Publication: Socioeconomic Inequities in the Health and Nutrition of Children in Low/Middle Income Countries
No Thumbnail Available
Published
2010
ISSN
0034-8910
Date
2012-03-30
Author(s)
Editor(s)
Abstract
OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys. RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished. CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.
Link to Data Set
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication The (Positive) Effect of Macroeconomic Crises on the Schooling and Employment Decisions of Children in a Middle-Income Country(World Bank, Washington, DC, 2002-01-31)The impact of macroeconomic crises on parents' investments in the human capital of their children is a widely contested issue. The author analyzes the effects of the profound macroeconomic crisis in Peru in 1988-92 on the schooling and employment decisions made by urban school-age children. He arrives at two basic findings: First, the crisis had no effect on the attendance rates of school-age children. But the share of children who were both employed and in school fell significantly during the crisis. Second, mean educational attainment was significantly higher for children who were exposed to the crisis than for those who were not. THe author argues that these findings may be related: children who are not employed have more time available and may therefore put more effort into school. He concludes with a discussion of the implications of his findings for the design of appropriate social protection policies.Publication Reaching the Poor with Health, Nutrition, and Population Services : What Works, What Doesn't, and Why(Washington, DC: World Bank, 2005)Health services can make an important contribution to improved health conditions among disadvantaged groups. Yet as the contents of this volume make clear, the health services supported by governments, and by agencies like ours too often fail to reach these people who need them most. This is not acceptable. Nor need it be accepted. The studies presented here point to numerous strategies that can help health programs reach the poor much more effectively than at present. In doing so, they strongly reinforce the messages of the 2004 World Development Report and other recent publications about the importance and possibility of making services work better for poor people. Different views will be formed about which of the strategies are most promising for a particular setting-whether, for example, one would be best advised to follow Brazil's approach of seeking universal coverage for basic health services, Cambodia's strategy of contracting with non-governmental organizations, Nepal's use of participatory program development, or some other approach. The report provides a discussion on issues like these, in order to build upon the important basic findings presented herewith, i.e., that better performance is possible. In brief, better performance in reaching the poor is both needed and feasible. These are the two messages from this report that will be discussed further.Publication Brazil : Are Health and Nutrition Programs Reaching the Neediest(World Bank, Washington, DC, 2005-05)Brazil has one of the greatest income concentrations in the planet. Most adverse health outcomes are more common among the poor. The Family Health Program (PSF) was introduced in the 1990s to provide high quality primary health care especially to the poorest. The program (PSF) seems to have an important role guaranteeing access to the poor. However, the PSF is not well focused, and coverage among the poor is still inadequate. Findings from this study will be fed back to policy makers to help improve the program. This discussion paper was prepared for the Program on Reaching the Poor with Effective Health, Nutrition, and Population Services, organized by the World Bank in cooperation with the William and Melinda Gates Foundation and the Governments of the Netherlands and Sweden.Publication Health Labor Market Analyses in Low- and Middle-Income Countries(Washington, DC: World Bank, 2016-10-12)This book, produced jointly by the World Bank, the University of California, Berkeley, and the WHO, aims to provide decision-makers at sub-national, national, regional and global levels with additional insights into how to address their workforce challenges rather than describe them. In order to optimize and align HRH investments and develop targeted policy responses, a thorough understanding of unique, country-specific labor market dynamics and determinants of these dynamics is critical. Policies need to take into account the fact that workers are economic actors, responsive to different levels of compensation and opportunities to generate revenue found in different sub-labor markets. Policies need to take into account the behavioral characteristics of the individuals who provide health care, but also the individuals who consume health care services and the institutions that employ health personnel. In other words, it is necessary to understand the determinants of both the supply (numbers of health workers willing to work in the health sector) and the demand for health workers (resources available to hire health workers), how these interact, and how this interaction varies in different contexts. This interaction will determine the availability of health personnel, their distribution as well as their performance levels, thus ensuring stronger health systems capable to deliver universal health coverage. The book is structured to be of use to researchers, planners, and economists who are tasked with analyzing key areas of health labor markets, including overall labor market assessments as well as and more narrow and targeted analyses of demand and supply (including production and migration), performance, and remuneration of health workers. The chapters, written by a number of internationally renowned experts on Human Resources for Health, discuss data sources and empirical tools that can be used to assess health labor markets across high-, middle- or low-income countries, but draws primarily from examples and case-studies in LMICs.Publication Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries(World Bank, Washington, DC, 2021-10)Financial incentives for health providers and households are increasingly used to improve reproductive, maternal, and child health service coverage in low- and middle-income countries. This study provides a quantitative synthesis of their effectiveness. A systematic review was conducted of the effects of performance-based financing, voucher, and conditional cash transfer programs on six reproductive, maternal, and child health service indicators, with eligible evidence coming from randomized controlled trials and studies using double-difference, instrumental variables, and regression discontinuity designs. Four literature searches were conducted between September 2016 and March 2021 using seven academic databases, Google Scholar, development agency and think tank websites, and previous systematic reviews. Random effects meta-analysis was used to obtain mean effect sizes. From 58 eligible references 212 impact estimates were extracted, which were synthesized into 130 program-specific effect sizes. Financial incentives increase coverage of all considered reproductive, maternal, and child health indicators, but mean effects sizes are of modest magnitude. Effect size heterogeneity is typically low to moderate, and there is no indication that study bias risk, baseline indicator levels, or a combination of provider- and household-level incentives impact effect sizes. There is, however, weak evidence that mean effect sizes are somewhat smaller for performance-based financing than for voucher and conditional cash transfer programs, and that the increase in income, rather than the incentive itself, drives coverage improvements. Financial incentives improve reproductive, maternal, and child health service coverage. If future research confirms the preliminary finding that performance-based financing has smaller effects, voucher and conditional cash transfer programs are the preferred policy option among incentive interventions to achieve higher reproductive, maternal, and child health service coverage. The relative effectiveness and efficiency of incentives compared with unconditional increases of provider and household incomes, however, need to be studied further.
Users also downloaded
Showing related downloaded files
No results found.