Abstract
ABSTRACTBackground: Understanding the magnitude of inequalities and drivers for reducing gender-related health inequalities is crucial in developing countries. This is particularly the case for Liberia with its very high level of gender-related inequalities in health and health outcomes.Objective: This paper assesses the magnitude of gender health inequalities and the relative contribution of different factors to health inequality in Liberia.Methods: Data came from the Liberian Household Income Expenditure Survey 2014. A two stage sampling methodology was used and 4,104 households were randomly selected and interviewed. The main variable of interest is dichotomised, good versus poor self-assessed health. Gender-related health inequality is assessed using the Oaxaca–Blinder decomposition for non-linear models. The decomposition reveals the magnitude of inequality and contributions of different factors.Results: We found large gender disparities (0.054, p < 0.01) characterised by women disadvantages in health status. In addition, the gender health disparities are mostly pronounced in rural areas. About 54% of the gender inequalities in health status were explained by the differences in endowments. Equalizing access to information, wealth and utilization of mosquito nets would reduce the gender gaps by 44, 5 and 4%, respectively.Conclusions: Addressing gender health inequalities inter alia requires access to health information (i.e. electronic and print media), gender responsive interventions that improve wealth in key sectors (i.e. education, employment, social protection, housing, and other appropriate infrastructure). In addition, the government, private sector and civil society should ensure that the health sector provides access to quality mosquito nets and improved health services including preventive care in order to reduce disease burden.
Highlights
Understanding the magnitude of inequalities and drivers for reducing genderrelated health inequalities is crucial in developing countries
The descriptive results show that the significant women disadvantages in health status, education, wealth, access to information and mosquito net exists in rural areas
We found that household expenditure explained gender inequalities in self-assessed health status in Liberia, and this is compatible with the findings of previous studies in India [24] and Spain [38]
Summary
Understanding the magnitude of inequalities and drivers for reducing genderrelated health inequalities is crucial in developing countries. This is the case for Liberia with its very high level of gender-related inequalities in health and health outcomes. Onadja et al [9] found that women reported worse cognitive impairment and mobility disability than men and that nutritional status and education opportunities reduced the gender differences in Burkina Faso. In India, Singh et al [10] highlights that women reported worse cognitive health than men and that education, marital status, caste, religion, tobacco consumption and chronic health status contributed to the reduction in gender gap. According to [17], higher levels of education are positively associated with better employment opportunities and
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