Stretching the severely constrained health system budgets of low- and middle-income countries to ensure access to essential health care while protecting against financial hardship caused by medical expenses is, arguably, the greatest challenge in the field of health economics. Our research contributes evidence of the effects on health, health care, and financial protection of extensions to coverage and of policies intended to motivate health care professionals. We have produced measures of health inequality, health care inequity, and financial protection from medical expenses that are used in monitoring progress toward Universal Health Coverage. We are using insights from behavioural economics and field experiments to explain major issues on the global health agenda: low take-up of health insurance, limited quality of provided care, insufficient prevention to slow the accumulating burden of non-communicable diseases, and poor adherence to TB medication. Innovative research with strong policy relevance feeds directly into our teaching.
Our research on global health economics
We have published about:
Effectiveness of health care financing reforms
- Voluntary health insurance in Nigeria: Effects on takers and non-takers.
- Can a Bottom-up Results-based Reform Project Improve Health System Performance?
- Did management contracting-in affect the use of primary health care units in Pakistan?
- Introduction of Performance-Based Financing in Burundi was associated with improvements in care and quality
- The effects of performance incentives on the utilization and quality of maternal and child care in Burundi
- Can vouchers deliver? An evaluation of subsidies for maternal health care in Cambodia
Universal health coverage
- Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand
- Universal health coverage: A (social insurance) job half done?
- Progressive Universalism? The Impact of Targeted Coverage on Healthcare Access and Expenditures in Peru
- Financial protection of patients through compensation of providers: The impact of Health Equity Funds in Cambodia
- Catastrophic Medical Expenditure Risk
- Impact and spill-over effects of an asset transfer program on child undernutrition: Evidence from a randomized control trial in Bangladesh
- Health shocks, coping strategies and foregone healthcare among agricultural households in Kenya.
Inequality and inequity in health
- Effects and determinants of tuberculosis drug stockouts in South Africa
- SMS nudges as a tool to reduce tuberculosis treatment delay and pretreatment loss to follow-up. A randomized controlled trial.
- Explaining the fall of socioeconomic inequality in childhood stunting in Indonesia.
- The rise and fall of mortality inequality in South Africa in the HIV era.
- Inequity in the face of death.
- Inequalities in use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE study, an observational study
- What explains the fall in child stunting in Sub-Saharan Africa?
- Rising inequalities in income and health in China: Who is left behind?
- Handbook of Income Distribution vol. 2B
Methodology of inequality measurement
- Conindex: Estimation of concentration indices. The Stata Journal, 16(1): 112-138.
- Poor Health Reporting? Using Anchoring Vignettes to Uncover Health Disparities by Wealth and Race.
- Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: a recipe for good practice.
- O.A. O'Donnell & T.G.M. Van Ourti (2020). ‘Dominance analysis’ and ‘Rank-dependent equity weights’ in ‘Distributional cost-effectiveness analysis: Quantifying Health Equity Impacts and Trade-Offs’. Oxford: Oxford University Press
- O.A. O'Donnell (2020). ‘Financial Protection Against Medical Expense’. In ‘The Oxford Encyclopedia of Health Economics’. Oxford: Oxford University Press
- Subjective Expectations of Medical Expenditures and Insurance in Rural Ethiopia.
Collaborations
The Rotterdam Global Health Initiative is a multi-disciplinary global health research and education network drawing on expertise from the Erasmus School of Health Policy & Management, Erasmus Medical Center, International Institute of Social Studies, and the Erasmus School of Economics. We are also involved in the Erasmus Initiative (EI) “Smarter choices for better health”. We collaborate with researchers, health care providers, health insurers, and NGOs in Asia, Africa, and Latin America, and have worked closely with the World Bank and the World Health Organization.
Media coverage and policy briefs
- Dr. Igna Bonfrer new director Global Health Initiative
- First Adam Wagstaff Memorial Lecture
- Health Equity and Financial Protection in Asia Documentary
- Professor Eddy van Doorslaer in G20 committee on UHC
- Frequent contributions to news stations such as the Dutch BNR News Radio
Memberships and editorial positions
- Professor Eddy van Doorslaer is an Elected Member of the Koninklijke Nederlandse Akademie van Wetenschappen (KNAW)
- Editorial positions at a.o. Health Economics and Journal of Health Economics
Researchers working on this theme
Dr. Igna BonfrerEmail address
Callum Brindley MScEmail address
Charlotte Dieteren MScEmail address
Dr. Judith BomEmail address
Novat Pugo Sambodo MScEmail address
Mila Duvekot MScEmail address
Fiorella Parra MujicaEmail address
Prof. Eddy van DoorslaerEmail address
Prof. Owen O’DonnellEmail address
Prof. Tom Van OurtiEmail address
Links
- MSc course Economics of Health and Health Care
- MSc course Global Health Economics
- Rotterdam Global Health Initiative
- Erasmus Initiative “Smarter choices for better health”
Contact
Questions or remarks? Click on one of the publications or researcher profiles above for more information or send an email to Igna Bonfrer via bonfrer@eshpm.eur.nl.
Want to stay up to date? Follow the Rotterdam Global Health Initiative via @EurRghi and the Erasmus Centre for Health Economics Rotterdam (EsCHER) via @healtheconrdam on Twitter.