Khouloud Khemiri
Despite the latest wave of Tunisia’s healthcare financing
reform initiated in 2007 has achieved unprecedented
progress, little is known for specific vulnerable women
groups’ catastrophic health expenditure (CHE) determinants
in urban and rural areas of Tunisia. This study
aims to estimate the trend of the economic and access
incidence factors and inequality of CHE between rural
and urban women, Tunisia in 2010.
Materials and methods
Using on the Tunisia - National Survey on Household
Budget, Consumption and Standard of Living for 2005
and 2010 which was conducted by the Tunisian institute
for Statistics, we employ the Simultaneous Logistic Model
to determine CHE determinants between the rural
and urban women in Tunisia using 40% of a household’s
capacity to pay (nonfood expenditures). Concentration
index and its decomposition were employed to measure
the income-related inequality of CHE.
Results
We find that CHE occurred in 12.80% of the women
in rural areas against 8.22% in the urban areas. Furthermore,
there were strong pro-poor inequalities in CHE
in the rural women (−0.279 and −0.283). The majority of
observed inequalities in CHE could be associated with
household economic status, access factors and having elderly
members.
Conclusion
Despite the 2007 financing reform, we find a sharp increase
of CHE occurrence and the sustained strong propoor
inequalities among the rural and urban Tunisian
women but with a high intensity in the rural areas. Our
study suggests that more concerns are needed for the vulnerable
especially the women situation