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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), pp. 247-258. (doi:10.1016/S0277-9536(03)00008-X).

Record type: Article

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.

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More information

Published date: 2004
Keywords: health financing, informal payments, poverty, tajikistan

Identifiers

Local EPrints ID: 35006
URI: http://eprints.soton.ac.uk/id/eprint/35006
ISSN: 0277-9536
PURE UUID: cd4d6317-b29c-4a9a-9d38-ad2c6c198c7b

Catalogue record

Date deposited: 18 May 2006
Last modified: 17 Jul 2017 15:48

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