Abstract:
Benefit incidence analysis (BIA) considers who (in terms of socio-economic
groups) receive what benefit from using health services. While traditionally BIA
has focused on only publicly funded health services, to assess whether or not
public subsidies are ‘pro-poor’, the same methodological approach can be used
to assess how well the overall health system is performing in terms of the
distribution of service benefits. This is becoming increasingly important in the
context of the growing emphasis on promoting universal health systems. To
conduct a BIA, a household survey dataset that incorporates both information
on health service utilization and some measure of socio-economic status is
required. The other core data requirement is unit costs of different types of
health service. When utilization rates are combined with unit costs for different
health services, the distribution of benefits from using services, expressed in
monetary terms, can be estimated and compared with the distribution of the
need for health care. This paper aims to provide an introduction to the methods
used in the ‘traditional’ public sector BIA, and how the same methods can be
applied to undertake an assessment of the whole health system. We consider
what data are required, potential sources of data, deficiencies in data frequently
available in low- and middle-income countries, and how these data should
be analysed.
