Abstract
BackgroundIn developing countries, Pakistan is one of the countries where access to health and health-related indicators is a major concern. Their improvement would reduce inequalities among various Communities/Districts or groups of Communities. A Community health index (CHI) in this regard is estimated to explore inequality ratio, inequality slope, and spatial analysis of inequalities among all Communities at regional and geographical levels.MethodsData from Pakistan Social and Living Standard Measurement (PSLM) survey, Round-VI, 2014–15 were used to construct CHI. The index was constructed in two steps. In the first step, the study indicators were standardized while in the second step, the standardized indicators were aggregated into a single metric by applying non-linear Geometric Mean formula.ResultsThe inequality ratio of 16.59 estimated for Pakistan was found to be higher than the ratio of Atlanta city, GA (5.92), whereas, a lower slope coefficient was estimated for Pakistan than Atlanta city, GA (0.38 < 0.54). This ratio of disparity was also found to be lower for urban regions as compared to rural (7.78 < 17.54). While the slope coefficient was slightly higher for urban regions (0.45 > 0.43). The results of the spatial analysis revealed different patterns of inequalities. A cluster of healthy districts was found in Punjab province, whereas districts from Baluchistan had made a bunch of deprived/unhealthy districts in terms of CHI scores. Besides, separate maps for all provinces showed that capital districts of all provinces were relatively well-off/developed.ConclusionThe instant results concluded that inequalities in access to health and health-related indicators exist across countries as well as across geographical regions. To reduce or eradicate these inequalities, government and public health workers are recommended to set priorities based on access to composite index.
Highlights
IntroductionPakistan is one of the countries where access to health and health-related indicators is a major concern
In developing countries, Pakistan is one of the countries where access to health and health-related indicators is a major concern
Visualization of Community Health Index (CHI) scores on maps As one of the objectives is to assess the patterns of spatial geographical disparities among districts of Pakistan, the CHI scores were displayed on choropleth maps
Summary
Pakistan is one of the countries where access to health and health-related indicators is a major concern. Their improvement would reduce inequalities among various Communities/Districts or groups of Communities. Access to health-related social indicators is one of the major subjects playing a pivotal role in the determination of economic growth [2, 3]. Sociodemographic factors of income and education, housingrelated indicators, geographical and environmental attributes are considered as a range of significant social determinants of health which are multiple and interactive [7,8,9,10,11,12]. Nations throughout the globe are lacking access to health and health-related indicators, but more in low- and middle-income countries. In 2018, 4.2 billion world population lived in cities and is expected to increase by 90% in developing countries [1]
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