Health equity and financial protection datasheet : Mauritius

Health Equity and Financial Protection DATASHEET 72109 Mauritius The Health Equity and Financial Protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. Data are drawn from the Demographic and Health Surveys (DHS), World Health Surveys (WHS), Multiple Indicator Cluster Surveys (MICS), Living Standards and Measurement Surveys (LSMS), as well as other household surveys where available. The datasheets use a common set of health indicators for all countries. All analyses are conducted using the health modules of the ADePT software. INEQUALITIES CHILD HEALTH1,2,3 Q1 Q2 Q3 Q4 Q5 Total CI IN HEALTH 2003 3 OUTCOMES Diarrhea 22.6% 34.7% 17.4% 25.4% 17.5% 24.0% -0.043 Acute respiratory infection 18.5% 29.3% 27.3% 41.2% 28.2% 29.5% 0.086 Fever 88.4% 95.5% 93.2% 91.9% 92.8% 92.4% 0.000 adult health1,3 Q1 Q2 Q3 Q4 Q5 Total CI 2003 3 Tuberculosis 12.0% 9.3% 8.8% 9.2% 6.0% 9.1% -0.112*** Obesity among non-pregnant 15.0% 19.7% 12.3% 7.4% 8.9% 12.0% -0.166*** women Road traffic accident 1.2% 1.4% 1.2% 1.7% 2.1% 1.5% 0.097 Non-road traffic accident 8.1% 6.4% 5.0% 5.3% 4.9% 6.0% -0.098** Angina 5.2% 4.5% 4.5% 3.9% 3.5% 4.3% -0.061 Arthritis 9.1% 7.1% 7.7% 6.9% 6.3% 7.4% -0.065* Asthma 6.8% 3.8% 3.4% 4.3% 5.0% 4.6% -0.059 Depression 8.8% 7.1% 6.6% 6.3% 3.1% 6.4% -0.135*** Diabetes 10.4% 9.2% 8.1% 9.0% 10.1% 9.4% -0.004 Difficulty with work and 14.4% 9.3% 9.5% 6.2% 2.9% 8.5% -0.254*** household activities Poor self-assessed health 21.1% 17.3% 11.1% 9.7% 5.4% 13.1% -0.242*** status Risk factors1,2,3 Q1 Q2 Q3 Q4 Q5 Total CI INEQUALITIES IN 2003 3 RISKY BEHAVIOR Smoking (all) 26.8% 24.5% 23.0% 17.9% 20.6% 22.6% -0.078*** Smoking (women) 2.4% 2.9% 1.0% 4.1% 5.7% 3.2% 0.170* Insufficient intake of fruit and 93.7% 91.1% 89.0% 87.6% 84.1% 89.2% -0.021*** vegetables Insufficient physical activity 0.3% 0.1% 0.1% 0.4% 0.0% 0.2% -0.193 Drinking 5.5% 5.4% 5.8% 5.7% 3.2% 5.2% -0.061 Concurrent partnerships 0.4% 0.0% 0.4% 0.0% 0.0% 0.2% -0.536* INEQUALITIES Adult preventive care2,3 Q1 Q2 Q3 Q4 Q5 Total CI IN HEALTH CARE 2003 3 UTILIZATION TB screening 0.4% 0.8% 0.7% 0.8% 0.5% 0.6% 0.048 Cervical cancer screening 38.4% 27.3% 36.5% 34.0% 44.0% 36.3% 0.047 Breast cancer screening 16.6% 10.3% 14.5% 13.0% 17.2% 14.3% 0.012  INEQUALITIES adult curative care3 Q1 Q2 Q3 Q4 Q5 Total CI IN HEALTH CARE 2003 3 UTILIZATION Inpatient or outpatient (CONT.) 67.1% 64.1% 61.9% 65.7% 58.1% 63.5% -0.016** (12 months) Inpatient (12 months) 16.2% 15.5% 12.0% 12.5% 9.6% 13.2% -0.091*** Inpatient (5 years) 36.0% 37.5% 29.3% 30.2% 26.2% 31.9% -0.063*** Outpatient (12 months) 63.7% 63.6% 60.7% 62.3% 52.9% 60.6% -0.026** Threshold share of total household consumption FINANCIAL Catastrophic out-of- 5% 10% 15% 25% 40% PROTECTION pocket spending 2003 3 Headcount 42.5% 25.0% 14.7% 6.5% 2.4% Concentration index 0.053*** 0.078*** 0.111*** 0.233*** 0.446*** Threshold share of nonfood consumption Catastrophic out-of- 5% 10% 15% 25% 40% pocket spending 2003 3 Headcount 53.6% 41.3% 31.9% 17.6% 8.8% Concentration index 0.044*** 0.024** 0.025* 0.061*** 0.122*** Impoverishment Poverty line at US$1.25 per Consumption Consumption Change % change capita per day including OOP excluding OOP 2003 3 Percentage in poverty 0.5% 0.9% 0.4 pp 75.6% Average shortfall from the $0.00 $0.00 $0.00 59.3% poverty line Average shortfall from the $0.18 $0.16 -$0.02 -9.3% poverty line, among the poor Poverty line at US$2.00 per Consumption Consumption Change % change capita per day including OOP excluding OOP 2003 3 Percentage in poverty 4.3% 6.2% 1.9 pp 44.2% Average shortfall from the $0.01 $0.02 $0.01 44.8% poverty line Average shortfall from the $0.35 $0.35 $0.00 0.4% poverty line, among the poor Note: The Health Equity and Financial Protection datasheets use a standardized selection of indicators (see Measurement of Indicators for full list). When (1) data sources are not available or (2) indicator-specific sample size is less than 250 per quintile for mortality indicators or less than 25 per quintile for all others, indicators are not reported for the country under analysis. For analysis of inequalities using WHS, DHS and MICS, quintile ranking is based on an asset index. For all other analyses, ranking is based on household consumption. Q = quintile (where quintile 1 is the poorest) CI = concentration index; ranges between -1 and 1; negative sign indicates that the health outcome takes higher values among the poor * Significant at 10%, **Significant at 5%, ***Significant at 1%. Poverty lines are at 2005 purchasing power parity, adjusted to current prices using Mauritius’s consumer price index. Data sources: 1=n/a Demographic and Health Survey, 2=n/a Multiple Indicator Cluster Survey, 3=2003 Mauritius World Health Survey. Recommended citation: World Bank. 2012. Health Equity and Financial Protection Datasheet - Mauritius. Washington, D.C.: World Bank. For more information and the latest versions of the Health Equity and Financial Protection reports and datasheets, see: www.worldbank.org/povertyandhealth. Photo credit: Francis Dobbs  I nterpre tatIon of results InequalItIes In health outcomes, rIsky behavIor and health care utIlIzatIon the tables in this section show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. the quintiles are based on an asset index constructed using principal components analysis. the tables show the mean values of the indicator for each quintile, as well as for the sample as a whole. also shown are the concentration indices which capture the direction and degree of inequality. a negative value indicates that the variable (e.g. stunting or skilled birth attendance) is more concentrated among the poor, while a positive value indicates that the variable is concentrated among the better off. the larger the index in absolute size, the more inequality there is. the statistical significance of the concentration index is also shown, at 1% (***), 5% (**) and 10% (*) significance levels. For example, if stunting has a concentration index of -0.121***, then stunting is significantly concentrated among the poor. beneFIt-IncIdence analysIs benefit-incidence analysis (bIa) shows whether, and by how much, government health expenditure disproportionately benefits the poor. there are three tables showing, respectively, the distribution of service utilization across consumption quintiles for different types of care, the distribution of user fees, and the distribution of the estimated subsidies. all tables also show the concentration indices which capture the direction and degree of inequality. a negative value indicates that the variable (i.e. utilization, fees or subsidies) is more concentrated among the poor, while a positive value indicates that the variable is concentrated among the better off. the larger the index in absolute size, the greater is the inequality. For example, if the concentration index of subsidies to hospitals is positive, the non-poor benefit more than the poor from government spending on hospital services. the distribution of subsidies depends on the assumptions made to allocate subsidies to households. under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service (i.e. subsidies plus user fees) divided by the number of units of utilization. under the constant unit subsidy assumption, the unit subsidy is assumed to be constant, equal to total subsidies for the service in question divided by the number of units of utilization of that service. under the proportional cost assumption, higher fees are indicative of a more costly type of care; specifically, it is assumed that unit costs and fees are proportional to one another. If the concentration index is negative, then the subsidy to the particular level of care is pro-poor and if the concentration index is positive, then the subsidy is pro-rich. the column labeled “share