Observational studyHealth policy and planning2016
Inequality and inequity in healthcare utilization in urban Nepal: a cross-sectional observational study.
Observational study in Health policy and planning, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed, 83 citations in OpenAlex.
- Exploring the roles of informal healthcare providers in urban settings to improve access and quality of care for the urban poor: experience from Bangladesh, Ghana, Nepal, and Nigeria.Health policy and planning · 2026Article
- What happens when public primary care is ill-prepared to respond to non-communicable diseases: a mixed-method study of diabetes and hypertension care in urban Nepal.Journal of global health · 2026Article
- Public Oral Healthcare Utilisation and Its Associated Factors in Malaysian Adults: A Time-Series Analysis (1992-2019).International dental journal · 2026Article
- Assessment of drug-related problems and associated factors among patients with chronic obstructive pulmonary disease in Dailekh, Nepal: a cross-sectional study.Scientific reports · 2026Article
- Gender Differences in Service Utilization and Pattern of Free Presbyopia Glasses Distribution among Patients at Eye Camps in Nepal: A Retrospective Study.JNMA; journal of the Nepal Medical Association · 2025Observational
- Mitigating inequitable access to appropriate antibiotics in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Readiness of the health system to provide non-communicable disease services in Nepal: a comparison between the 2015 and 2021 comprehensive health facility surveys.BMC health services research · 2024Article
- Inequity in the utilization of the home and community integrated healthcare and daily care services in older adults with limited mobility in China.BMC geriatrics · 2024Article
- Healthcare System Sustainability Challenges in Nepal and Opportunities Offered by Alternative Healthcare Delivery Arrangements.JNMA; journal of the Nepal Medical Association · 2024Article
- Assessing intersectional gender analysis in Nepal's health management information system: a case study on tuberculosis for inclusive health systems.Infectious diseases of poverty · 2024Article
- Healthcare cost coverage inequality and its impact on hypertension and diabetes: A five-year follow-up study in a Malaysian rural community.Health science reports · 2024Article
- Impact of cash transfer programs on healthcare utilization and catastrophic health expenditures in rural Zambia: a cluster randomized controlled trial.Frontiers in health services · 2024Article
- Horizontal inequity trends of health care utilization in rural China after the medicine and healthcare system reform: based on longitudinal data from 2010 to 2018.International journal for equity in health · 2023Article
- Ethical issues with geographical variations in the provision of health care services.BMC medical ethics · 2022Article
- The impact of COVID-19 lockdown on abortion care: a time series analysis of data from Marie Stopes Nepal.Sexual and reproductive health matters · 2022Article
- Determinants affecting utilisation of health services and treatment for children under-5 in rural Nepali health centres: a cross-sectional study.BMC public health · 2022Article
- Mobility-related inequality in healthcare utilization between floating and native populations and its influencing factors: evidence from China.International health · 2022Article
- Dalit's livelihoods in Nepal: income sources and determinants.Environment, development and sustainability · 2022Article
- The Impact of Multidimensional Health Levels on Rural Poverty: Evidence from Rural China.International journal of environmental research and public health · 2022Article
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Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inequality in access to quality healthcare is a major health policy challenge in many low- and middle-income countries. This study aimed to identify the major sources of inequity in healthcare utilization using a population-based household survey from urban Nepal. A cross-sectional survey was conducted covering 9177 individuals residing in 1997 households in five municipalities of Kathmandu valley between 2011 and 2012. The concentration index was calculated and a decomposition method was used to measure inequality in healthcare utilization, along with a horizontal inequity index (HI) to estimate socioeconomic inequalities in healthcare utilization. Results showed a significant pro-rich distribution of general healthcare utilization in all service providers (Concentration Index: 0.062, P < 0.001; HI: 0.029, P < 0.05) and private service providers (Concentration Index: 0.070, P < 0.001; HI: 0.030, P < 0.05). The pro-rich distribution of probability in general healthcare utilization was attributable to inequalities in the level of household economic status (percentage contribution: 67.8%) and in the self-reported prevalence of non-communicable diseases such as hypertension (36.7%) and diabetes (14.4%). Despite the provision of free services by public healthcare providers, our analysis found no evidence of the poor making more use of public health services (Concentration Index: 0.041, P = 0.094). Interventions to reduce the household economic burden of major illnesses, coupled with improvement in the management of public health facilities, warrant further attention by policy-makers.
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