title: Treatment seeking and health financing in selected poor urban neighbourhoods in India, Indonesia and Thailand.
abstract: This article presents a comparative analysis of socio-economic disparities in relation to treatment-seeking strategies and healthcare expenditures in poor neighbourhoods within larger health systems in four cities in India, Indonesia and Thailand. About 200 households in New Delhi, Bhubaneswar, Jogjakarta and Phitsanulok were repeatedly interviewed over 12 months to relate health problems with health seeking and health financing at household level. Quantitative data were complemented with ethnographic studies involving the same neighbourhoods and a number of private practitioners at each site. Within each site, the higher and lower income groups among the poor were compared. The lower income group was more likely than the higher income group to seek care from less qualified health providers and incur catastrophic health spending. The study recommends linking quality control mechanisms with universal health coverage (UHC) policies; to monitor the impact of UHC among the poorest; intervention research to reach the poorest with UHC; and inclusion of private providers without formal medical qualification in basic healthcare.
authors.affiliation: Department of Culture and Society, Aarhus University, Moesgaard, DK-8270 Hoejbjerg, Denmark. Electronic address: jseeberg@hum.au.dk.
authors.forename: Jens
authors.initials: J
authors.lastname: Seeberg
authors.affiliation: Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Thailand.
authors.forename: Supasit
authors.initials: S
authors.lastname: Pannarunothai
authors.affiliation: Faculty of Medicine, Gadjah Mada University, Indonesia.
authors.forename: Retna Siwi
authors.initials: RS
authors.lastname: Padmawati
authors.affiliation: Faculty of Medicine, Gadjah Mada University, Indonesia.
authors.forename: Laksono
authors.initials: L
authors.lastname: Trisnantoro
authors.affiliation: Department for International Development (DFID), British High Commission, India(1).
authors.forename: Nupur
authors.initials: N
authors.lastname: Barua
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, India.
authors.forename: Chandrakant S
authors.initials: CS
authors.lastname: Pandav
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002947:Cities / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007194:India; D007214:Indonesia; D007223:Infant; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011204:Poverty Areas; D036301:Qualitative Research; D013785:Thailand; D019472:Universal Health Insurance; D055815:Young Adult
keywords: Health finance; Health seeking; India; Indonesia; Inequity; Poor urban neighbourhoods; Thailand; Universal health coverage