Seminar Series: Dr. John Ataguba

Does the choice of poverty line matter for assessing financial impoverishment from paying out-of-pocket for health services?

ataguba.jpgDr. John Ataguba

Health Economics Unit
University of Cape Town

Financial protection in health is an essential aspect of the universal health coverage discourse, and indeed the Sustainable Development Goals (SDGs). It is about ensuring that paying for health services does not affect the ability of households and individuals to afford necessities. A well-known way to assess financial protection is whether or not people are pushed into—or further into—poverty by paying out-of-pocket for health services. Paying out-of-pocket for health services is very common in many developing countries. Although impoverishment from out-of-pocket health spending is not stated explicitly as an indicator of the SDGs, it is prominent in global development discourse because of its intuitive appeal and link to poverty reduction, a fundamental goal in many developing countries. This paper uses data from Nigeria, a country where out-of-pocket spending for health services remains significant, to demonstrate that the choice of poverty line matters for assessing the impoverishing effect of paying out-of-pocket for health services. In essence, the choice of poverty lines may provide inconsistent impoverishment estimates. Among other things, the inconsistencies (or lack of dominance) could occur in ranking impoverishment levels by mutually exclusive groups within a country or in ranking different countries or a country over time. The implication is that the choice of the poverty line could lead to manipulation of results for policy and could support an agenda that demonstrates an improvement in financial protection when this may not necessarily be the case.

Short Biography:
Prof. John Ataguba is a professor of economics and director of the Health Economics Unit at the University of Cape Town. He is a Deputy Director for the African Health Economics and Policy Association and a member of the Board of Directors for the International Health Economics Association. He received many awards, including the TW Kambule-NSTF Award to emerging researchers in South Africa (described as the ‘Oscar Award’ for science and research in South Africa). He served as the interim South African Research Chair in Health and Wealth (2018-2020) and was a Mellon Mandela Fellow at Harvard University (20016/17).