2012年-世界发展银行全球_Health_Equity_and_Financial_Protection_Datasheets___Europe_and_Central_Asia_42页_8mb

报告摘要

Health Equity and Financial Protection Datasheets Summary

Overview

This document presents health equity and financial protection data for various countries in the Europe and Central Asia region. The data are based on standardized health indicators collected from household surveys such as the Demographic and Health Surveys (DHS), World Health Surveys (WHS), Multiple Indicator Cluster Surveys (MICS), and Living Standards and Measurement Surveys (LSMS). The analysis is conducted using the ADePT software, and the concentration index (CI) is used to measure inequality, where a negative CI indicates higher health outcomes among the poor.

Core Content and Key Topics

Health Equity: Analysis of inequalities in health outcomes, health behavior, and health care utilization.
Financial Protection: Assessment of the financial burden of health care and the progressivity of health financing.
Benefit Incidence Analysis: Examination of how health benefits are distributed across different income quintiles.
Data Sources: Multiple surveys including DHS, WHS, MICS, and LSMS.
Methodology: Quintile ranking based on asset index for WHS, DHS, and MICS; household consumption for other analyses.
CI Interpretation: Ranges from -1 to 1; negative values indicate greater health outcomes among the poor.

Country-Specific Summary

Albania

Health Outcomes

Child Health:
- Stunting: 33.4% (Q1) to 19.0% (Q5), with a concentration index of -0.106***.
- Underweight: 12.1% (Q1) to 2.7% (Q5), CI of -0.309***.
- Diarrhea: 9.5% (Q1) to 4.1% (Q5), CI of -0.174***.
- Acute respiratory infection (ARI): 8.7% (Q1) to 7.4% (Q5), CI of -0.075.
- Fever: 8.1% (Q1) to 5.0% (Q5), CI of -0.078.
2008-09:
- Infant mortality rate: 29.9 (Q1) to 14.3 (Q5), CI of -0.127*.
- Under-five mortality rate: 40.1 (Q1) to 12.9 (Q5), CI of -0.194***.
- Stunting: 30.6% (Q1) to 15.9% (Q5), CI of -0.122***.
- Underweight: 9.6% (Q1) to 3.7% (Q5), CI of -0.153**.
- Diarrhea: 5.5% (Q1) to 4.2% (Q5), CI of -0.063.
- ARI: 9.6% (Q1) to 6.6% (Q5), CI of -0.098*.

Health Behavior

Smoking (women): 0.8% (Q1) to 11.6% (Q5), CI of 0.519***.
Concurrent partnerships: 2.5% (Q1) to 8.2% (Q5), CI of 0.268***.
Condom usage (more than one partner): 11.6% (Q1) to 40.1% (Q5), CI of 0.310***.

Health Care Utilization

Full immunization: 88.4% (Q1) to 65.2% (Q5), CI of -0.042***.
Skilled antenatal care (4+ visits): 49.3% (Q1) to 91.4% (Q5), CI of 0.137***.
Skilled birth attendance: 98.7% (Q1) to 100.0% (Q5), CI of 0.003***.
Contraceptive prevalence: 0.2% (Q1) to 0.4% (Q5), CI of 0.284.

Armenia

Health Outcomes

Child Health:
- Infant mortality rate: 56.5 (Q1) to 26.6 (Q5), CI of -0.122**.
- Under-five mortality rate: 57.7 (Q1) to 38.2 (Q5), CI of -0.082.
- Stunting: 24.8% (Q1) to 13.1% (Q5), CI of -0.133***.
- Underweight: 9.6% (Q1) to 3.7% (Q5), CI of -0.153**.
- Diarrhea: 19.9% (Q1) to 13.1% (Q5), CI of -0.066.
- ARI: 10.7% (Q1) to 11.3% (Q5), CI of 0.040.
- Fever: 16.0% (Q1) to 14.1% (Q5), CI of 0.032.
2010:
- Infant mortality rate: 22.1 (Q1) to 17.5 (Q5), CI of -0.008.
- Stunting: 26.4% (Q1) to 17.0% (Q5), CI of -0.061.
- Underweight: 6.8% (Q1) to 2.2% (Q5), CI of -0.192***.
- Diarrhea: 5.5% (Q1) to 10.7% (Q5), CI of 0.092.
- ARI: 4.6% (Q1) to 11.2% (Q5), CI of 0.223***.
- Fever: 9.5% (Q1) to 16.4% (Q5), CI of 0.160***.

Health Behavior

Smoking (women): 0.8% (Q1) to 11.6% (Q5), CI of 0.519***.
Concurrent partnerships: 2.5% (Q1) to 8.2% (Q5), CI of 0.268***.
Condom usage (more than one partner): 11.6% (Q1) to 40.1% (Q5), CI of 0.310***.

Health Care Utilization

Full immunization: 65.2% (Q1) to 66.9% (Q5), CI of 0.097**.
Treatment of diarrhea: 31.2% (Q1) to 42.3% (Q5), CI of 0.094.
Medical treatment of ARI: 16.5% (Q1) to 10.9% (Q5), CI of 0.195**.
Skilled antenatal care (4+ visits): 20.7% (Q1) to 80.3% (Q5), CI of 0.262***.
Skilled birth attendance: 79.2% (Q1) to 99.6% (Q5), CI of 0.051***.
Contraceptive prevalence: 42.5% (Q1) to 37.1% (Q5), CI of -0.012.

Azerbaijan

Health Outcomes

Child Health:
- Infant mortality rate: 56.9 (Q1) to 31.2 (Q5), CI of -0.106**.
- Under-five mortality rate: 63.7 (Q1) to 42.2 (Q5), CI of -0.112**.
- Stunting: 34.9% (Q1) to 19.2% (Q5), CI of -0.142***.
- Underweight: 15.6% (Q1) to 4.9% (Q5), CI of -0.292***.
- Diarrhea: 13.3% (Q1) to 9.6% (Q5), CI of -0.087*.
- ARI: 5.0% (Q1) to 1.6% (Q5), CI of -0.121*.
- Fever: 11.9% (Q1) to 8.8% (Q5), CI of -0.073.

Adult Health

Obesity among non-pregnant women: 11.8% (Q1) to 21.7% (Q5), CI of 0.115***.

Health Care Utilization

Full immunization: 38.3% (Q1) to 66.9% (Q5), CI of 0.097**.
Treatment of diarrhea: 31.2% (Q1) to 42.3% (Q5), CI of 0.094.
Medical treatment of ARI: 16.5% (Q1) to 10.9% (Q5), CI of 0.195**.
Skilled antenatal care (4+ visits): 20.7% (Q1) to 80.3% (Q5), CI of 0.262***.
Skilled birth attendance: 79.2% (Q1) to 99.6% (Q5), CI of 0.051***.
Contraceptive prevalence among women: 42.5% (Q1) to 37.1% (Q5), CI of -0.012.

Belarus

Health Outcomes

Child Health:
- Stunting: 8.3% (Q1) to 2.0% (Q5), CI of -0.313**.
- Underweight: 2.6% (Q1) to 0.4% (Q5), CI of -0.275*.
- Diarrhea: 4.2% (Q1) to 3.1% (Q5), CI of -0.042.
- ARI: 13.2% (Q1) to 17.3% (Q5), CI of 0.020.
Adult Health:
- Tuberculosis: 8.6% (Q1) to 3.0% (Q5), CI of -0.238**.
- Obesity among non-pregnant women: 4.2% (Q1) to 6.2% (Q5), CI of -0.081.
- Road traffic accident: 2.9% (Q1) to 0.3% (Q5), CI of -0.063**.
- Non-road traffic accident: 9.1% (Q1) to 1.8% (Q5), CI of -0.285.
- Angina: 13.0% (Q1) to 2.7% (Q5), CI of -0.253***.
- Arthritis: 15.7% (Q1) to 10.0% (Q5), CI of -0.129.
- Asthma: 4.8% (Q1) to 1.1% (Q5), CI of -0.129.
- Depression: 9.8% (Q1) to 1.8% (Q5), CI of -0.142.
- Diabetes: 7.8% (Q1) to 0.6% (Q5), CI of -0.284***.
- Difficulty with work and household activities: 18.3% (Q1) to 3.9% (Q5), CI of -0.313***.
- Poor self-assessed health status: 22.8% (Q1) to 6.6% (Q5), CI of -0.309***.

Health Behavior

Smoking (all): 45.8% (Q1) to 41.6% (Q5), CI of -0.011.
Smoking (women): 22.1% (Q1) to 46.3% (Q5), CI of 0.042.
Insufficient intake of fruit and vegetables: 82.0% (Q1) to 78.2% (Q5), CI of -0.014.
Insufficient physical activity: 21.5% (Q1) to 33.4% (Q5), CI of 0.092**.
Drinking: 2.0% (Q1) to 4.3% (Q5), CI of 0.201.
Concurrent partnerships: 0.0% (Q1) to 0.8% (Q5), CI of -0.125.

Health Care Utilization

Full immunization: 90.4% (Q1) to 89.4% (Q5), CI of -0.001.
Contraceptive prevalence: 5.0% (Q1) to 16.1% (Q5), CI of 0.225***.
TB screening: 2.1% (Q1) to 2.9% (Q5), CI of -0.031.
Cervical cancer screening: 68.8% (Q1) to 82.8% (Q5), CI of 0.057**.
Breast cancer screening: 3.0% (Q1) to 16.4% (Q5), CI of 0.264***.
Inpatient or outpatient (12 months): 53.0% (Q1) to 50.8% (Q5), CI of -.

Key Findings

Health Inequality: Significant inequalities are observed in health outcomes and utilization across income quintiles, with poorer populations generally experiencing worse health outcomes.
Concentration Index (CI): Negative CI values indicate that poorer quintiles have higher rates of health issues, while positive CI values suggest that wealthier quintiles have higher rates of health behaviors and care utilization.
Child Health: Stunting, underweight, and diarrhea are prevalent, with significant disparities across quintiles.
Adult Health: Obesity and certain conditions like angina, arthritis, and depression show varying degrees of inequality.
Health Behavior: Smoking, physical inactivity, and alcohol consumption are reported, with some significant inequalities.
Health Care Utilization: There is a trend of increased utilization of skilled birth attendance and antenatal care among wealthier quintiles, indicating potential disparities in access to health services.

Conclusion

The Health Equity and Financial Protection Datasheets highlight significant disparities in health outcomes and utilization across different income groups in the Europe and Central Asia region. These disparities suggest the need for targeted interventions to improve health equity and ensure financial protection for vulnerable populations.

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