Poverty-Targeted Social Assistance and Health Utilization in Armenia - PowerPoint PPT Presentation

1 / 12
About This Presentation
Title:

Poverty-Targeted Social Assistance and Health Utilization in Armenia

Description:

Poverty-Targeted Social Assistance. and Health Utilization in Armenia. Edmundo Murrugarra ... Armenia: Fiscal collapse, low public expenditures on health (less ... – PowerPoint PPT presentation

Number of Views:21
Avg rating:3.0/5.0
Slides: 13
Provided by: WB1673
Category:

less

Transcript and Presenter's Notes

Title: Poverty-Targeted Social Assistance and Health Utilization in Armenia


1
Poverty-Targeted Social Assistance and Health
Utilization in Armenia
  • Edmundo Murrugarra
  • Nazmul Chadhury
  • Jeff Hammer
  • Rodica Cnobloch
  • REACHING THE POOR CONFERENCE
  • February 18-20, 2004
  • World Bank
  • Washington, D.C.

2
Contents
  1. Introduction
  2. Health sector background
  3. Fee waivers and targeting reform
  4. Effects on utilization
  5. Conclusions

3
1. Introduction
  • How to improve health care access among the poor?
  • Price Fee-waivers
  • Income transfers
  • Exploit a natural experiment
  • Eligibility expansion change in Armenia
  • Effects on utilization (not OOPs, type of
    provider)

4
2. Background
  • Armenia Fiscal collapse, low public expenditures
    on health (less than 2 GDP)
  • High poverty incidence (gt50)
  • Decreased utilization
  • Relying on OOPS
  • Marked inequality in health care utilization

5
2. Background
6
3. Fee waivers (1)
  • Social Assistance Reform (1998-1999)
  • Improved incidence of social assistance

1998 Before 1999 After
26 social benefits Eligibility based on categories Poverty Family Benefit Household allocation Proxy-mean targeting
7
3. Fee waivers (2)
  • Basic Benefit Package (BBP), part of the reform
  • Provided freely for eligible individuals
  • A.Demographics (4 kids, orphans) - Majority
  • B. Disability
  • Previous findings (1996-1998)
  • Improved utilization for those disabled (group B)
  • No effect on other groups
  • Group A largest decline in utilization
  • Worked as an income transfer.

8
3. Fee waivers (3)
  • 2001 Reform Eligibility expansion
  • Poverty Family Beneficiaries entitled to BBP
    freely poverty targeting in health care

Before 2001 2001
Categorical Eligibility
Categorical Eligibility
PFB Eligibility
9
3. Fee waivers (4)
  • Data
  • National Household surveys 1998/99 , 2001
  • Similar sample design and instruments
  • Focus on health care utilization

10
4. Effects on utilization
11
4. Effects on utilization
12
5. Conclusions
  • After dramatic adverse effects on utilization,
    gradual reduction in inequality
  • Reflects the financial protection of the poor
  • The better off suffered declines anyway
  • Also reflects improvements in institutional and
    budgetary arrangements
Write a Comment
User Comments (0)
About PowerShow.com