50.4 47.6 54.1 -0.035 under-five mortality rate 55.5 63.7 62.6 59.9 49.4 58.3 -0.010 Stunting 33.3% 37 .5% 36.4% 31.5% 27.4% 33.6% -0.027* underweight 15.6% 15.8% 13.4% 12.3% 6.5% 13.3% -0.131*** diarrhea 15.1% 13.4% 15.1% 10.6% 8.5% 12.8% -0.093*** acute respiratory infection 14.4% 13.7% 13.4% 9.6% 5.9% 11.8% -0.126*** Fever 7.8% 7.8% 9.4% 6.5% 7.4% 7.7% -0.027 2010-11 1d infant mortality rate 58.2 64.6 53.2 41.8 47.9 53.6 -0.058** under-five mortality rate 86.5 91.8 74.4 51.2 57.9 73.5 -0.092*** Stunting 35.8% 31.8% 34.3% 29.3% 24.7% 31.8% -0.061*** underweight 13.1% 11.2% 8.6% 9.3% 6.9% 10.2% -0.127*** diarrhea 13.4% 14.6% 12.5% 14.7% 12.6% 13.6% -0.011 acute respiratory infection 13.3% 11.0% 10.3% 9.2% 8.9% 10.7% -0.094*** Fever 11.9% 8.7% 10.6% 9.2% 9.5% 10.0% -0.037 106 inequalitieS adult HealtH1a,1b,1c,1d,3 q1 q2 q3 q4 q5 total ci in HealtH 1994 1a outcoMeS obesity among non-pregnant 1.1% 3.6% 4.7% 6.6% 17.2% 6.3% 0.457*** (cont.) women 1999 1b obesity among non-pregnant 2.2% 5.0% 5.7% 7.9% 13.6% 7.4% 0.318*** women 2003 3 tuberculosis 10.8% 10.4% 14.9% 9.7% 5.4% 10.2% -0.110*** road traffic accident 1.1% 2.4% 1.7% 2.2% 2.2% 1.9% 0.114 non-road traffic accident 2.6% 4.8% 2.8% 3.4% 1.6% 3.0% -0.087 angina 7.3% 8.4% 8.7% 5.3% 4.6% 6.8% -0.105** arthritis 6.4% 7.1% 6.9% 6.5% 3.8% 6.1% -0.068 asthma 2.6% 3.9% 3.4% 2.6% 3.5% 3.2% 0.003 depression 5.5% 6.7% 8.6% 6.7% 7.5% 7.0% 0.044 diabetes 0.2% 0.4% 0.8% 1.4% 1.0% 0.8% 0.259*** difficulty with work and 9.2% 9.4% 10.6% 5.8% 4.3% 7.8% -0.129*** household activities Poor self-assessed health 15.1% 14.1% 13.4% 7.4% 4.9% 10.8% -0.198*** status 2005-06 1c obesity among non-pregnant 2.7% 3.0% 5.1% 8.5% 13.8% 7.3% 0.335*** women HiV positive 17.1% 18.2% 18.4% 22.1% 15.7% 18.4% -0.000 2010-11 1d obesity among non-pregnant 4.3% 6.7% 8.4% 13.0% 16.1% 10.3% 0.248*** women HiV positive 15.9% 15.2% 16.3% 16.4% 13.7% 15.5% -0.018 inequalitieS in riSk FactorS1a,1b,1c,1d,2,3 q1 q2 q3 q4 q5 total ci riSky BeHaVior 2003 3 Smoking (all) 16.0% 17.0% 11.4% 7.8% 12.8% 12.8% -0.093*** insufficient intake of fruit and 86.0% 84.5% 86.6% 85.9% 85.2% 85.7% -0.001 vegetables insufficient physical activity 2.5% 2.4% 1.4% 1.2% 1.2% 1.7% -0.200** drinking 6.4% 8.7% 6.6% 7.1% 10.3% 7.8% 0.083* 2005-06 1c Smoking (women) 1.7% 0.7% 1.1% 0.7% 0.7% 0.9% -0.159** concurrent partnerships 5.9% 4.8% 6.4% 9.0% 9.8% 7.4% 0.141*** condom usage (more than 25.7% 30.5% 37.6% 51.0% 54.0% 44.0% 0.128*** one partner) Mosquito net use by children 14.2% 12.8% 20.0% 15.3% 11.4% 13.9% -0.045 Mosquito net use by pregnant 0.7% 1.0% 2.6% 6.2% 9.7% 3.3% 0.480*** women 2010-11 1d Smoking (women) 0.7% 0.3% 0.5% 0.5% 0.5% 0.5% -0.025 concurrent partnerships 6.8% 5.7% 7.3% 8.8% 10.8% 8.1% 0.111*** condom usage (more than 39.9% 40.3% 53.4% 56.5% 67.0% 54.8% 0.110*** one partner) Mosquito net use by children 10.1% 9.8% 10.4% 11.1% 11.0% 10.4% 0.027 Mosquito net use by pregnant 12.1% 8.7% 9.4% 7.9% 13.6% 10.1% 0.005 women 107 inequalitieS Maternal and cHild HealtH q1 q2 q3 q4 q5 total ci in HealtH care interVentionS1a,1b,1c,1d,2 utiliZation 1994 1a Full immunization 71.4% 79.1% 84.5% 81.7% 85.3% 80.2% 0.031*** treatment of diarrhea 74.7% 78.8% 76.9% 86.1% 83.9% 79.2% 0.025* Medical treatment of ari 44.0% 48.7% 52.3% 65.5% 64.0% 52.2% 0.090*** Skilled antenatal care (4+ visits) 70.3% 72.6% 70.8% 77.9% 87.2% 75.3% 0.040*** Skilled birth attendance 54.1% 59.3% 65.5% 79.7% 92.7% 69.2% 0.117*** 1999 1b Full immunization 64.6% 67.8% 68.4% 57.1% 64.4% 64.3% -0.007 treatment of diarrhea 68.0% 71.0% 72.5% 66.5% 71.5% 69.8% 0.000 Medical treatment of ari 54.3% 47.0% 41.0% 53.9% 55.9% 50.0% 0.006 Skilled antenatal care (4+ visits) 74.3% 75.1% 73.0% 73.1% 77.9% 74.6% 0.004 Skilled birth attendance 58.4% 66.6% 66.4% 80.5% 93.6% 73.1% 0.097*** 2005-06 1c Full immunization 42.7% 51.8% 53.0% 56.7% 64.0% 52.7% 0.069*** treatment of diarrhea 56.8% 58.4% 64.5% 71.1% 68.2% 62.3% 0.054** Medical treatment of ari 23.2% 26.8% 35.6% 21.7% 49.9% 28.5% 0.119** Skilled antenatal care (4+ visits) 64.9% 68.7% 73.2% 72.7% 83.0% 71.9% 0.045*** Skilled birth attendance 47.1% 56.4% 71.3% 86.4% 95.6% 69.0% 0.156*** contraceptive prevalence 34.6% 40.8% 35.9% 46.0% 37.7% 39.2% 0.016* 2010-11 1d Full immunization 55.2% 62.3% 60.1% 76.0% 72.4% 64.7% 0.064*** treatment of diarrhea 58.3% 69.0% 50.7% 67.3% 71.1% 63.3% 0.022 Medical treatment of ari 45.8% 40.2% 42.5% 45.3% 44.1% 43.7% 0.005 Skilled antenatal care (4+ visits) 14.5% 15.6% 22.5% 28.0% 42.4% 23.7% 0.230*** Skilled birth attendance 18.0% 24.8% 31.5% 51.2% 63.4% 36.0% 0.260*** contraceptive prevalence 41.2% 39.9% 41.8% 43.4% 37.1% 40.6% -0.014* adult PreVentiVe care2,3 q1 q2 q3 q4 q5 total ci 2003 3 tB screening 3.2% 4.2% 3.1% 4.7% 5.8% 4.2% 0.107* Voluntary counseling and 70.5% 73.7% 80.7% 67.6% 89.3% 77.6% 0.041* testing for HiV cervical cancer screening 44.3% 43.8% 59.5% 38.3% 52.2% 48.5% 0.021 Breast cancer screening 1.4% 1.5% 2.4% 1.2% 9.7% 2.9% 0.371** adult curatiVe care3 q1 q2 q3 q4 q5 total ci 2003 3 inpatient or outpatient 56.8% 54.5% 50.4% 49.4% 52.1% 52.5% -0.019 (12 months) inpatient (12 months) 7.5% 7.3% 9.2% 8.4% 5.6% 7.6% -0.028 inpatient (5 years) 15.7% 18.2% 18.8% 21.8% 18.3% 18.6% 0.032 outpatient (12 months) 52.5% 49.5% 44.8% 42.2% 49.3% 47 .6% -0.021 threshold share of total household consumption Financial cataStroPHic out-oF- 5% 10% 15% 25% 40% Protection Pocket SPending3 2003 3 Headcount 13.5% 10.0% 7.6% 5.9% 4.6% concentration index 0.130*** 0.054 -0.033 -0.106 -0.318*** threshold share of nonfood consumption cataStroPHic out-oF- 5% 10% 15% 25% 40% Pocket SPending3 2003 3 Headcount 29.4% 26.4% 25.0% 22.1% 19.8% concentration index -0.086*** -0.129*** -0.153*** -0.209*** -0.273*** 108 I nterpre tatIon of results InequalItIes In health outcomes, rIsky behavIor and health care utIlIzatIon the tables in this section show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. the quintiles are based on an asset index constructed using principal components analysis. the tables show the mean values of the indicator for each quintile, as well as for the sample as a whole. also shown are the concentration indices which capture the direction and degree of inequality. a negative value indicates that the variable (e.g. stunting or skilled birth attendance) is more concentrated among the poor, while a positive value indicates that the variable is concentrated among the better off. the larger the index in absolute size, the more inequality there is. the statistical significance of the concentration index is also shown, at 1% (***), 5% (**) and 10% (*) significance levels. For example, if stunting has a concentration index of -0.121***, then stunting is significantly concentrated among the poor. beneFIt-IncIdence analysIs benefit-incidence analysis (bIa) shows whether, and by how much, government health expenditure disproportionately benefits the poor. there are three tables showing, respectively, the distribution of service utilization across consumption quintiles for different types of care, the distribution of user fees, and the distribution of the estimated subsidies. all tables also show the concentration indices which capture the direction and degree of inequality. a negative value indicates that the variable (i.e. utilization, fees or subsidies) is more concentrated among the poor, while a positive value indicates that the variable is concentrated among the better off. the larger the index in absolute size, the greater is the inequality. For example, if the concentration index of subsidies to hospitals is positive, the non-poor benefit more than the poor from government spending on hospital services. the distribution of subsidies depends on the assumptions made to allocate subsidies to households. under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service (i.e. subsidies plus user fees) divided by the number of units of utilization. under the constant unit subsidy assumption, the unit subsidy is assumed to be constant, equal to total subsidies for the service in question divided by the number of units of utilization of that service. under the proportional cost assumption, higher fees are indicative of a more costly type of care; specifically, it is assumed that unit costs and fees are proportional to one another. If the concentration index is negative, then the subsidy to the particular level of care is pro-poor and if the concentration index is positive, then the subsidy is pro-rich. the column labeled “share� shows the distribution of the total subsidy across different levels of care. FInancIal protectIon: catastrophIc and ImpoverIshIng expendIture measures of financial protection relate out-of-pocket spending to a threshold. one approach is to classify spending as ‘catastrophic’ if it exceeds a certain fraction of household income or consumption or nonfood consumption. catastrophic payments are defined as health care payments in excess of a predetermined percentage (i.e. 5% to 40%) of their total household spending or nonfood spending. the first line of the first table shows the catastrophic payment “headcount�, i.e. the proportion of households with a health payment budget share greater than the given threshold. For example, if the “headcount� figure given in the last column of the first table is 6%, then 6% of households spend more than 40% of their pre-payment income on health payments. the concentration indices in the second line of each table show whether there is a greater tendency for the better off to have out-of-pocket spending in excess of the payment threshold (in which case it takes on a positive value), or whether the poor are more likely to have out-of-pocket spending exceeding the threshold (in which case it takes on a negative value). another approach is to classify health spending as ‘impoverishing’ if it is sufficiently large to make the household cross the poverty line, i.e. the household would not have been poor had it been able to use for general consumption the money it was forced to spend on health care. the extent of impoverishment due to health care expenditure is measured by comparing the extent of poverty computed using household consumption gross and net of out-of-pocket health spending. the table shows three measures of poverty. the first line of the table shows the percentage of the population living below the poverty line, i.e. the poverty “headcount�. the second line shows the population’s average shortfall from the poverty line, i.e. the “normalized poverty gap�; the normalization is useful when making comparisons across countries with different poverty lines and currency units. Finally, the last line shows the average shortfall from the poverty line, among those who are poor, i.e. the normalized mean positive poverty gap. the last column shows the percentage increase in poverty, the percentage increase in the average shortfall from the poverty line and the percentage increase in the average shortfall from the poverty line among the poor due to out-of-pocket health spending, respectively. progressIvIty oF health FInancIng the table in this section reports whether overall health financing, as well as the individual sources of finance, is regressive (i.e. a poor household contributes a larger share of its resources than a rich one), progressive (i.e. a poor household contributes a smaller share of its resources than a rich one) or proportional. the 1st through 5th columns show the distribution of consumption and different sources of health care financing. the 6th column shows the summary measures of inequality; in the case of consumption, this is the gini coefficient and in the case of other sources of financing it is the concentration index. In the 7th column, the kakwani index (defined as the concentration index less the gini coefficient) takes on a positive value, then payments are more concentrated among the better off than consumption, and is a sign that payments are progressive. If the kakwani index is negative, then payments are regressive. the last column shows the contribution of each financing source to total health care financing (obtained from national health accounts data). For more guIdance on InterpretatIon oF results, see: o’donnell, o., e. van doorslaer, a. Wagstaff and m. lindelow. (2008). analyzing health equity using household survey data: a guide to techniques and their implementation. Washington, d.c.: World bank. Wagstaff, a., m. bilger, z. sajaia and m. lokshin. (2011). health equity and financial protection: streamlined analysis with adept software. Washington, d.c.: World bank. Me asureMent of I n dIcators IndIcator MeasureMent data chIld health number of deaths among children under 12 months of age per 1,000 live births (note: mortality Infant mortality rate rate calculated using the true cohort life table approach; the dhs reports use the synthetic cohort dhs life table approach) number of deaths among children under 5 years of age per 1,000 live births (note: mortality rate under-five mortality rate calculated using the true cohort life table approach; the dhs reports use the synthetic cohort life dhs table approach) % of children with a height-for-age z-score <-2 standard deviations from the reference median stunting dhs, MIcs (note: z-score calculated using Who 2006 child Growth standards) % of children with a weight-for-age z-score <-2 standard deviations from the reference median underweight dhs, MIcs (note: z-score calculated using Who 2006 child Growth standards) diarrhea % of children with diarrhea (past two weeks) dhs, MIcs diarrhea % of children with diarrhea (past two weeks; youngest child) Whs acute respiratory infection % of children with an episode of coughing and rapid breathing (past two weeks) dhs, MIcs acute respiratory infection % of children with an episode of coughing and rapid breathing (past two weeks; youngest child) Whs Fever % of children with fever (past two weeks) dhs, MIcs Fever % of children with fever (past two weeks; youngest child) Whs Malaria % of children with an episode of malaria (past year; youngest child) Whs adult health tuberculosis % of adults who reported tuberculosis symptoms (past year) Whs obesity among non-pregnant women % of women aged 15 to 49 with a BMI above 30 dhs obesity among all women % of women aged 18 to 49 with a BMI above 30 Whs road traffic accident % of adults involved in a road traffic accident with bodily injury (past year) Whs % of adults who suffered bodily injury that limited everyday activities, due to a fall, burn, poisoning, non-road traffic accident Whs submersion in water, or by an act of violence (past year) angina % of adults ever diagnosed with angina or angina pectoris Whs arthritis % of adults ever diagnosed with arthritis Whs asthma % of adults ever diagnosed with asthma Whs depression % of adults ever diagnosed with depression Whs diabetes % of adults ever diagnosed with diabetes Whs difficulty with work and household % of adults who have severe or extreme difficulties with work or household activities (past 30 days) Whs activities (note: this indicator was created from an ordinal variable with five categories) % of adults who rate own health as bad or very bad (note: this indicator was created from an Poor self-assessed health status Whs ordinal variable with five categories) hIV Positive Percentage of adults aged 15 to 49 whose blood tests are positive for hIV 1 or hIV 2. dhs rIsk Factors smoking (all) % of adults who smoke any tobacco products such as cigarettes, cigars or pipes Whs smoking (women) % of women aged 15 to 49 who smoke cigarettes, pipe or other tobacco dhs smoking (women) % of women aged 18 to 49 who smoke cigarettes, pipe or other tobacco Whs Insufficient intake of fruit and vegetables % of adults who have insufficient intake of fruit/vegetables (less than 5 servings) Whs Insufficient physical activity % of adults who spend < 150 minutes on walking/ moderate activity/vigorous activity (past week) Whs drinking % of adults who consume ≥5 standard drinks on at least one day (past week) Whs concurrent partnerships % of women aged 15 to 49 who had sexual intercourse with more than one partner (past year) dhs, MIcs concurrent partnerships % of women aged 18 to 49 who had sexual intercourse with more than one partner (past year) Whs % of women aged 15 to 49 who had more than one partner in the past year and used a condom condom usage (more than one partner) dhs, MIcs during last sexual intercourse % of women aged 18 to 49 who had more than one partner in the past year and used a condom condom usage (more than one partner) Whs during last sexual intercourse Mosquito net use by children % of children who slept under an (ever) insecticide treated bed net (Itn) (past night) dhs, MIcs % of pregnant women aged 15 to 49 who slept under an (ever) insecticide treated bed net (Itn) Mosquito net use by pregnant women dhs (past night) Maternal and chIld health InterVentIons % of children aged 12-23 months who received BcG, measles, and three doses of polio and dPt, Full immunization dhs, MIcs either verified by card or by recall of respondent treatment of diarrhea % of children with diarrhea given oral rehydration salts (ors) or home-made solution dhs, MIcs % of children with a cough and rapid breathing who sought medical treatment for acute respiratory Medical treatment of arI dhs, MIcs infection (past 2 weeks) % of mothers aged 15 to 49 who received at least 4 antenatal care visits from any skilled personnel skilled antenatal care (4+ visits) dhs (doctor, nurse/midwife, auxiliary midwife, feldsher, family nurse, trained birth attendant) skilled birth attendance % of mothers aged 15 to 49 that were attended by any skilled personnel at child’s birth dhs contraceptive prevalence % of women aged 15 to 49 who currently use a modern method of contraception dhs, MIcs adult PreVentIVe care tB screening % of adults who were tested for tuberculosis (past year) Whs Voluntary counseling and testing for hIV % of women aged 18 to 49 who were tested for hIV and were told the results of the test Whs,MIcs cervical cancer screening % of women aged 18 to 69 who received a pap smear during last pelvic examination (past 3 years) Whs Breast cancer screening % of women aged 40 to 69 who received a mammogram (past 3 years) Whs adult curatIVe care Inpatient or outpatient (12 months) % of adults who used any inpatient or outpatient health care (past year) Whs Inpatient (12 months) % of adults who used any inpatient health care (past year) Whs Inpatient (5 years) % of adults who used any inpatient health care (past 5 years) Whs % of adults who used any outpatient health care (past year; conditional on having not used any outpatient (12 months) Whs inpatient care past 5 years) note: unless otherwise noted, all children are under the age of 5 and all adults are aged 18 and older About the Health Equity and Financial Protection datasheets The Health Equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. Data are drawn from the Demographic and Health Surveys, World Health Surveys, Multiple Indicator Cluster Surveys, Living Standards and Measurement Surveys, as well as other household surveys, and use a common set of health indicators for all countries in the series. All analyses are conducted using the health modules of the ADePT software. Also available are Health Equity and Financial Protection country reports. The most recent versions of the Health Equity and Financial Protection reports and datasheets can be downloaded at www.worldbank.org/povertyandhealth.