Three methods to monitor utilization of healthcare services by the poor

<p>Abstract</p> <p>Background</p> <p>Achieving equity by way of improving the condition of the economically poor or otherwise disadvantaged is among the core goals of contemporary development paradigm. This places importance on monitoring outcome indicators among the po...

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Main Authors: Urni Farhana, Hanifi SMA, Bhuiya Abbas, Mahmood Shehrin
Format: Article
Language:English
Published: BMC 2009-08-01
Series:International Journal for Equity in Health
Online Access:http://www.equityhealthj.com/content/8/1/29
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author Urni Farhana
Hanifi SMA
Bhuiya Abbas
Mahmood Shehrin
author_facet Urni Farhana
Hanifi SMA
Bhuiya Abbas
Mahmood Shehrin
author_sort Urni Farhana
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Achieving equity by way of improving the condition of the economically poor or otherwise disadvantaged is among the core goals of contemporary development paradigm. This places importance on monitoring outcome indicators among the poor. National surveys allow disaggregation of outcomes by socioeconomic status at national level and do not have statistical adequacy to provide estimates for lower level administrative units. This limits the utility of these data for programme managers to know how well particular services are reaching the poor at the lowest level. Managers are thus left without a tool for monitoring results for the poor at lower levels. This paper demonstrates that with some extra efforts community and facility based data at the lower level can be used to monitor utilization of healthcare services by the poor.</p> <p>Methods</p> <p>Data used in this paper came from two sources- Chakaria Health and Demographic Surveillance System (HDSS) of ICDDR,B and from a special study conducted during 2006 among patients attending the public and private health facilities in Chakaria, Bangladesh. The outcome variables included use of skilled attendants for delivery and use of facilities. Rate-ratio, rate-difference, concentration index, benefit incidence ratio, sequential sampling, and Lot Quality Assurance Sampling were used to assess how pro-poor is the use of skilled attendants for delivery and healthcare facilities.</p> <p>Findings</p> <p>Poor are using skilled attendants for delivery far less than the better offs. Government health service facilities are used more than the private facilities by the poor.</p> <p>Benefit incidence analysis and sequential sampling techniques could assess the situation realistically which can be used for monitoring utilization of services by poor. The visual display of the findings makes both these methods attractive. LQAS, on the other hand, requires small fixed sample and always enables decision making.</p> <p>Conclusion</p> <p>With some extra efforts monitoring of the utilization of healthcare services by the poor at the facilities can be done reliably. If monitored, the findings can guide the programme and facility managers to act in a timely fashion to improve the effectiveness of the programme in reaching the poor.</p>
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spelling doaj.art-e2500558eed04bf5a4be44771bbd6ba72022-12-22T03:25:26ZengBMCInternational Journal for Equity in Health1475-92762009-08-01812910.1186/1475-9276-8-29Three methods to monitor utilization of healthcare services by the poorUrni FarhanaHanifi SMABhuiya AbbasMahmood Shehrin<p>Abstract</p> <p>Background</p> <p>Achieving equity by way of improving the condition of the economically poor or otherwise disadvantaged is among the core goals of contemporary development paradigm. This places importance on monitoring outcome indicators among the poor. National surveys allow disaggregation of outcomes by socioeconomic status at national level and do not have statistical adequacy to provide estimates for lower level administrative units. This limits the utility of these data for programme managers to know how well particular services are reaching the poor at the lowest level. Managers are thus left without a tool for monitoring results for the poor at lower levels. This paper demonstrates that with some extra efforts community and facility based data at the lower level can be used to monitor utilization of healthcare services by the poor.</p> <p>Methods</p> <p>Data used in this paper came from two sources- Chakaria Health and Demographic Surveillance System (HDSS) of ICDDR,B and from a special study conducted during 2006 among patients attending the public and private health facilities in Chakaria, Bangladesh. The outcome variables included use of skilled attendants for delivery and use of facilities. Rate-ratio, rate-difference, concentration index, benefit incidence ratio, sequential sampling, and Lot Quality Assurance Sampling were used to assess how pro-poor is the use of skilled attendants for delivery and healthcare facilities.</p> <p>Findings</p> <p>Poor are using skilled attendants for delivery far less than the better offs. Government health service facilities are used more than the private facilities by the poor.</p> <p>Benefit incidence analysis and sequential sampling techniques could assess the situation realistically which can be used for monitoring utilization of services by poor. The visual display of the findings makes both these methods attractive. LQAS, on the other hand, requires small fixed sample and always enables decision making.</p> <p>Conclusion</p> <p>With some extra efforts monitoring of the utilization of healthcare services by the poor at the facilities can be done reliably. If monitored, the findings can guide the programme and facility managers to act in a timely fashion to improve the effectiveness of the programme in reaching the poor.</p>http://www.equityhealthj.com/content/8/1/29
spellingShingle Urni Farhana
Hanifi SMA
Bhuiya Abbas
Mahmood Shehrin
Three methods to monitor utilization of healthcare services by the poor
International Journal for Equity in Health
title Three methods to monitor utilization of healthcare services by the poor
title_full Three methods to monitor utilization of healthcare services by the poor
title_fullStr Three methods to monitor utilization of healthcare services by the poor
title_full_unstemmed Three methods to monitor utilization of healthcare services by the poor
title_short Three methods to monitor utilization of healthcare services by the poor
title_sort three methods to monitor utilization of healthcare services by the poor
url http://www.equityhealthj.com/content/8/1/29
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