Poverty, out of pocket payments and access to health care: evidence from Tajikistan


Falkingham, J. (2004) Poverty, out of pocket payments and access to health care: evidence from Tajikistan. Social Science & Medicine, 58, (2), 247-258. (doi:10.1016/S0277-9536(03)00008-X).

Download

Full text not available from this repository.

Description/Abstract

Most countries of the Former Soviet Union (FSU) have either initiated or are contemplating reform of the health sector. With negative real income growth and falling government revenues, a key concern of many governments is to secure additional finance through non-budgetary sources such as hypothecated payroll taxes, voluntary insurance, and increased private finance through patient cost-sharing. However, before such reforms can be considered, information is needed both on the current levels and distribution of household expenditures on health care, and the extent to which increased charges may affect access to health services, especially amongst the poor. This paper uses the Tajikistan Livings Standard Survey to investigate the level and distribution of out-of-pocket payments for health care in Tajikistan and to examine the extent to which such payments act as barriers to health-care access. The data show that there are significant differences in health-care utilisation rates across socio-economic groups and that these differences are related to ability to pay. Official and informal payments are acting both to deter people from seeking medical assistance and once advice has been sought, from receiving the most appropriate treatment. Despite informal exemptions, out-of-pocket payments for health care are exacting a high toll on household welfare with households being forced to sell assets or go into debt to meet the costs of care. Urgent action is needed to ensure equity in access to health care.

Item Type: Article
ISSNs: 0277-9536 (print)
Related URLs:
Keywords: health financing, informal payments, poverty, tajikistan
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine
Divisions: University Structure - Pre August 2011 > School of Social Sciences > Social Statistics
ePrint ID: 35006
Date Deposited: 18 May 2006
Last Modified: 27 Mar 2014 18:21
Contact Email Address: j.c.falkington@soton.ac.uk
URI: http://eprints.soton.ac.uk/id/eprint/35006

Actions (login required)

View Item View Item