Do efficiency and equity move together? Cross-dynamics of Health System performance and Universal Health Coverage

Pavitra Paul, Ulrich Nguemdjo, Armel Ngami, Natalia Kovtun and Bruno Ventelou ()
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Ulrich Nguemdjo: AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique
Armel Ngami: AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique
Natalia Kovtun: Taras Shevchenko National University of Kyiv
Bruno Ventelou: AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique

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Abstract: Efficiency within the health system is well recognised as key for achieving Universal Health Coverage (UHC). However, achieving equity and efficiency simultaneously is often seen as a conflicting effort. Using 12 years of data (2003–2014) from the selection of a number of low- and lower middle-income countries (Afghanistan, Bangladesh, Burkina Faso, Ghana, Indonesia, Mongolia, Mozambique, Tajikistan, Togo, Uzbekistan and Yemen Republic), we compute an index of Universal health coverage (UHC), measure the health system's performance (HSp) and, finally, investigate the cross-dynamics of the resulting HSp and the UHC previously obtained. We find that, with the few exceptions over the statistical sample, the causality between performances of the national health system and the universal health coverage is typically bidirectional. From an empirical standpoint, our findings challenge the idea from economic orthodoxy that efficiency must precede equity in healthcare services. Rather, our findings support the view of simultaneous efforts to improve expansion of the coverage and efficiency of the health system, directing attention towards the importance of organisation of the health system in the country context.

Date: 2022-12
New Economics Papers: this item is included in nep-eff, nep-hea and nep-sea
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Published in Humanities and Social Sciences Communications, 2022, 9 (1), pp.293. ⟨10.1057/s41599-022-01271-9⟩

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Journal Article: Do efficiency and equity move together? Cross-dynamics of Health System performance and Universal Health Coverage (2022)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03997298

DOI: 10.1057/s41599-022-01271-9

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