Nazim Habibov
University of Windsor, Social Work, Faculty Member
This study assesses informal payments (IPs) in 29 transitional countries using a fully comparable household survey. The countries of the former Soviet Union, especially those in the Caucasus and Central Asia, exhibit the highest scale of... more
This study assesses informal payments (IPs) in 29 transitional countries using a fully comparable household survey. The countries of the former Soviet Union, especially those in the Caucasus and Central Asia, exhibit the highest scale of IPs, followed by Southern Europe, and then Eastern Europe. The lowest and the highest scale of IPs were in Slovenia (2.7%) and Azerbaijan (73.9%) respectively. We found that being from a wealthier household, experiencing lower quality of healthcare in the form of long waiting times, lack of medicines, absence of personnel, and disrespectful treatment, and having relatives to help when needed, are associated with a higher odds ratio of IPs. Conversely, working for the government is associated with a lower odds ratio of IPs. Living in the countries of the former Soviet Union and in Mongolia is associated with the highest likelihood of IPs, and this is followed by the countries of the Southern Europe. In contrast, living in the countries of Eastern Europe is associated with the lowest likelihood of IPs.
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We used a high-quality cross-sectional data set that covers a diverse set of 29 transitional countries, to find the effect of education of probability of people being self-employed using standard probit models and instrumental variable... more
We used a high-quality cross-sectional data set that covers a diverse set of 29 transitional countries, to find the effect of education of probability of people being self-employed using standard probit models and instrumental variable biprobit that address endogeneity. Our findings suggest a negative effect of university education on the propensity of being self-employed. This finding remains the same for the single-stage model (i.e. standard probit) and the instrumental variable model (i.e. biprobit). We found strong endogeneity in the estimation of education effect on the propensity of being self-employed, ignoring which renders estimations biased. Regression models, which do not address endogeneity tend to underestimate the negative effect of the education on the probability of being self-employed in the countries of transition. Researchers should use alternative approaches to reduce endogeneity, such as instrumental variables and longitudinal analysis.
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Prior research on HIV infections in Tajikistan and other Central Asian countries has focused primarily on injection drug users. Given the recent rise of heterosexual transmission, especially among women, there is a need to assess... more
Prior research on HIV infections in Tajikistan and other Central Asian countries has focused primarily on injection drug users. Given the recent rise of heterosexual transmission, especially among women, there is a need to assess women's knowledge about HIV/AIDS and its methods of prevention and transmission across two time periods to examine cross-time changes and identify areas that need improvements. Logistic regression and simulation of predicted probability analyses were based on data from Tajik women ranging in age from 15 to 49 who participated in the Multiple Indicator Cluster Survey (MICS) study in 2000 and 2005. We found that an over 2-fold increase in general knowledge about HIV/AIDS was accompanied by a substantial decrease in the ability to identify correct methods of prevention and to reject myths regarding its transmission. These alarming findings should prompt policy makers and program implementers to shift the focus of programs from raising general awareness to ...
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ABSTRACT The purpose of this study is to measure and compare income inequality and its driving forces in the low-income countries of the Caucasus by drawing on micro-data from nationally representative household surveys in Armenia,... more
ABSTRACT The purpose of this study is to measure and compare income inequality and its driving forces in the low-income countries of the Caucasus by drawing on micro-data from nationally representative household surveys in Armenia, Georgia, and Azerbaijan. Inequality in the region of the Caucasus is very high. The Gini coefficient for the regions as a whole reached 55%. Azerbaijan has the lowest income inequality, followed by Armenia and Georgia. Among predictors, graduate and postgraduate education has the strongest positive effect on income in all countries. By contrast, the positive effect of technical vocational education is relatively smaller and can be observed only in Azerbaijan and Georgia. In addition to formal education, knowledge of English and computers also has a separate positive effect in all countries. An increase in age, and therefore an increase in years of experience, has a low positive impact on the increase in income in all countries. By contrast, being a female has the strongest negative effect on income across the region. Living in rural areas and reporting poor health is associated with having lower income.
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... Poverty and Inequality in Azerbaijan, a low-income country in transition NAZIM N. HABIBOV LIDA FAN ... Take-up Take-up of social assistance benefits can be analyzed from the perspectives of horizontal and vertical efficiency... more
... Poverty and Inequality in Azerbaijan, a low-income country in transition NAZIM N. HABIBOV LIDA FAN ... Take-up Take-up of social assistance benefits can be analyzed from the perspectives of horizontal and vertical efficiency (Atkinson, 1995; Beckerman, 1979). ...
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This study evaluates the effects of family planning message broadcast on radio and TV on the probability of modern contraception utilization in post-Soviet Central Asia. Viewing family planning messages on TV improves the chances of using... more
This study evaluates the effects of family planning message broadcast on radio and TV on the probability of modern contraception utilization in post-Soviet Central Asia. Viewing family planning messages on TV improves the chances of using modern contraception for a woman who actually saw the messages by about 11 and 8 per cent in Kyrgyzstan and Tajikistan, respectively. If every woman in Kyrgyzstan and Tajikistan had an opportunity to watch a family planning message on TV, then the likelihood of using modern contraception would have improved by 10 and 7 per cent in Kyrgyzstan and Tajikistan, respectively. By contrast, the effect of hearing family planning messages on radio is not significant in both countries. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. Viewing family planning messages on TV improves the chances of using modern contraception for a woman who actually saw the messages by about 11 and 8 per cent in Kyrgyzstan and Tajikistan, respectively. If every woman in Kyrgyzstan and Tajikistan had an opportunity to watch a family planning message on TV, then the probability of using modern contraception would have improved by 10 and 7 per cent in Kyrgyzstan and Tajikistan, respectively. Consequently, using TV family planning messages in both countries should be encouraged. In comparison, the effect of hearing family planning messages on radio is not significant in both countries. Copyright © 2015 John Wiley & Sons, Ltd.
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This study assesses the effects of maternal healthcare on child survival by using nonrandomized data from a cross-sectional survey in Azerbaijan. Using 2SLS and simultaneous equation bivariate probit models, we estimate the effects of... more
This study assesses the effects of maternal healthcare on child survival by using nonrandomized data from a cross-sectional survey in Azerbaijan. Using 2SLS and simultaneous equation bivariate probit models, we estimate the effects of delivering in healthcare facility on probability of child survival taking into account self-selection into the treatment. For women who delivered at healthcare facilities, the probability of child survival increases by approximately 18%. Furthermore, if every woman had the opportunity to deliver in healthcare facility, then the probability of child survival in Azerbaijan as a whole would have increased by approximately 16%.
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This study examined the prevalence and ecological correlates of intimate partner violence against women in Ukraine. A nationally representative sample of ever-married female respondents of the 2007 Ukraine Demographic Health Survey was... more
This study examined the prevalence and ecological correlates of intimate partner violence against women in Ukraine. A nationally representative sample of ever-married female respondents of the 2007 Ukraine Demographic Health Survey was used for this analysis. Findings suggest that although numerous ecological factors predict women's experiences of emotional, physical, and sexual intimate partner violence, two factors were common correlates of all three forms of violence: the frequent intoxication of women's partners and the exhibition of marital controlling behaviors by male perpetrators. Implications for the development of effective programming to prevent violence against Ukrainian women are provided.
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ABSTRACT We investigate population groups' attitude regarding inequality reduction in post-Soviet transitional countries of the Baltic, Central Asia and the Caucasus, as well as the Slavic countries and Moldova. Empirical evidence... more
ABSTRACT We investigate population groups' attitude regarding inequality reduction in post-Soviet transitional countries of the Baltic, Central Asia and the Caucasus, as well as the Slavic countries and Moldova. Empirical evidence presented in this article demonstrates that despite skyrocketing inequality, erosion of social provisions and efforts to introduce an individualistic market economy ideology during the last 15 years, overall support for redistribution and welfare state efforts to counterbalance rising inequality remained strongly legitimized among citizens in all post-Soviet countries. Nevertheless, there are differences between population groups in attitude: the older, the less educated, the poor and women express more support for redistribution; while the younger, the better educated, the rich and men tend to not support redistribution. Populations in transitional countries of the Caucasus and Central Asia that face higher inequality and less effective redistribution policies expressed a strong desire for more redistribution and more active social welfare policies.
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ABSTRACT The purpose of this paper is to assess changes of life-satisfaction and trust in transitional countries as well as their interaction resulting from the global economic and financial crisis of 2007, and its aftermath. For all... more
ABSTRACT The purpose of this paper is to assess changes of life-satisfaction and trust in transitional countries as well as their interaction resulting from the global economic and financial crisis of 2007, and its aftermath. For all indicators used, the level of life-satisfaction significantly decreased in transitional countries after the crisis. The smallest reduction can be observed in general life-satisfaction, while the reduction was larger for economic satisfaction and for confidence in better life of children. However, change in post-crisis trust experienced a mixed picture. Levels of institutional trust decreased after crisis, while the degree of interpersonal trust increased. Interpersonal trust continued to have a positive impact on life-satisfaction after the crisis, but the magnitude of its effect stagnated during the post-crisis period. Conversely, the significant magnitude of institutional trust effect grew after crisis for all types of indicators used. These findings suggest that both interpersonal and institutional trust, which are used here as indicators of social capital, are powerful resources that can directly improve life-satisfaction during transition. Most importantly, these resources can be employed to mitigate the outcomes of the crisis.
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ABSTRACT The purpose of this study is to measure and compare income inequality and its driving forces in the low-income countries of the Caucasus by drawing on micro-data from nationally representative household surveys in Armenia,... more
ABSTRACT The purpose of this study is to measure and compare income inequality and its driving forces in the low-income countries of the Caucasus by drawing on micro-data from nationally representative household surveys in Armenia, Georgia, and Azerbaijan. Inequality in the region of the Caucasus is very high. The Gini coefficient for the regions as a whole reached 55%. Azerbaijan has the lowest income inequality, followed by Armenia and Georgia. Among predictors, graduate and postgraduate education has the strongest positive effect on income in all countries. By contrast, the positive effect of technical vocational education is relatively smaller and can be observed only in Azerbaijan and Georgia. In addition to formal education, knowledge of English and computers also has a separate positive effect in all countries. An increase in age, and therefore an increase in years of experience, has a low positive impact on the increase in income in all countries. By contrast, being a female has the strongest negative effect on income across the region. Living in rural areas and reporting poor health is associated with having lower income.
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Die vorliegende Studie untersucht anhand einer nationalen repräsentativen Umfrage die Leistung des Sozialschutzes in Aserbaidschan unter dem Gesichtspunkt der Armutslinderung. Die vorgestellten empirischen Daten lassen vermuten, dass die... more
Die vorliegende Studie untersucht anhand einer nationalen repräsentativen Umfrage die Leistung des Sozialschutzes in Aserbaidschan unter dem Gesichtspunkt der Armutslinderung. Die vorgestellten empirischen Daten lassen vermuten, dass die ...
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Effect of corruption on healthcare satisfaction was assessed in transitional nations.The “grease in the wheels”, “cultural norm”, “sand in the wheels” hypotheses tested.Experiencing corruption significantly reduces healthcare... more
Effect of corruption on healthcare satisfaction was assessed in transitional nations.The “grease in the wheels”, “cultural norm”, “sand in the wheels” hypotheses tested.Experiencing corruption significantly reduces healthcare satisfaction.The “sand in the wheels” hypothesis was supported.There is the lack of consensus about the effect of corruption on healthcare satisfaction in transitional countries. Interpreting the burgeoning literature on this topic has proven difficult due to reverse causality and omitted variable bias. In this study, the effect of corruption on healthcare satisfaction is investigated in a set of 12 Post-Socialist countries using instrumental variable regression on the sample of 2010 Life in Transition survey (N = 8655). The results indicate that experiencing corruption significantly reduces healthcare satisfaction.
The purpose of this study is to provide policy implications by estimating the individual and community level determinants of preventive health-care utilization in China based upon data from the China Health and Nutrition Survey. Two... more
The purpose of this study is to provide policy implications by estimating the individual and community level determinants of preventive health-care utilization in China based upon data from the China Health and Nutrition Survey. Two different frameworks, a human capital model and a psychological-behavioral model, are tested using a multilevel logit estimation. The results demonstrate different patterns for medical and nonmedical preventive activities. There is a strong correlation between having medical insurance and utilizing preventive health services. For the usage of medical-related preventive health care (MP), age, gender, education, urban residence, and medical insurance are strong predictors. High income did not provide much of an increase in the usage level of MP, but the lack of income was a huge obstacle for low-income people to overcome. Community variation in number of facilities accounted for about one third of the total variation in the utilization of MP. The utilization of MP in China remains dependent upon the individual's social-economic conditions.The purpose of this study is to provide policy implications by estimating the individual and community level determinants of preventive health-care utilization in China based upon data from the China Health and Nutrition Survey. Two different frameworks, a human capital model and a psychological-behavioral model, are tested using a multilevel logit estimation. The results demonstrate different patterns for medical and nonmedical preventive activities. There is a strong correlation between having medical insurance and utilizing preventive health services. For the usage of medical-related preventive health care (MP), age, gender, education, urban residence, and medical insurance are strong predictors. High income did not provide much of an increase in the usage level of MP, but the lack of income was a huge obstacle for low-income people to overcome. Community variation in number of facilities accounted for about one third of the total variation in the utilization of MP. The utilization of MP in China remains dependent upon the individual's social-economic conditions.
ABSTRACT Parent–child interaction is important for early childhood development and best practice in early child care and education (ECCE) promotes effective parent–child interaction. However, research about ECCE impact on parent–child... more
ABSTRACT Parent–child interaction is important for early childhood development and best practice in early child care and education (ECCE) promotes effective parent–child interaction. However, research about ECCE impact on parent–child interaction is inconclusive. This study analyzed data from Multiple Indicator Cluster Surveys (MICS) to examine the effect of ECCE attendance on parent–child interactions in Central Asia, using a 2SLS regression analysis to explicitly model selection bias and isolate the causal effect of ECCE on the quality of parent–child interactions.The study found that increased hours of ECCE led to increased parent–child interaction in every country under investigation. This demonstrates that even underfunded ECCE programs in Central Asia can have significant positive effect, and has broader implications for all ECCE programs.
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The current literature lacks a solid assessment of inequality in the transitional countries of the former Soviet Union during the transition from a centrally planned to a market economy. Against this background, the objective of this... more
The current literature lacks a solid assessment of inequality in the transitional countries of the former Soviet Union during the transition from a centrally planned to a market economy. Against this background, the objective of this study is to provide an initial assessment of the intertemporal evolution of inequality in Azerbaijan. Drawing on microdata from two nationally representative surveys, this
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Azerbaijan is a country with one of the highest child mortality rates in the regions of Eastern Europe and the former Soviet Union. Drawing on the nationally representative Demographic and Health Survey, this study examines the... more
Azerbaijan is a country with one of the highest child mortality rates in the regions of Eastern Europe and the former Soviet Union. Drawing on the nationally representative Demographic and Health Survey, this study examines the utilization of antenatal care in Azerbaijan to identify the socio-economic determinants of the usage, and its frequency, timing and quality. Consequently, binomial logit, two ordered logit and negative binomial regression models are specified to estimate the effect of various socio-economic characteristics on the likelihood of utilization. Place of living is an important determinant of antenatal healthcare utilization in Azerbaijan. It is important in determining the likelihood of utilization, its timing and quality of care received, whereas it is not significant in the model predicting the frequency of antenatal utilization. Women's education is also significant in three models out of four. Education is important in explaining the frequency and timing of utilization as well as the quality of services received, but it is not significant in predicting the likelihood of utilization. Wealth gradient is another important determinant of antenatal care utilization in Azerbaijan inasmuch as it is significant in explaining the likelihood of prenatal care utilization and its frequency. In addition, two variables, birth order and desirability of the last child or current pregnancy, are significant only in explaining the likelihood of utilization. Therefore, we confirm the findings of previous studies, which reported that the utilization of prenatal health care is a multistage process in which decisions are sequential. Although the same set of factors may affect decision-making at all stages, the effect of these factors is different at different stages. Implications for reforms in the healthcare sector to improve antenatal care utilization in Azerbaijan are provided and discussed.
Research Interests: Program Evaluation, Law, Primary Health Care, Behavior, Developing Countries, and 19 morePopulation Dynamics, Health, Health Policy, Adolescent, Social Class, Applied Economics, Azerbaijan, Health Care reform, Pregnancy, Population, Humans, Female, Young Adult, Technical Report, Middle Aged, Public Administration and Policy, Adult, Antenatal Care, and Prenatal Care
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Drawing on a set of recent nationally-representative surveys, this study examines Early Childhood Care and Education attendance in Central Asia. Between 12% and 22% of children attended ECCE, while the number of attendance hours was... more
Drawing on a set of recent nationally-representative surveys, this study examines Early Childhood Care and Education attendance in Central Asia. Between 12% and 22% of children attended ECCE, while the number of attendance hours was irregular and varied greatly. Having a mother with lower education and being from a poorer household reduced the likelihood of attendance in all countries. Living
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Based on two household surveys, this article investigates the over-time evolution of the determinants of living standards in Azerbaijan during the transition from a centrally planned economy to a market economy. Quintile regression is... more
Based on two household surveys, this article investigates the over-time evolution of the determinants of living standards in Azerbaijan during the transition from a centrally planned economy to a market economy. Quintile regression is used to estimate the relative importance of inter-temporal changes in individual, household, and environmental factors to household expenditures from 1995 to 2002. Results highlight systematic differences
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Using micro-data from two nationally representative surveys, we quantify and explain intertemporal evolution in inequality reduction effectiveness of income security programmes in Canada caused by change from a mixed to a neo-liberal... more
Using micro-data from two nationally representative surveys, we quantify and explain intertemporal evolution in inequality reduction effectiveness of income security programmes in Canada caused by change from a mixed to a neo-liberal welfare regime. The presented empirical evidence shows that the overall inequality reduction effectiveness of income security declined significantly as a result of regime change. The new neo-liberal welfare
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Purpose – Against a background of rising inequalities in transitional countries, the purpose of this study is to focus on the analysis of the self-perceived social stratification in the low-income countries of the South Caucasus.... more
Purpose – Against a background of rising inequalities in transitional countries, the purpose of this study is to focus on the analysis of the self-perceived social stratification in the low-income countries of the South Caucasus. Design/methodology/approach – Using data from the recent multi-country comparative survey conducted in Armenia, Azerbaijan and Georgia, this study examines the factors explaining self-perceived stratification in
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The objective of this study is to analyze the effect of social capital on self-rated health in transitional countries of the South Caucasus region. The study is based on recent, 2009, cross-sectional nationally-representative surveys of... more
The objective of this study is to analyze the effect of social capital on self-rated health in transitional countries of the South Caucasus region. The study is based on recent, 2009, cross-sectional nationally-representative surveys of 2082 respondents in Armenia, 2014 in Azerbaijan, and 1837 in Georgia with response rate of 78-80%. Two-level random-coefficient ordered logistic regression, modeling individual and community variations in subjective health was estimated to account for the hierarchical structure of the data set which includes individuals nested within communities. The results allow several interesting conclusions to be drawn. First, a proportion of the total variation in self-rated health explained at the community level is 0.23 for Azerbaijan, 0.10 for Georgia, and 0.08 for Armenia. These findings highlight the importance of more decentralized community-based healthcare interventions in the region. Second, human capital covariates remained significant predictors of health status even after controlling for social capital both at individual and community levels. Likewise, social capital variables are significant predictors of health status when used alone and when they are controlled by human capital covariates. These findings suggest that human capital and social capital influence health status independently of each other. Finally, this study sheds light on whether social capital collectively benefits members of a community in transitional countries beyond the individual benefits. In Armenia and Azerbaijan, community level differences in health status are rooted in "compositional" differences between social capital of individuals in the communities rather than at the community "contextual" level. In Georgia, by contrast, the beneficial effect of social capital can be simultaneously observed at the individual "compositional", and community "contextual" levels. These findings suggest that neither "compositional" nor "contextual" models of the social capital effect of health status can apply to all transitional societies universally.
Research Interests: Sociology, Medical Sociology, Anthropology, Trust, Community-Based Mental Health Services, and 27 moreHealth Care, Politics, Social Capital, Social Support, Human Capital, Health Policy, Azerbaijan, Armenia, Social Science & Medicine, Humans, Female, Male, Health Status, Aged, Middle Aged, Transition Countries, Adult, Cross Section, Public health systems and services research, Multilevel Analysis, Logistic Regression Model, Self report, Cross Sectional Studies, Random Coefficients, Self Rated Health, Total Variation, and Socioeconomic Factors
The current literature lacks a solid assessment of inequality in the transitional countries of the former Soviet Union during the transition from a centrally planned to a market economy. Against this background, the objective of this... more
The current literature lacks a solid assessment of inequality in the transitional countries of the former Soviet Union during the transition from a centrally planned to a market economy. Against this background, the objective of this study is to provide an initial assessment of the intertemporal evolution of inequality in Azerbaijan. Drawing on microdata from two nationally representative surveys, this
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Drawing on two nationally representative household surveys, this paper investigates changes in poverty reduction effectiveness of social programs in Canada caused by dismantling the mixed welfare regime in favor of a liberal welfare... more
Drawing on two nationally representative household surveys, this paper investigates changes in poverty reduction effectiveness of social programs in Canada caused by dismantling the mixed welfare regime in favor of a liberal welfare regime. We measure and explain how the social security system affects poverty before and after regime changes and what types of social security programs become more effective in poverty reduction. The paper shows that, as a result of regime change, overall poverty reduction of social security declined. However, the decline was fairly modest considering the magnitude of the reforms. Favorable economic conditions played an important role in mitigating negative consequences of the reforms.
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... While acknowledg-ing that more research is necessary, Albert and Caitlin (2002) concluded in their study on the 48 contiguous states that their ... applicant may be entitled to, and the real value of benefits declined over time... more
... While acknowledg-ing that more research is necessary, Albert and Caitlin (2002) concluded in their study on the 48 contiguous states that their ... applicant may be entitled to, and the real value of benefits declined over time (Habibov & Fan, 2007; Hick, 2007; McMullin & Tomchick ...
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The purpose of this paper is to quantify the impact of socio-economic characteristics on out-of pocket expenditures for prescribed medications in Tajikistan and provide recommendations for healthcare sector reform. The research question... more
The purpose of this paper is to quantify the impact of socio-economic characteristics on out-of pocket expenditures for prescribed medications in Tajikistan and provide recommendations for healthcare sector reform. The research question in this paper is: what household, personal, economic, and health factors help explain expenditures on medications? From a theoretical perspective, this paper contributes to the on-going discussion of out-of-pocket expenditures in Tajikistan. From a practical perspective, in line with this recent development in the Tajikistan healthcare sector, it helps to develop evidence-based decision-making by answering practical questions: what factors affect pattern of out-of-pocket expenditures for prescribed medication? Which groups of the population should be granted a discount or fee-waiver when buying them? Based on micro-file data from the most recent cross-sectional nationally-representative survey of Tajik households, this paper develops and tests a multivariate model of identifying determinants of out-of-pocket expenditures on prescribed medications in Tajikistan. The paper finds that economic status, chronic illness, disability, number of small children, short supply of necessary drugs, and cardiac and acute illnesses are the strongest determinants of spending for prescribed medications in the country. This paper demonstrates that to ensure accessibility to and affordability of prescribed medications, discounts or fee-waivers should be granted to specific categories of households, those in poverty, with chronically ill members and with small children. These discounts or fee-waivers should cover prescribed medications for children, long-standing illness as well as for cardiac and acute infectious diseases. Administrative and economic measures should be taken to reduce the extra costs incurred due to the shortage of prescribed medications. Hence, these findings can be used in developing and designing reforms in the Tajikistan healthcare sector.
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Drawing on the comparative household surveys, this article examines subjective wellbeing in Armenia, Azerbaijan and Georgia, three low-income transitional countries located on the Caucasus. We found that economic factors explain a... more
Drawing on the comparative household surveys, this article examines subjective wellbeing in Armenia, Azerbaijan and Georgia, three low-income transitional countries located on the Caucasus. We found that economic factors explain a considerable part of the variation in subjective wellbeing. The results are significant and robust across all countries. Having a higher level of household income, university education and a larger number of people in household along with salary as a major income source positively affect subjective wellbeing. On the contrary, being unemployed or a migrant along with having social transfers as a major source of income negatively affect subjective wellbeing. Besides, subjective wellbeing is strongly associated with disagreement with the current direction of countries' development and withdrawal from discussing policy. We argue that analysis of subjective wellbeing can be used to enrich and validate the process of poverty analysis in the countries of the region.
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Purpose – Low-income transitional countries in the region of the Caucasus and Central Asia lack the existence of a solid assessment of public perceptions regarding the causes of poverty during transition. The purpose of this paper is to... more
Purpose – Low-income transitional countries in the region of the Caucasus and Central Asia lack the existence of a solid assessment of public perceptions regarding the causes of poverty during transition. The purpose of this paper is to fill that gap in the existing literature. Design/methodology/approach – This paper uses the secondary analysis of a recent cross-sectional multinational survey to
Research Interests: Sociology, Poverty, Urban And Regional Planning, Social Welfare, Public Perception, and 11 moreConceptual Framework, Design Methodology, Urban Sociology and Social Policy, Public Administration and Policy, Transition Countries, Multinomial logit models, Cross Section, Regression Model, Theoretical Framework, Unified Model, and Low Income
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The government of Tajikistan is currently exploring the ways to test the possible introduction of a Basic Benefit Package which is to provide healthcare for the most vulnerable groups within the population. In this context, the objective... more
The government of Tajikistan is currently exploring the ways to test the possible introduction of a Basic Benefit Package which is to provide healthcare for the most vulnerable groups within the population. In this context, the objective of this study is to analyze individual, household, geographical and systemic factors which explain healthcare utilization and out-of-pocket expenditures in Tajikistan. Using a nationally-representative survey, the author examines the determinants of healthcare utilization and its related out-of-pocket expenditures. Two empirical multivariate models are employed: binomial logit regression to estimate the determinants of healthcare utilization and Tobit regression to estimate the determinants of out-of-pocket expenditures. An increase in the ability to pay is associated with a higher propensity to utilize healthcare. Likewise, being a woman, being elderly, having higher educational attainment and having chronic illness also increase the propensity to utilize healthcare. Conversely, needing to travel a long distance to health post reduces the likelihood of utilization. An increase in ability to pay, being female and using specialized healthcare facilities increases the amount of out-of-pocket expenditures. In contrast, using ancillary healthcare personnel and outpatient facilities reduced the amount of out-of-pocket expenditures. Linking receipt of the package with targeted social assistance and development of Community Based social insurance scheme can improve accessibility and affordability of healthcare.
Research Interests: Higher Education, Poverty, Social Insurance, Public Health, Health Policy, and 23 moreChronic illness, Tajikistan, Multivariate Analysis, Travel, Health Care reform, Humans, Social Assistance, Health Services, Inequality, Chronic Disease, Female, Male, Vulnerable Populations, Health Expenditures, Public health systems and services research, Sex Factors, Time Factors, Age Factors, Out - Of- Pocket Payments, Cross Sectional Studies, Public Assistance, Long Distance, and Socioeconomic Factors
Out-of-pocket expenditures (OPE) for healthcare are a widespread and enduring phenomenon in post-communist countries. However, evidence regarding their effect on health equity is limited, especially in the low-income countries of Central... more
Out-of-pocket expenditures (OPE) for healthcare are a widespread and enduring phenomenon in post-communist countries. However, evidence regarding their effect on health equity is limited, especially in the low-income countries of Central Asia. With this in mind, the current paper presents the results of an analysis of the impact of OPE on equity in Tajikistan, one of the poorest transitional countries. Utilizing a sample from a nationally representative household survey, this paper presents a systematic examination of the effect of OPE on equity using concentration curve, quintile analysis and concentration indices. The impact was disaggregated by inpatient and outpatient services, and medication purchase. Further disaggregation was performed according to spatial dimensions, by types of providers, condition or disease, by place of medication purchase, and by type of facility and treatment received. Overall, OPE in Tajikistan are equally distributed across the population, with the poorest and the wealthiest, in most cases, bearing a similar level of burden. However, the poor bear the heaviest burden in terms of expenditures for medication and other supplies in inpatient services. There is considerable spatial variation in the expenditures burden, with regional variation being more substantial than rural-urban variation. More importantly, the poor experience a larger proportion of burden with regard to expenditures in vital areas such as those of infectious diseases and maternal health. While current economic constraints and the ongoing health sector reform in Tajikistan promote OPE for healthcare utilization, the lack of financial protection against the risk of these conditions should be of major concern to policy-makers. In particular, the problems of OPE, which have been found to place a higher burden on the poor, should be taken into consideration during healthcare reform in Tajikistan.