| Measuring wealth-based health inequality
among Indian children: the importance of
equity vs efficiency |
| Authors: |
P Arokiasamy and J Pradhan |
| Source: |
Health Policy and Planning, 2010;1–12; doi:10.1093/heapol/czq075 |
| Topic(s): |
Child health
Inequality
|
| Country: |
Asia
India
|
| Published: |
FEB 2010 |
| Abstract: |
The concentration index is the most commonly used measure of socioeconomic-
related health inequality. However, a critical constraint has been
that it is just a measure of inequality. Equity is an important goal of health
policy but the average level of health also matters. In this paper, we explore
evidence of both these crucial dimensions—equity (inequality) and efficiency
(average health)—in child health indicators by adopting the recently developed
measure of the extended concentration index on the National Family Health
Survey (NFHS-3) data from India. An increasing degree of inequality aversion is
used to measure health inequalities as well as achievement in the following
child health indicators: under-2 child mortality, full immunization coverage, and
prevalence of underweight, wasting and stunting among children. State-wise
adjusted under-2 child mortality scores reveal an increasing trend with
increasing values of inequality aversion, implying that under-2 child deaths
have been significantly concentrated among the poor households. The level of
adjusted under-2 child mortality scores increases significantly with the
increasing value of aversion even in states advanced in the health transition,
such as Kerala and Goa. The higher values of adjusted scores for lower values of
aversion for child immunization coverage are evidence that richer households
benefited most from the rise in full immunization coverage. However, the lack of
radical changes in the adjusted scores for underweight among children with
increasing degrees of aversion implies that household economic status was not
the only determinant of poor nutritional status in India. |
|