Alejandro N. Herrin

Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data.

BACKGROUND Conventional estimates of poverty do not take account of out-of-pocket payments to finance health care. We aimed to reassess measures of poverty in 11 low-to-middle income countries in Asia by calculating total household resources both with and without out-of-pocket payments for health care. METHODS We obtained data on payments for health care from nationally representative surveys, and subtracted these payments from total household resources. We then calculated the number of individuals with less than the internationally accepted threshold of absolute poverty (US1 dollar per head per day) after making health payments. We also assessed the effect of health-care payments on the poverty gap--the amount by which household resources fell short of the 1 dollar poverty line in these countries. FINDINGS Our estimate of the overall prevalence of absolute poverty in these countries was 14% higher than conventional estimates that do not take account of out-of-pocket payments for health care. We calculated that an additional 2.7% of the population under study (78 million people) ended up with less than 1 dollar per day after they had paid for health care. In Bangladesh, China, India, Nepal, and Vietnam, where more than 60% of health-care costs are paid out-of-pocket by households, our estimates of poverty were much higher than conventional figures, ranging from an additional 1.2% of the population in Vietnam to 3.8% in Bangladesh. INTERPRETATION Out-of-pocket health payments exacerbate poverty. Policies to reduce the number of Asians living on less than 1 dollar per day need to include measures to reduce such payments.

Who pays for health care in Asia

We estimate the distributional incidence of health care financing in 13 Asian territories that account for 55% of the Asian population. In all territories, higher-income households contribute more to the financing of health care. The better-off contribute more as a proportion of ability to pay in most low- and lower-middle-income territories. Health care financing is slightly regressive in three high-income economies with universal social insurance. Direct taxation is the most progressive source of finance and is most so in poorer economies. In universal systems, social insurance is proportional to regressive. In high-income economies, the out-of-pocket (OOP) payments are proportional or regressive while in low-income economies the better-off spend relatively more OOP. But in most low-/middle-income countries, the better-off not only pay more, they also get more health care.

Children's education in the Phillipines: Does high fertility matter?

This paper examines the effects of family size and sibling position on childrens current school enrollment status in the Philippines. The theoretical framework focuses on the determinants of childrens participation in alternative activities, specifically schooling, market work, and home production. This approach allows for a greater understanding of the mechanisms through which fertility, as reflected by number of siblings and sibling composition, influences childrens education than would examining the determinants of schooling alone. The model is estimated using the 1983 wave of the Bicol Multipurpose Survey. The results indicate the existence of negative effects of fertility on school enrollment, which, in part, operate through work status. In addition, these effects differ according to the sibling position of the child.

Factors Influencing the Choice of Location: Local and Foreign Firms in the Philippines

HERRIN A. N. and PERNIA E. M. (1987) Factors influencing the choice of location: local and foreign firms in the Philippines, Reg. Studies 21, 531–541. The paper addresses the following questions. Is the locational behaviour of foreign firms systematically different from that of local enterprises? What are the more important determinants of industrial location, in general, and by specific types of firms? How effective are direct government influences in the choice of location? This analysis is based on data from a survey of 100 firms drawn from the top 1,000 corporations in the Philippines. The overall finding is that out of thirty-four factors that are commonly thought to influence location decision, only seven are considered as crucial. These determinants can be distilled into four, namely, access and transport, power, information and communication, and physical plant requirements. On the whole, they apply more or less equally to local and foreign firms, implying that there is little difference in their ...

Household health care facility utilization in the Philippines.

This paper presents probit estimates of household utilization of health care facilities in the Philippines. Using household data from the 1987 National Health Survey and supply data from the Department of Health, separate probit equations are estimated for each of the four major types of facilities in the Philippines: Public hospitals, private hospitals, major rural health units and barangay (village) health stations. The probability that a household will utilize services from these facilities is estimated as a function of socioeconomic, demographic and supply variables. The results indicate substantial differences in utilization patterns by income class. Households in the highest income quartile are approximately twice as likely (0.451 versus 0.236) to utilize private hospital services vis-à-vis households in the lowest income quartile, ceteris paribus. The results also indicate substantial substitution between public and private. services. An increase in the availability of private hospital beds significantly reduces the probability that a household will utilize government facilities.

Integrating population and development planning.

This paper examines the integration of population and development planning by the Association of South East Asian Nations (ASEAN) Population Program. Integration refers to consideration of socioeconomic and demographic interrealationships in the formulation of development policies. Goals expressed often include sustained economic growth total human development (education employment health) and equitable distribution of the fruits of development. Population goals and policies are integral parts of social economic and cultural development aimed at improving standards of living. Since 1976 19 projects have been implemented by the ASEAN Population Program encompassing the areas of human resource development information and communication and research and policy studies. Goals of such programs include increasing agricultural production providing income-producing activities for women and increasing effective implementation of family planning policies.