Multidimensional Poverty Modeling for Namibia Using the Beta Distribution

Despite global efforts in alleviating poverty, many people are still living in poverty. Different methods were employed to estimate poverty with many researchers moving from monetary to multidimensional poverty modeling approach. In Namibia, very few studies have been conducted to estimate poverty in a multidimensional sense. The 2015/2016 Namibia household income and expenditure survey dataset was employed to develop multidimensional poverty indices (MPIs) using beta distribution. We showed that the MPI is equivalent to the mean of the left truncated beta distribution. The results revealed that the northern regions of Namibia are the most affected by multidimensional poverty. The results from this study can be used to identify areas that are severely affected by poverty and consequently form a basis to develop appropriate measures intended to alleviate poverty.

Households’ Socio-Economic Characteristics and Their Food Purchase Patterns: A Macro Study on IRAN Households Income and Expenditure Survey

Objectives Dietary pattern analysis has a holistic approach to the eating behaviors of populations. The objective of this study was to identify the patterns of food expenditure (as a proxy of dietary patterns) in Iranian urban households. Methods The study made use of Iran Households Income and Expenditure Survey data in the urban areas that included 18,701 households. Principal components analysis was used to identify major household food expenditure patterns (FEPs) and binary logistic regression models for relation between households’ socioeconomic characteristics with FEPs. Results Four FEPs could be identified: “Affordable and Diverse” (ADP), “Expensive and Modern” (EMP), “Traditional" (TP), and “Cheap and Western” (CWP). Factors that increased the ORs of EMP and CWP had many similarities. Being a child under 5 years old, being a child or adolescent with 6 to 18 years old and being a mother's with a university education level in the household, increased the ORs of these patterns. Also Factors that increased the ORs of ADP and TP had many similarities. Smaller family size, older family, no children under 5, and lower maternal education in the household, increased the ORs of these patterns. The ORs of " ADP" Showed no difference between income quarters rather the ORs of EMP, TP, and CWP In households in the fourth quarter of income compared to the first quarter, were 3.57 (95% CI = 3.12–4.17), 0.55 (95% CI = 0.49–0.62) and 0.59 (95% CI = 0.53–0.67) respectively. Conclusions This study clearly shows the role of mother's education and the presence of children in the choice of household food expenditure pattern and in Iranian urban households, especially households with children, improving household income should be considered along with creating healthier food environments. Funding Sources Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Assessing the incidence of catastrophic health expenditure and impoverishment from out-of-pocket payments and their determinants in Bangladesh: evidence from the nationwide Household Income and Expenditure Survey 2016

Background Out-of-pocket (OOP) payments for healthcare have been increasing steadily in Bangladesh, which deteriorates the financial risk protection of many households. Methods We aimed to investigate the incidence of catastrophic health expenditure (CHE) and impoverishment from OOP payments and their determinants. We employed nationally representative Household Income and Expenditure Survey 2016 data with a sample of 46 076 households. A household that made OOP payments of >10% of its total or 40% of its non-food expenditure was considered to be facing CHE. We estimated the impoverishment using both national and international poverty lines. Multiple logistic models were employed to identify the determinants of CHE and impoverishment. Results The incidence of CHE was estimated as 24.6% and 10.9% using 10% of the total and 40% of non-food expenditure as thresholds, respectively, and these were concentrated among the poor. About 4.5% of the population (8.61 million) fell into poverty during 2016. Utilization of private facilities, the presence of older people, chronic illness and geographical location were the main determinants of both CHE and impoverishment. Conclusion The financial hardship due to OOP payments was high and it should be reduced by regulating the private health sector and covering the care of older people and chronic illness by prepayment-financing mechanisms.

Demand for tobacco products in Bangladesh

BackgroundTobacco tax increase is considered as one of the most effective means to reduce tobacco consumption and its consequences. An increase in taxes, which results in an increase in the price of tobacco products, reduces consumption. Historically, a number of studies estimated the responsiveness of quantity demanded to a change in price—the price elasticity of demand—of tobacco products in Bangladesh. However, the government’s stronger commitment to reducing tobacco use, rising standard of living, rapidly changing cultural norms due to globalisation, and the substantial fall in tobacco use seen in GATS 2017 necessitate an updated measure of price elasticity of tobacco use, which will allow for more accurate answers to questions of tobacco tax policy in the country. This study endeavours to fill this gap in the literature on demand for tobacco products in Bangladesh.ObjectiveTo estimate the price elasticity of demand for tobacco products, namely cigarettes, biris and smokeless tobacco (SLT) products with the 2016 household income and expenditure survey data in Bangladesh.MethodsWe used the Deaton model (1997) to estimate the price elasticities of demand for tobacco products using the Household Income and Expenditure Survey (HIES) 2016 dataset of the Bangladesh Bureau of Statistics. The HIES 2016 surveyed 46 076 households spread over 2304 primary sampling units across the country. We have calculated own price elasticities of demand for tobacco products by expenditure groups and by regions (rural and urban).ResultsThe estimates of own-price elasticity of demand for cigarette, biri and SLT products are −1.03, −1.34 and −0.30, respectively. The results show that rural households are more responsive to changes in the prices of cigarettes than urban households. Households with low expenditure are found to be more responsive to changes in the price of cigarettes than the households with high expenditure. This suggests that increases in cigarette prices at the lower end would effectively reduce cigarette consumption among the people having low expenditure and improve health equity.ConclusionsOur results suggest that the demand for smoking tobacco products is responsive to price changes. Therefore, substantial increase in the prices of tobacco products through taxation will result in significant reduction in tobacco use, particularly among the low expenditure households, while increasing government revenue.

The carbon footprint of Brazilian households through the Consumer Expenditure Survey (POF)

The main objective of this article is to assess the carbon footprint of Brazilian families based on the Household Expenditure Survey (POF), 2008-2009, from the Brazilian Institute of Geography and Statistics (IBGE). The methodology used to quantify the Brazilian households’ carbon footprint has comprised three data sources: i) Household expenditure Survey, 2008-2009; ii) Leontief matrix of Brazilian accounts, year 2010; and iii) 2009 World Input-Output Database (WIOD) environmental inventory. Initially, an input-output (IO) model was created. Next, the results from the IO model were combined with the information of the POF. The poorest families, with a monthly income of up to $ 415.00, emit less than 1.5 metric tons per year, in contrast, the wealthiest families, with a monthly income above $ 5,187.50, release around 18.5 tons, almost 12 times more. It was found that an increase in income, results in an increase in CO2eq emissions. Thus, while the poorest families, which represent more than 20% of the total Brazilian families, cause 7% of the total emissions, the wealthiest families cause 16% of the total emissions although they represent only 4% of the total families. It was observed that the food category loses importance as income increases, while the opposite occurs in the services category. For the poorest families, there is great importance in the housing category, mostly caused by the consumption of electricity and LPG. Therefore, important measures for economic growth supported by actions become particularly relevant.

Health services utilization and out-of-pocket (OOP) expenditures in public and private facilities in Pakistan: an empirical analysis of the 2013–14 OOP health expenditure survey

Background As low- and middle-income countries progress toward Universal Health Coverage, there is an increasing focus on measuring out-of-pocket (OOP) expenditure and health services utilization within countries. While there have been several reforms to improve health services coverage and financial protection in Pakistan, there is limited empirical research comparing OOP expenditure and health services utilization between public and private facilities and exploring their determinants, a knowledge gap addressed in this study. Methods We used data from 2013 to 14 OOP Health Expenditure Survey, a population-based household survey carried out for Pakistan’s National Health Accounts. The analysis included 7969 encounters from 4293 households. We conducted bivariate analyses to describe patterns of care utilization, estimated annualized expenditures by type and sector of care, and assessed expenditure composition. We used multivariable logistic regression modeling to identify factors associated with sector of care and generalized linear model (GLM) with log link and gamma distribution to identify determinants of OOP expenditures stratified by type of care (inpatient and outpatient). Results Most encounters (82.5%) were in the private sector and were for outpatient visits (85%). Several public-private differences were observed in annualized expenditures and expenditure components. Logistic regression results indicate males, wealthier individuals, Punjab and Sindh residents, and those in smaller households were more likely to access private outpatient care. In the inpatient model, rural residents were more likely to use a private provider, while Khyber Pakhtunkhwa residents were less likely to use private care. GLM results indicate private sector inpatient expenditures were approximately PKR 6660 (USD 61.8) higher than public sector expenditures, but no public-private differences were observed for outpatient expenditures. Several demographic factors were significantly associated with outpatient and inpatient expenditures. Of note, expenditures increased with increasing wealth, decreased with increasing household size, and differed by province and region. Conclusions This is the first study comprehensively investigating how healthcare utilization and OOP expenditures vary by sector, type of care, and socio-economic characteristics in Pakistan. The findings are expected to be particularly useful for the next phase of social health protection programs and supply side reforms, as they highlight sub-populations with higher OOP and private sector utilization.

Health services utilization and out-of-pocket (OOP) expenditures in public and private facilities in Pakistan: An empirical analysis of the 2013-14 OOP Health Expenditure Survey

Background As low- and middle-income countries progress toward Universal Health Coverage, there is an increasing focus on measuring out-of-pocket (OOP) expenditure and health services utilization within countries. While there have been several reforms to improve health services coverage and financial protection in Pakistan, there is limited empirical research comparing OOP expenditure and health services utilization between public and private facilities and exploring their determinants, a knowledge gap addressed in this study. Methods We used data from 2013-14 OOP Health Expenditure Survey, a population-based household survey carried out for Pakistan’s National Health Accounts. The analysis included 7,969 encounters from 4,293 households. We conducted bivariate analyses to describe patterns of care utilization, estimated annualized expenditures by type and sector of care, and assessed expenditure composition. We used multivariable logistic regression modeling to identify factors associated with sector of care and generalized linear model (GLM) with log link and gamma distribution to identify determinants of OOP expenditures stratified by type of care (inpatient and outpatient). Results Most encounters (82.5%) were in the private sector and were for outpatient visits (85%). Several public-private differences were observed in annualized expenditures and expenditure components. Logistic regression results indicate males, wealthier individuals, Punjab and Sindh residents, and those in smaller households were more likely to access private outpatient care. In the inpatient model, rural residents were more likely to use a private provider, while Khyber Pakhtunkhwa residents were less likely to use private care. GLM results indicate private sector inpatient expenditures were approximately PKR 6,660 (USD 61.8) higher than public sector expenditures, but no public-private differences were observed for outpatient expenditures. Several demographic factors were significantly associated with outpatient and inpatient expenditures. Of note, expenditures increased with increasing wealth, decreased with increasing household size, and differed by province and region. Conclusions This is the first study comprehensively investigating how healthcare utilization and OOP expenditures vary by sector, type of care, and socio-economic characteristics in Pakistan. The findings are expected to be particularly useful for the next phase of social health protection programs and supply side reforms, as they highlight sub-populations with higher OOP and private sector utilization.