On Decomposing the Causes of Health Sector Inequalities with an Application to Malnutrition Inequalities in Vietnam

21 Pages Posted: 20 Apr 2016

See all articles by Adam Wagstaff

Adam Wagstaff

World Bank - Development Research Group (DECRG)

Eddy van Doorslaer

Erasmus School of Economics

Naoke Watanabe

World Bank

Multiple version iconThere are 2 versions of this paper

Date Written: November 2001

Abstract

A method for decomposing inequalities in the health sector into their causes is developed and applied to data on child malnutrition in Vietnam.

Wagstaff, van Doorslaer, and Watanabe propose a method for decomposing inequalities in the health sector into their causes, by coupling the concentration index with a regression framework. They also show how changes in inequality over time, and differences across countries, can be decomposed into the following: - Changes due to changing inequalities in the determinants of the variable of interest. - Changes in the means of the determinants. - Changes in the effects of the determinants on the variable of interest.

The authors illustrate the method using data on child malnutrition in Vietnam. They find that inequalities in height-for-age in 1993 and 1998 are accounted for largely by inequalities in household consumption and by unobserved influences at the commune level. And they find that an increase in such inequalities is accounted for largely by changes in these two influences.

In the case of household consumption, rising inequalities play a part, but more important have been the inequality - increasing effects of rising average consumption and the increased protective effect of consumption on nutritional status. In the case of unobserved commune-level influences, rising inequality and general improvements seem to have been roughly equally important in accounting for rising inequality in malnutrition.

This paper - a joint product of Public Services for Human Development, Development Research Group, and the Development Data Group - is part of a larger effort in the Bank to investigate the links between health and poverty. The authors may be contacted at awagstaff@worldbank.org, vandoorslaer@econ.bmg.eur.nl., or nwatanabe@worldbank.org.

Keywords: Health Sector Inequalities Malnutrition Viet Nam

Suggested Citation

Wagstaff, Adam and van Doorslaer, Eddy and Watanabe, Naoke, On Decomposing the Causes of Health Sector Inequalities with an Application to Malnutrition Inequalities in Vietnam (November 2001). World Bank Policy Research Working Paper No. 2714. Available at SSRN: https://ssrn.com/abstract=634439

Adam Wagstaff (Contact Author)

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

HOME PAGE: http://econ.worldbank.org/staff/awagstaff

Eddy Van Doorslaer

Erasmus School of Economics ( email )

Netherlands

Naoke Watanabe

World Bank ( email )

1818 H Street, N.W.
Washington, DC 20433
United States

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