How do Supply- and Demand-side Interventions Influence Equity in Healthcare Utilisation? Evidence from Maternal Healthcare in Senegal

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How do Supply- and Demand-side Interventions Influence Equity in Healthcare Utilisation? Evidence from Maternal Healthcare in Senegal


JournalCity Research Online
Article typeThesis
Publication date – Jan – 2021
Authors – Divya Parmar and Aneesh Banerjee
KeywordsAccess, Emergency obstetric care, equity, exemption, maternal health, Quality of care., Senegal, user fees
Open access – Yes
SpecialityHealth policy, Obstetrics and Gynaecology
World region Western Africa
Country: Senegal
Language – English
Submitted to the One Surgery Index on January 17, 2021 at 7:39 am
Abstract:

The launch of the Millennium Development Goals in 2000, followed by the Sustainable Development Goals in 2015, and the increasing focus on achieving universal health coverage has led to numerous interventions on both supply- and demand-sides of health systems in low- and middle-income countries. While tremendous progress has been achieved, inequities in access to healthcare persist, leading to calls for a closer examination of the equity implications of these interventions. This paper examines the equity implications of two such interventions in the context of maternal healthcare in Senegal. The first intervention on the supply-side focuses on improving the availability of maternal health services while the second intervention, on the demand-side, abolished user fees for facility deliveries. Using three rounds of Demographic Health Surveys
covering the period 1992 to 2010 and employing three measures of socioeconomic status (SES) based on household wealth, mothers’ education and rural/urban residence – we find that although both interventions increase utilisation of maternal health services, the rich benefit more from the supply-side intervention, thereby increasing inequity, while the poor benefit more from the demand-side intervention i.e. reducing inequity. Both interventions positively influence facility deliveries in rural areas although the increase in facility deliveries after the demand-side intervention is more than the increase after the supply-side intervention. There is no significant difference in utilisation based on mothers’ education. Since people from different SES categories are likely to respond differently to interventions on the supply- and demand-side of the health system, policymakers involved in the design of health programmes should pay closer attention to concerns of inequity and elite capture that may unintentionally result from these interventions

OSI Number – 20877

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