Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo
Using unique direct observations of patient-provider interactions linked to patient exit interviews and detailed household surveys, this paper assesses the relationship between patient wealth and the quality and price of antenatal care in the Democ...
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World Bank, Washington, DC
2019
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| Online Access: | http://documents.worldbank.org/curated/en/851111555342898988/Inequality-in-the-Quality-of-Health-Services-Wealth-Content-of-Care-and-Price-of-Antenatal-Consultations-in-the-Democratic-Republic-of-Congo http://hdl.handle.net/10986/31560 |
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okr-10986-315602022-08-01T00:25:47Z Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo Fink, Gunther Kandpal, Eeshani Shapira, Gil HEALTH SERVICES QUALITY OF CARE ACCESS TO HEALTH CARE SERVICE CLINICS PRENATAL CARE Using unique direct observations of patient-provider interactions linked to patient exit interviews and detailed household surveys, this paper assesses the relationship between patient wealth and the quality and price of antenatal care in the Democratic Republic of Congo. Overall, the analysis finds a significant wealth-quality gradient, with a standard deviation increase in wealth being associated with an increase of 4 percentage points in protocol compliance. This increase in compliance represents 8 percent of the average quality of care received by women in the lowest wealth quintile. Over half of the wealth-quality gradient is driven by lower facility quality in poorer areas. However, the analysis also finds statistically significant within-village and even within-facility wealth-quality relationships. Within villages, wealth-quality gradients are primarily driven by wealthier women seeking care at higher-quality even if more distant facilities. Within the same facilities, poorer women tend to receive worse care, but on average they also pay less for the same quality of care compared with wealthier women. The price gap increases in the local ratio of wealthy to poor households, suggesting that providers do not charge different prices only for redistributive reasons. 2019-04-18T20:36:04Z 2019-04-18T20:36:04Z 2019-04 Working Paper http://documents.worldbank.org/curated/en/851111555342898988/Inequality-in-the-Quality-of-Health-Services-Wealth-Content-of-Care-and-Price-of-Antenatal-Consultations-in-the-Democratic-Republic-of-Congo http://hdl.handle.net/10986/31560 English Policy Research Working Paper;No. 8818 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper Africa Congo, Democratic Republic of |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English |
| topic |
HEALTH SERVICES QUALITY OF CARE ACCESS TO HEALTH CARE SERVICE CLINICS PRENATAL CARE |
| spellingShingle |
HEALTH SERVICES QUALITY OF CARE ACCESS TO HEALTH CARE SERVICE CLINICS PRENATAL CARE Fink, Gunther Kandpal, Eeshani Shapira, Gil Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo |
| geographic_facet |
Africa Congo, Democratic Republic of |
| relation |
Policy Research Working Paper;No. 8818 |
| description |
Using unique direct observations of
patient-provider interactions linked to patient exit
interviews and detailed household surveys, this paper
assesses the relationship between patient wealth and the
quality and price of antenatal care in the Democratic
Republic of Congo. Overall, the analysis finds a significant
wealth-quality gradient, with a standard deviation increase
in wealth being associated with an increase of 4 percentage
points in protocol compliance. This increase in compliance
represents 8 percent of the average quality of care received
by women in the lowest wealth quintile. Over half of the
wealth-quality gradient is driven by lower facility quality
in poorer areas. However, the analysis also finds
statistically significant within-village and even
within-facility wealth-quality relationships. Within
villages, wealth-quality gradients are primarily driven by
wealthier women seeking care at higher-quality even if more
distant facilities. Within the same facilities, poorer women
tend to receive worse care, but on average they also pay
less for the same quality of care compared with wealthier
women. The price gap increases in the local ratio of wealthy
to poor households, suggesting that providers do not charge
different prices only for redistributive reasons. |
| format |
Working Paper |
| author |
Fink, Gunther Kandpal, Eeshani Shapira, Gil |
| author_facet |
Fink, Gunther Kandpal, Eeshani Shapira, Gil |
| author_sort |
Fink, Gunther |
| title |
Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo |
| title_short |
Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo |
| title_full |
Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo |
| title_fullStr |
Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo |
| title_full_unstemmed |
Inequality in the Quality of Health Services : Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo |
| title_sort |
inequality in the quality of health services : wealth, content of care, and price of antenatal consultations in the democratic republic of congo |
| publisher |
World Bank, Washington, DC |
| publishDate |
2019 |
| url |
http://documents.worldbank.org/curated/en/851111555342898988/Inequality-in-the-Quality-of-Health-Services-Wealth-Content-of-Care-and-Price-of-Antenatal-Consultations-in-the-Democratic-Republic-of-Congo http://hdl.handle.net/10986/31560 |
| _version_ |
1764474604880920576 |