Abu-Zaineh

Publications

Wealth, Health, and the Measurement of Multidimensional Inequality: Evidence from the Middle East and North AfricaBook chapterMohammad Abu-Zaineh et Ramses H. Abul Naga, In: Health and Inequality, Pedro Rosa Dias et Owen O’Donnell (Eds.), 2013-12, Volume 21, Number 21, pp. 421-439, Emerald Group Publishing Limited, 2013

Recent decades have witnessed a rising interest in the measurement of inequality from a multidimensional perspective. This literature has however remained largely theoretical. This chapter presents an empirical application of a recent methodology and in doing so offers practical insights on how multidimensional inequality can be measured over two attributes (wealth and health) in the developing country context. Following Abul Naga and Geoffard (2006), a methodological framework allowing the decomposition of multidimensional inequality into two univariate Atkinson–Kolm–Sen equality indices and a third term measuring the association between the attributes is implemented. The methodology is then illustrated using data from the World Health Surveys 2002–2003. Specifically, this study presents the first comparative analysis on multidimensional inequality for a set of Middle East and North African (MENA) countries. Results reveal that the multidimensional (in-)equality indices tend to mimic the (in-)equality ordering of the wealth distributions as the latter are always less equally distributed than health. An empirical conclusion that emerges is that reducing the correlation between the attributes may help to reduce overall welfare inequality, specifically when socioeconomic inequality in health is pro-poor. The finding that the correlation between attributes has a significant contribution in the quantification of inequality has important policy implications since it reveals that it is not only wealth and health inequalities per se that matter in the measurement of welfare inequality but also the associations between them.

Measuring and decomposing socioeconomic inequality in healthcare delivery: A microsimulation approach with application to the Palestinian conflict-affected fragile settingJournal articleMohammad Abu-Zaineh, Awad Mataria, Jean-Paul Moatti et Bruno Ventelou, Social Science & Medicine, Volume 72, Issue 2, pp. 133-141, 2011

Socioeconomic-related inequalities in healthcare delivery have been extensively studied in developed countries, using standard linear models of decomposition. This paper seeks to assess equity in healthcare delivery in the particular context of the occupied Palestinian territory: the West Bank and the Gaza Strip, using a new method of decomposition based on microsimulations. Besides avoiding the 'unavoidable price' of linearity restriction that is imposed by the standard methods of decomposition, the microsimulation-based decomposition enables to circumvent the potentially contentious role of heterogeneity in behaviours and to better disentangle the various sources driving inequality in healthcare utilisation. Results suggest that the worse-off do have a disproportinately greater need for all levels of care. However with the exception of primary-level, utilisation of all levels of care appears to be significantly higher for the better-off. The microsimulation method has made it possible to identify the contributions of factors driving such pro-rich patterns. While much of the inequality in utilisation appears to be caused by the prevailing socioeconomic inequalities, detailed analysis attributes a non-trivial part (circa 30% of inequalities) to heterogeneity in healthcare-seeking behaviours across socioeconomic groups of the population. Several policy recommendations for improving equity in healthcare delivery in the occupied Palestinian territory are proposed.

Density of dental practitioners and access to dental care for the elderly: a multilevel analysis with a view on socio-economic inequality.Journal articleLaurence Lupi-Pégurier, Isabelle Clerc-Urmes, Mohammad Abu-Zaineh, Alain Paraponaris et Bruno Ventelou, Health Policy, Volume 103, Issue 2-3, pp. 160-167, 2011

To examine the relations between density of dental practitioners (DDP) and socio-economic and demographic factors shown to affect access to dental care for the elderly.

Does HIV services decentralization protect against the risk of catastrophic health expenditures?: some lessons from Cameroon.Journal articleSylvie Boyer, Mohammad Abu-Zaineh, Jérôme Blanche, Sandrine Loubiere, Cécile-Renée Bonono, Jean-Paul Moatti et Bruno Ventelou, Health services research, Volume 46, Issue 6pt2, pp. 2029-2056, 2011

OBJECTIVE: Scaling up antiretroviral treatment (ART) through decentralization of HIV care is increasingly recommended as a strategy toward ensuring equitable access to treatment. However, there have been hitherto few attempts to empirically examine the performance of this policy, and particularly its role in protecting against the risk of catastrophic health expenditures (CHE). This article therefore seeks to assess whether HIV care decentralization has a protective effect against the risk of CHE associated with HIV infection. DATA SOURCE AND STUDY DESIGN: We use primary data from the cross-sectional EVAL-ANRS

Individual and Structural Factors Associated With HIV Status Disclosure to Main Partner in Cameroon: ANRS 12-116 EVAL Survey, 2006-2007Journal articleMarie Suzan-Monti, Jérôme Blanche, Paule Bilé, Sinata Koulla-Shiro, Mohammad Abu-Zaineh, Fabienne Marcellin, Sylvie Boyer, Maria Patrizia Carrieri et Bruno Spire, JAIDS Journal of Acquired Immune Deficiency Syndromes, Volume 57, Issue Suppl. 1, pp. s22-s26, 2011

Encouraging HIV-positive people to disclose their serostatus to their main partner is considered as a key component of secondary prevention. The purpose of this study was to identify individual and structural factors associated with HIV serostatus disclosure to one's steady partner in Cameroon, a...

Assessing the causes of inequality in health care in PalestineBook chapterMohammad Abu-Zaineh et Awad Mataria, In: The Palestinian Economy: Theoretical and Practical Challenges, V. Gianni, M. Missaglia et F. Kattan (Eds.), 2010-01, Volume II, pp. 341-394, Pavia University Press, 2010
Catastrophic healthcare payments and impoverishment in the occupied Palestinian territoryJournal articleAwad Mataria, Firas Raad, Mohammad Abu-Zaineh et Cam Donaldson, Applied Health Economics and Health Policy, Volume 8, Issue 6, pp. 393-405, 2010

The inability of the Palestinian healthcare system to protect against the financial risks of ill health could be attributed to the prevailing sociopolitical conditions of the occupied Palestinian territory, and to some intrinsic system characteristics. It is recommended that pro-poor financing schemes be pursued to mitigate the negative impact of the recurrent health shocks affecting Palestinian households. Copyright Adis Data Information BV 2010

Equity in health care finance in Palestine: The triple effects revealedJournal articleMohammad Abu-Zaineh, Awad Mataria, Stéphane Luchini et Jean-Paul Moatti, Journal of Health Economics, Volume 28, Issue 6, pp. 1071-1080, 2009

This paper presents an application of the Urban and Lambert"upgraded-AJL Decomposition" approach that was designed to deal with the problem of close-income equals in equity analysis, and as applied to the area of health care finance. Contrary to most previous studies, vertical and horizontal inequities and the triple effects of inter-groups, intra-group and entire-group reranking of various financing schemes are estimated, with statistical significance calculated using the bootstrap method. Application is made on the three financing schemes present in the case of the Occupied Palestinian Territory. Results demonstrate the relative importance of the three forms of reranking in determining overall inequality. The paper offers policy recommendations to limit the existing inequalities in the system and to enhance the capacity of the governmental insurance scheme.

Contribution to the analysis of health equity: measurement and explanation of inequality and inequity in the health care sector in the context of developing countries: the palestinian caseBookMohammad Abu-Zaineh, 2009-10, 196 pages, VDM Verlag, 2009

"This is an exemplary PhD thesis. It shows the PhD candidate's thorough thinking and econometric skills, together with a sense of policy-related research work still ahead. Policy-wise, the thesis is bound to be influential in discussions about the future design of social health protection in the Occupied Palestinian Territories (OPT). Also, by putting a quote by John Rawls at the beginning of the thesis, Mr Abu-Zaineh lets us understand how challenging it is to the economics discipline to tackle the overall issue of equity". Professor Guy Carrain World Health Orginization

Equity in health care financing in Palestine: The value-added of the disaggregate approachJournal articleMohammad Abu-Zaineh, Awad Mataria, Stéphane Luchini et Jean-Paul Moatti, Social Science & Medicine, Volume 66, Issue 11, pp. 2308-2320, 2008

This paper analyzes the redistributive effect and progressivity associated with the current health care financing schemes in the Occupied Palestinian Territory, using data from the first Palestinian Household Health Expenditure Survey conducted in 2004. The paper goes beyond the commonly used “aggregate summary index approach” to apply a more detailed “disaggregate approach”. Such an approach is borrowed from the general economic literature on taxation, and examines redistributive and vertical effects over specific parts of the income distribution, using the dominance criterion. In addition, the paper employs a bootstrap method to test for the statistical significance of the inequality measures. While both the aggregate and disaggregate approaches confirm the pro-rich and regressive character of out-of-pocket payments, the aggregate approach does not ascertain the potential progressive feature of any of the available insurance schemes. The disaggregate approach, however, significantly reveals a progressive aspect, for over half of the population, of the government health insurance scheme, and demonstrates that the regressivity of the out-of-pocket payments is most pronounced among the worst-off classes of the population. Recommendations are advanced to improve the performance of the government insurance schemes to enhance its capacity in limiting inequalities in health care financing in the Occupied Palestinian Territory.