The 130th Annual Meeting of APHA

3182.0: Monday, November 11, 2002 - 12:30 PM

Abstract #45126

Gender inequality in health and healthcare in rural Bangladesh: Role of a health insurance program in reducing gender-gap

Mahmud Khan, PhD1, Kamrul Islam, MSc2, Kuntal K. Saha3, Nazmul Sohel, MA3, Maarten Desmet, PhD4, and A.Q. Chowdhury5. (1) Health Systems Management, Tulane University, 1440 Canal Street, 19th floor, new orleans, LA 70112, 5045841979, khan@tulane.edu, (2) Department of Economics, Jahangirnagar University, Jahangirnagar, Savar, Bangladesh, (3) Health Economics Program, PHSD, ICDDR,B, Health Economics Program, Dhaka, Bangladesh, ICDDR,B, Mohakhali, Dhaka 1212, Dhaka, Bangladesh, (4) Foreign Ministry, Belgium, Belgiam Administration for Development Cooperation, Kerkstraat 24, B-9870, Zulte, Belgium, (5) Gonoshasthaya Kendra Health Center, Ganoshasthya Kendra, Nayarhat, Dhaka 1350, Bangladesh

Objectives: Burden of ill health is higher among women than men and they also face significant barriers to access healthcare. This paper examines the gender-gap in health status, utilization of healthcare resources and expenditures per illness and evaluates the inequity lowering impact of a health insurance program.

Methods: A longitudinal survey of 4071 persons in 675 households conducted in 1997 has been used. Health status has been measured by illness incidence found during the longitudinal follow-up period (6 months). Access has been measured by health care utilization, controlling for the needs for medical care based on severity as well as incidence of illness. Six multivariate regression models were estimated to examine the determinants of ill health and healthcare utilization by gender.

Results: Significant (p<0.001) gender differences in health status and utilization of medical care services were found in the area. The likelihood of utilizing modern care is higher for males in all disease categories. A significant (p<0.001) sex disparity in expenditures on per illness episode has been observed for uninsured individuals. For insured persons, no significant gender disparity was found. Except for modern healthcare services, gender is a significant predictor of utilization of healthcare resources in multivariate analyses.

Conclusion: Reducing inequity in health status and healthcare utilization is directly related to improving access to health services. Insurance status does not lower gender disparity in health or utilization of healthcare resources, although it reduces the inequality in health care expenditures.

Learning Objectives:

Keywords: Economic Analysis, Health Insurance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Health Sector Reform

The 130th Annual Meeting of APHA