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Inequalities in Access to Health Care Inequalities in Access to Health Care in Brazil and Indiain Brazil and India

Closing the Gap for the Poorest-poorClosing the Gap for the Poorest-poor

Tiziana Leone, PhD LSE Health

T.Leone@lse.ac.uk

ESRC Collaborative Analysis of Micro Data Resources: BRAZIL-INDIA PATHFINDER Research Project

Real Data - Real World Presentation at the ESDS International Annual Conference 30 November 2009, London

Objectives Facilitate international research partnerships and

networking of social scientists from Brazil, India and the UK

Analyse large-scale national survey data to address policy-oriented research problems in the area related to social inequalities and population health

Share research experiences and build capacity in quantitative analysis of health and demographic data from household surveys

Produce joint academic research outputs and disseminate findings at international conferences

Identify priority research areas and strengthen the research consortium by developing joint research proposals.

Research Team: UK partners

Sabu Padmadas (PI), Zoe Matthews, Maria Evandrou, Andrew Channon, Fiifi Amoako Johnson, Jane Falkingham

Saseendran Pallikadavath Tiziana Leone

Expertise: Reproductive and child health, Family planning, Health care systems, Health inequalities, Poverty, Ageing, Spatial analysis, Demographic & Health Surveys

Research Team: Brazil

André Junqueira Caetano, Eduardo L.G. Rios-Neto, Carla Jorge Machado, Ernesto F. L. Amaral

Expertise: Reproductive and child Health, Family planning, Economic demography, Policy evaluation, Health care systems, Health inequalities Infectious diseases, Poverty, Ageing, Demographic & Health Surveys

Research Team: India

KS James, Lekha Subaiya Dilip TR, US Mishra

Abhishek Singh

Expertise: Reproductive and child Health, Health inequalities, Economic demography, Health care systems, Health inequalities, Morbidity, Poverty, Ageing, Demographic & Health Surveys, National Sample Surveys

Research questions (1)

What are the assessment criteria to measure and quantify inequalities in health care access in Brazil and India?

What is the extent of inequalities in access to health care and how do these vary over time and within (intra) and across (inter) wealth and expenditure classes and by geographical location of residence?

What are the individual, household and community barriers to health care access and how these differ between Brazil and India?

Research questions (2)

How do individual, household and community attributes interact and mediate the relationship between household wealth and health care access?

What is the extent of heterogeneity in health care access at the community level?

To what extent do differences in inequalities in access to health care between Brazil and India reflect differences in health care system functioning and policies and whether they have narrowed or widened the gap between the rich and the poor?

Conceptual framework

Datasets

Brasil: 1986, 2003, 2006 Pesquisa Nacional de Demografia e Saúde, PNDS 1991, 1996 DHS2005 Avaliação de Impacto do Programa Bolsa Família; 2002/03 Pesquisa de Orçamentos Familiares; Administrative data on deaths, births and hospital records

India: 1992/93, 1998, 2005/06National Family Health Survey, NFHS

(Demographic & Health Surveys):1998/99, 2002/04 Reproductive and Child Health (RCH)1995/06, 2004/05 National Sample Survey Organisation (NSSO) dataOther ad hoc surveys

Timeline, activities & outputs

12 months (April 2010 – March 2011)

Three sets of research workshops with specific research agenda and capacity building activities (May 2010, Aug 2010 & Jan 2011) and routine e-conferences.

Dissemination: national and international conferences, project website, fact sheets, peer-reviewed joint publications