4211.0: Tuesday, October 23, 2001 - 3:06 PM

Abstract #31384

Multi-center project on equity in health, access and utilization of health services

J. Norberto W. Dachs, Program of Public Policy and Health, P.A.H.O., Pan American Health Organization, 525, 23rd Street, N.W., Washington, DC 20037, (202)974-3228, dachsnor@paho.org

The work was developed in five countries with the same protocol and the utilization of the same types of methodology. It combines analyses of data at the individual and household level from two types of household surveys (LSMS and DHS) as well as context variables created from census data, in five countries, to: - Describe inequalities in health status, access and utilization of health services using economic conditions of the households as distributive variable. - Fit explanatory models for mortality of children below age five, using a hierarchical approach. Both logistic regression and survival models (Weibull) are used. - Fit explanatory models for stunting from 6 to 59 months of age using linear regression and multi-level models. The context variables used - at the municipal level - were proportion of population with unmet basic needs (to capture social inequalities) and proportion of households with children whose head is a woman (to capture gender related conditions). The inequalities vary substantially from one country to another both in their size and some of their main determinations but in all cases the context variables are relevant in explaining inequalities in child mortality and stunting, with important interactions of the context variables with the individual and household determinants. The findings are particularly relevant for policy since they demonstrate that interventions should be designed and implemented considering not only the determinations at the individual and household levels, but also the social context at the municipal level.

Learning Objectives: Participants will be able to identify the main determinants of inequalities in health in five Latin American countries, as well as the important relationships of these with the social context.

Keywords: International Public Health, Latin American

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA