Health provider choice and implicit rationing in healthcare: Evidence from Mozambique

Salvucci, Vincenzo

doi:10.1080/0376835x.2014.887996

Cited by 2 publications

(4 citation statements)

References 21 publications

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“…For those living near a HF, the measure of health service availability that matters relates to the actual availability of inputs to provide the services, first because once distance is not a major barrier to use service, other factors may play a bigger role, and second because they probably have more and better information than those living further away. These findings are generally in line with previous studies from Mozambique [ 6 , 7 , 14 ]. Differences concern the insignificant effect of income [ 7 ] and of HF characteristics [ 14 ], which may be explained by the evolution of health seeking behavior over time and real increases in consumption per capita, respectively.…”

Section: Discussionsupporting

confidence: 93%

“…Indeed, when individuals have access and can afford user fees they may decide to go directly to hospitals which offer a wider range of services and have extended working hours [ 23 ]. Beyond the limited direct costs implied by user fees, the indirect cost implied by distance from the HF and low levels of education and income limit the use of health care services [ 6 , 7 ]. Provincially and temporally limited evidence suggests that the presence of trained health personnel in HF may influence institutional deliveries but not the use of outpatient care [ 14 ].…”

Section: Setting and Datamentioning

confidence: 99%

“…The empirical literature on the determinants of health care use in LMICs has mostly relied on household survey data. Health seeking behaviour has been analysed by estimating the individual probability of seeking care when ill, or the probability of choosing a specific type of provider [ 6 – 11 ]. Due to the limited data on health care services available to the household, most studies have focused on the influence of demand-side factors, including individual demographic and socio-economic characteristics, as well as the indirect cost of using services, proxied by the travel time to the nearest health facility (HF).…”

Section: Introductionmentioning

confidence: 99%

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Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique

2015

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Low-income countries are plagued by a high burden of preventable and curable disease as well as unmet need for healthcare, but detailed microeconomic evidence on the relationship between supply-side factors and service use is limited. Causality has rarely been assessed due to the challenges posed by the endogeneity of health service supply.In this study, using data from Mozambique, we investigate the effect of healthcare service availability, measured as the type of health facilities and their level of staffing and equipment, on the individual decision to seek care. We apply an instrumental variable approach to test for causality in the effect of staff and equipment availability on the decision to seek care and we explore heterogeneous effects based on the distance of households to the closest health facility.We find that living in the proximity of a health facility increases the probability of seeking care. A greater availability of referral health services in the locality has no significant effect on decision to seek care, while greater availability of staff and equipment increases the probability of seeking care when ill. Demand side barriers to health care use exist, but have a smaller impact when health care services are available within one hour walking distance.

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Section: Discussionsupporting

confidence: 93%

Section: Setting and Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique

2015

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“…Thanks to this support and based on the principle of universal health coverage, in Mozambican governmental facilities, AL is provided for free to patients upon presentation of medical receipt. However, patients are administered either less effective treatments or no treatment if health facilities run out‐of‐stock (Anselmi, Lagarde, & Hanson, ; Salvucci, ; Wagenaar et al, ). Alternatively, patients can buy either AL or other antimalarial drugs in the private market.…”

Section: Introductionmentioning

confidence: 99%

Market for Artemether‐Lumefantrine to treat childhood malaria in a district of southern Mozambique

Alonso

Munguambe

2017

Health Economics

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Malaria is one of the leading causes of death in sub-Saharan Africa. Artemisinin-based combination therapies are used as first-line treatment drugs, but their market is far from competitive. Market failures include limited availability, low quality, lack of information, and high costs of access. We estimated the theoretical demand for one of the most common artemisinin-based combination therapies, artemether-lumefantrine (AL), and its determinants among caregivers of children with malaria seeking care at public health facilities, thus, entitled to receive drugs for free, in southern Mozambique (year 2012). The predicted theoretical demand was contrasted with international and local private market AL prices. Respondents stated high willingness to pay but lower ability to pay (ATP), which was defined as the theoretical demand. The ATP was on average of 0.94 USD for the treatment of a malaria episode. This implied an average gap of 1.04 USD between average local private prices and theoretical demand. Predicted ATP decreased by 14% for every additional malaria episode that the child had suffered during the malaria season. The market price was unaffordable for a large share of our sample, highlighting an unequal welfare distribution between suppliers and potential consumers, as well as issues of inequity in the private delivery of AL.

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Health provider choice and implicit rationing in healthcare: Evidence from Mozambique

Cited by 2 publications

References 21 publications

Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique

Health service availability and health seeking behaviour in resource poor settings: evidence from Mozambique

Market for Artemether‐Lumefantrine to treat childhood malaria in a district of southern Mozambique

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