Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: A seemingly unrelated regression approach.

Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: A seemingly unrelated regression approach. Soc Sci Med. 2013 Jul;89:25-31 Authors: Johns B, Steinhardt L, Walker DG, Peters DH, Bishai D Abstract Producing services efficiently and equitably are important goals for health systems. Many countries pursue horizontal equity - providing people with the same illnesses equal access to health services - by locating facilities in remote areas. Staff are often paid incentives to work at such facilities. However, there is little evidence on how many fewer people are treated at remote facilities than facilities in more densely settled areas. This research explores if there is an association between the efficiency of health centers in Afghanistan and the remoteness of their location. Survey teams collected data on facility level inputs and outputs at a stratified random sample of 579 health centers in 2005. Quality of care was measured by observing staff interact with patients and determining if staff completed a set of normative patient care tasks. We used seemingly unrelated regression to determine if facilities in remote areas have fewer outpatient visits than other rural facilities. In this analysis, one equation compares the number of outpatient visits to facility inputs, while another compares quality of care to determinants of quality. The results indicate remote facilities have about 13% fewer outpatient visits...
Source: Rural Remote Health - Category: Rural Health Authors: Tags: Soc Sci Med Source Type: research