Trends and Causes of Socio-economic Inequality In Teenage Pregnancy and Childbearing in Tanzania
Corresponding Author(s) : Magashi Joseph
Journal of Humanities & Social Science (JHSS),
Vol. 10 No. 2 (2021): Special Issue on Gender I
Abstract
The paper analyses the trends and causes of socioeconomic inequalities in teenage
pregnancy and childbearing in Tanzania using the 2004/05, 2009/10 and 2015/16
Tanzania Demographic and Health Survey (TDHS) data. The analysis of trends and
causes of socioeconomic-inequality uses a representative sample of 7,450 teenagers
who were pregnant or had a child during the survey. Teenagers were obtained from a
multi-stage sampling technique. Erreygers Index (EI) and its decomposition are used in
the analyses. The EI indicates a significant increase in the magnitude of inequalities in
teenage pregnancy and childbearing over time. Further, there exists a pro-poor
inequality in teenage pregnancy and childbearing. A decomposition analysis revealed
that the major contributors to teenage pregnancy and childbearing includes early
marriage, early sexual debut, and teen education. The lack of social and economic
capital provides a possible explanation for the observed results. We thus argue for
compulsory secondary education and reproductive health education, as well as
addressing wealth inequalities, to redress the situation in Tanzania.
Keywords
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Endnote/Zotero/Mendeley (RIS)BibTeX
- Anderton, D. L., N. O. L. L Tsuya, Bean & G. P. Mineau. 1987. Intergenerational Transmission of
- Relative Fertility and Life Course Patterns. Demography, 24(4): 467–480. Retrieved on 18
- November 2020, from https://doi.org/10.2307/2061386.
- Arland, T. 1991. Influence of the Marital History of Parents on the Marital and Cohabitational
- Experiences of Children. American Journal of Sociology, 96(4): 868–894. Retrieved on 18
- November 2020, from https://doi.org/10.2307/2780734.
- Axinn, W. G. & A. Thornton. 1992. The Influence of Parental Resources on the Timing of the
- Transition to Marriage. Social Science Research, 21(3): 261–285. Retrieved on 18 November 2020,
- from https://doi.org/10.1016/0049–089x(92)90008–5.
- Barber, J. S. 2001. The Intergenerational Transmission of Age at First Birth Among Married and
- Unmarried Men and Women. Social Science Research, 30(2): 219–247. Retrieved on 18 November
- , from https://doi.org/10.1006/ssre.2000.0697.
- Bengtson, V. L. 1975. Generation and Family Effects in Value Socialization. American Sociological
- Review, 40(3): 358–371.
- Chirwa, C. G., J. Mazalale, G. Likupe, D. Nkhoma, L. Chiwaula & J. Chintsanya. 2019. An Evolution of
- Socioeconomic Related Inequality in Teenage Pregnancy and Childbearing in Malawi. Plos ONE,
- (11): 1–16. Retrieved on 6 July 2020, from https://doi.org/https://doi.org/10.1371/journal.
- pone.0225374 editor.
- Crockett, L. J., C. R. Bingham, J. S. Chopak & J. R. Vicary. 1996. Timing of First Sexual Intercourse:
- The Rolle of Social Control, Social Learning & Problem Behavior. Journal of Youth and Adolescence,
- (1): 89–111. Retrieved on 16 December 2020, from https://doi.org/ 10.1007/ bf01537382.
- Darroch, J. E., V. Woog & A. Bankole. 2016. Adding It Up: Costs and Benefits of Meeting the Contraceptive
- Needs of Adolescents. Retrieved on 30 June 2020, from https://www. guttmacher.
- org/report/adding-it-meeting-contraceptive-needs-of-adolescents.
- Erreygers, G. 2009. Correcting the Concentration Index. Journal of Health Economics, 28(2): 504–515.
- Retrieved on 6 July 2020, from https://doi.org/10.1016/j.jhealeco.2008.02.003.
- Filmer, D. & L. Pritchett. 2011. Estimating Wealth Effects Without Expenditure Data-Or Tears : An
- Application to Educational Enrollments in States of India. Demography, 38(1): 115–132.
- Retrieved on 6 August 2020, from https://doi.org/10.1353/dem.2001.0003.
- Hope, T. L., E. I. Wilder & T. T. Watt. 2003. The Relationships Among Adolescent Pregnancy,
- Pregnancy Resolution & Juvenile Delinquency. The Sociological Quarterly, 44(4): 555–576.
- Retrieved on 16 November 2020, from http://www.jstor.org/stable/4120722.
- Izugbara, C. O., F. M. Wekesah, T. Tilahun, J. Amo-Adjei & Z. T. Tsala Dimbuene. 2018. Family
- Planning in East Africa: Trends and Dynamics. Retrieved on 9 December 2020, from https://aphrc.
- org/wp-content/uploads/2019/07/family-planning-in-east-africa-report_january-2018.pdf.
- Kahn, J. R. & K. E. Anderson. 1992. Intergenerational Patterns of Teenage Fertility. Demography,
- (1): 39–57. Retrieved on 18 November 2020, from https://doi.org/10.2307/2061362.
- Kakwani, N., A. Wagstaff & E. Van Doorslaer. 1997. Socioeconomic Inequalities in Health:
- Measurement, Computation & Statistical Inferenc. Journal of Econometrics, 77: 87–103.
- Kassa, G. M., A. O. Arowojolu, A. T. A. Odukogbe & A. W. Yalew. 2019. Trends and Determinants of
- Teenage Childbearing in Ethiopia: Evidence from the 2000 to 2016 Demographic and Health
- Surveys. Italian Journal of Pediatrics, 45(1): 1–13. Retrieved on 6 July 2020, from https://doi. org/
- 1186/s13052–019–0745–4.Kenya National Bureau of Statistics, Ministry of Health/Kenya, National AIDS Control Council/Kenya,
- Kenya Medical Research Institute & National Council for Population and Development. 2015.
- Kenya. in Kenya Demographic and Health Survey 2014. Retrieved on 8 December 2020, from
- http://dhsprogram.com/pubs/pdf/fr308/fr308.pdf.
- Khoramrooz, M., A. Rezapour, S. Shirinbakhsh & A. Khosravi. 2019. Understanding Changes in
- Socioeconomic Inequality of Unintended Pregnancy Among Iranian Married Women: A BlinderOaxaca Decomposition Analysis. Health Scope, 8(4): E85011. Retrieved on 15 July 2020, from
- https://doi.org/10.5812/jhealthscope.85011.
- Michael, R. T. & N. B. Tuma. 1985. Entry Into Marriage and Parenthood by Young Men and Women:
- The Influence of Family Background. Demography, 22(4): 515–544. Retrieved on 18 November
- , from https://doi.org/10.2307/2061586.
- Miller, B. C., M. C. Norton, T. Curtis, J. E. Hill, P. Schvaneveldt & M. H. Young. 1997. The Timing of
- Sexual Intercourse Among Adolescents: Family, Peer & Other Antecedents. Youth and Society,
- (1): 54–83. Retrieved on 16 December 2020, from https://doi.org/https:// doi.org/ 10.1177/
- x97029001003.
- Montgomery, M. R., M. Gragnolati, K. A. Burke & E. Paredes. 2000. Measuring Living Standards With
- Proxy Variables. Demography, 37(2): 155–174. Retrieved on 7 July 2020, from https://
- doi.org/10.2307/2648118.
- National Institute of Statistics of Rwanda (NISR), Ministry of Finance and Economic Planning,
- Ministry of Health (MOH) & ICF International. 2016. Rwanda Demographic and Health Survey 2014–
- Retrieved on 8 December 2020, from http://dhsprogram.com/ pubs/pdf/ fr316/ fr316.pdf.
- National Bureau of Statisics (NBS) & ICF Macro. 2005. Tanzania Demographic and Health Survey 2004–
- Dar es Salaam, Tanzania: National Bureau of Statistics and ORC Macro.
- National Bureau of Statisics & ICF Macro. 2010. Tanzania Demographic and Health Survey 2010. Dar
- es Salaam, Tanzania: NBS and ICF Macro.
- —. 2016. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015–2016. Dar es
- Salaam, Tanzania & Rockville, Maryland, USA.
- Neal, S., Z. Matthews, M. Frost, H. Fogstad, A. V. Camacho & L. Laski. 2012. Childbearing in
- Adolescents Aged 12–15 Years in Low Resource Countries: A Neglected Issue. New Estimates
- from Demographic and Household Surveys in 42 Countries. Acta Obstetricia Et Gynecologica
- Scandinavica, 91(9): 1114–1118. Retrieved on 30 June 2020, from https://doi.org/10.1111/j.1600–
- 2012.01467.x.
- O’Donnell, O., S. O’neill, T. B. Ourti & Van Walsh. 2016. Conindex: Estimation of Concentration
- Indices. Stata Journal, 16(1): 112–138.
- O’Donnell, O., E. Van Doorslaer, A. Wagstaff & M. Lindelow. 2008. Analyzing Health Equity Using
- Household Survey Data: A Guide to Techniques and Their Implementation. in WBI Learning
- Resources Series. Retrieved on 4 June 2020, from https://doi.org/10.2471/blt.08.052357.
- Omani-Samani, R., M. A. Rarani, M. Sepidarkish, E. K. Morasae, S. Maroufizade & A. Almasi-Hashiani.
- Socioeconomic Inequality of Unintended Pregnancy in the Iranian Population: A
- Decomposition Approach. BMC Public Health, 18(607): 1–8. Retrieved on 15 July 2020, from
- https://doi.org/https://doi.org/10.1186/s12889–018–5515–5.
- Penman-Aguilar, A., M. Carter, M. Christine Snead & A. P. Kourtis. 2013. Socioeconomic
- Disadvantage as a Social Determinant of Teen Childbearing in the U.S. Public Health Reports, 128
- (SUPPL. 1): 5–22. Retrieved on 15 July 2020, from https://doi.org/10.1177/00333549131282s102.
- Poudel, S., N. Upadhaya, R. B. Khatri & R. Ghimire. 2018. Trends and Factors Associated With
- Pregnancies Among Adolescent Women in Nepal : Pooled Analysis of Nepal Demographic and
- Health Surveys ( 2006. 2011 and 2016. Plos ONE, 13(8): 1–13. Retrieved on 15 July 2020, from
- https://doi.org/https://doi.org/10.1371/journal. pone.0202107.
- Ramirez-Valles, J., M. A. Zimmerman & L. Juarez. 2002. Gender Differences of Neighborhood and
- Social Control Processes: A Study of the Timing of First Intercourse Among Low-Achieving,
- Urban, African American Youth. Youth and Society, 33(3): 418–441. Retrieved on 16 December
- , from https://doi.org/10.1177/0044118x02033003004.
- Sahn, D. E. & D. Stifel. 2003. Exploring Alternative Measures of Welfare in the Absence of
- Expenditure Data. Review of Income and Wealth, 49(4): 463–489.
- Singh, S., J. E. Darroch, J. J. Frost, M. Barrett, A. Mckay, E. Maticka-Tyndale, … & V. Woog. 2001.
- Socioeconomic Disadvantage and Adolescent Women’s Sexual and Reproductive Behavior: The
- Case of Five Developed Countries. Family Planning Perspectives, 33(6): 251–258 & 289. Retrieved
- on 15 July 2020, from https://doi.org/10.2307/3030192.
- Thornton, A. & D. Camburn. 1987. The Influence of the Family on Premarital Sexual Attitudes and
- Behaviour. Demography, 24(3): 323–340.
- Uganda Bureau of Statistics (UBOS) & ICF International. 2018. Uganda Demographic and Health Survey
- Retrieved on 8 December 2020, from http://dhsprogram.com/pubs/pdf/fr333/fr333.pdf.
- United Nations Population Fund (UNFPA). 2015. Girlhood, Not Motherhood: Preventing Adolescent
- Pregnancy. Retrieved on 15 April 2020 from https://www.unfpa.org/sites/default/files/pubpdf/girlhood_not_motherhood_final_web.pdf.
- —. 2018. Fact Sheet: Teenage Pregnancy. Retrieved on 22 November 2020, from https:// tanzania.
- unfpa.org/en/publications/fact-sheet-teenage-pregnancy.
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- Ending Child Marriage: Progress and Prospects, UNICEF (Issue New York). Retrieved on 15 July 2020
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- from https://doi.org/10.1016/s0140–6736(12)60149–4.
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- in Five East African Countries : A Multi-Level Analysis of Risk and Protective Factors. BMC
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References
Anderton, D. L., N. O. L. L Tsuya, Bean & G. P. Mineau. 1987. Intergenerational Transmission of
Relative Fertility and Life Course Patterns. Demography, 24(4): 467–480. Retrieved on 18
November 2020, from https://doi.org/10.2307/2061386.
Arland, T. 1991. Influence of the Marital History of Parents on the Marital and Cohabitational
Experiences of Children. American Journal of Sociology, 96(4): 868–894. Retrieved on 18
November 2020, from https://doi.org/10.2307/2780734.
Axinn, W. G. & A. Thornton. 1992. The Influence of Parental Resources on the Timing of the
Transition to Marriage. Social Science Research, 21(3): 261–285. Retrieved on 18 November 2020,
from https://doi.org/10.1016/0049–089x(92)90008–5.
Barber, J. S. 2001. The Intergenerational Transmission of Age at First Birth Among Married and
Unmarried Men and Women. Social Science Research, 30(2): 219–247. Retrieved on 18 November
, from https://doi.org/10.1006/ssre.2000.0697.
Bengtson, V. L. 1975. Generation and Family Effects in Value Socialization. American Sociological
Review, 40(3): 358–371.
Chirwa, C. G., J. Mazalale, G. Likupe, D. Nkhoma, L. Chiwaula & J. Chintsanya. 2019. An Evolution of
Socioeconomic Related Inequality in Teenage Pregnancy and Childbearing in Malawi. Plos ONE,
(11): 1–16. Retrieved on 6 July 2020, from https://doi.org/https://doi.org/10.1371/journal.
pone.0225374 editor.
Crockett, L. J., C. R. Bingham, J. S. Chopak & J. R. Vicary. 1996. Timing of First Sexual Intercourse:
The Rolle of Social Control, Social Learning & Problem Behavior. Journal of Youth and Adolescence,
(1): 89–111. Retrieved on 16 December 2020, from https://doi.org/ 10.1007/ bf01537382.
Darroch, J. E., V. Woog & A. Bankole. 2016. Adding It Up: Costs and Benefits of Meeting the Contraceptive
Needs of Adolescents. Retrieved on 30 June 2020, from https://www. guttmacher.
org/report/adding-it-meeting-contraceptive-needs-of-adolescents.
Erreygers, G. 2009. Correcting the Concentration Index. Journal of Health Economics, 28(2): 504–515.
Retrieved on 6 July 2020, from https://doi.org/10.1016/j.jhealeco.2008.02.003.
Filmer, D. & L. Pritchett. 2011. Estimating Wealth Effects Without Expenditure Data-Or Tears : An
Application to Educational Enrollments in States of India. Demography, 38(1): 115–132.
Retrieved on 6 August 2020, from https://doi.org/10.1353/dem.2001.0003.
Hope, T. L., E. I. Wilder & T. T. Watt. 2003. The Relationships Among Adolescent Pregnancy,
Pregnancy Resolution & Juvenile Delinquency. The Sociological Quarterly, 44(4): 555–576.
Retrieved on 16 November 2020, from http://www.jstor.org/stable/4120722.
Izugbara, C. O., F. M. Wekesah, T. Tilahun, J. Amo-Adjei & Z. T. Tsala Dimbuene. 2018. Family
Planning in East Africa: Trends and Dynamics. Retrieved on 9 December 2020, from https://aphrc.
org/wp-content/uploads/2019/07/family-planning-in-east-africa-report_january-2018.pdf.
Kahn, J. R. & K. E. Anderson. 1992. Intergenerational Patterns of Teenage Fertility. Demography,
(1): 39–57. Retrieved on 18 November 2020, from https://doi.org/10.2307/2061362.
Kakwani, N., A. Wagstaff & E. Van Doorslaer. 1997. Socioeconomic Inequalities in Health:
Measurement, Computation & Statistical Inferenc. Journal of Econometrics, 77: 87–103.
Kassa, G. M., A. O. Arowojolu, A. T. A. Odukogbe & A. W. Yalew. 2019. Trends and Determinants of
Teenage Childbearing in Ethiopia: Evidence from the 2000 to 2016 Demographic and Health
Surveys. Italian Journal of Pediatrics, 45(1): 1–13. Retrieved on 6 July 2020, from https://doi. org/
1186/s13052–019–0745–4.Kenya National Bureau of Statistics, Ministry of Health/Kenya, National AIDS Control Council/Kenya,
Kenya Medical Research Institute & National Council for Population and Development. 2015.
Kenya. in Kenya Demographic and Health Survey 2014. Retrieved on 8 December 2020, from
http://dhsprogram.com/pubs/pdf/fr308/fr308.pdf.
Khoramrooz, M., A. Rezapour, S. Shirinbakhsh & A. Khosravi. 2019. Understanding Changes in
Socioeconomic Inequality of Unintended Pregnancy Among Iranian Married Women: A BlinderOaxaca Decomposition Analysis. Health Scope, 8(4): E85011. Retrieved on 15 July 2020, from
https://doi.org/10.5812/jhealthscope.85011.
Michael, R. T. & N. B. Tuma. 1985. Entry Into Marriage and Parenthood by Young Men and Women:
The Influence of Family Background. Demography, 22(4): 515–544. Retrieved on 18 November
, from https://doi.org/10.2307/2061586.
Miller, B. C., M. C. Norton, T. Curtis, J. E. Hill, P. Schvaneveldt & M. H. Young. 1997. The Timing of
Sexual Intercourse Among Adolescents: Family, Peer & Other Antecedents. Youth and Society,
(1): 54–83. Retrieved on 16 December 2020, from https://doi.org/https:// doi.org/ 10.1177/
x97029001003.
Montgomery, M. R., M. Gragnolati, K. A. Burke & E. Paredes. 2000. Measuring Living Standards With
Proxy Variables. Demography, 37(2): 155–174. Retrieved on 7 July 2020, from https://
doi.org/10.2307/2648118.
National Institute of Statistics of Rwanda (NISR), Ministry of Finance and Economic Planning,
Ministry of Health (MOH) & ICF International. 2016. Rwanda Demographic and Health Survey 2014–
Retrieved on 8 December 2020, from http://dhsprogram.com/ pubs/pdf/ fr316/ fr316.pdf.
National Bureau of Statisics (NBS) & ICF Macro. 2005. Tanzania Demographic and Health Survey 2004–
Dar es Salaam, Tanzania: National Bureau of Statistics and ORC Macro.
National Bureau of Statisics & ICF Macro. 2010. Tanzania Demographic and Health Survey 2010. Dar
es Salaam, Tanzania: NBS and ICF Macro.
—. 2016. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015–2016. Dar es
Salaam, Tanzania & Rockville, Maryland, USA.
Neal, S., Z. Matthews, M. Frost, H. Fogstad, A. V. Camacho & L. Laski. 2012. Childbearing in
Adolescents Aged 12–15 Years in Low Resource Countries: A Neglected Issue. New Estimates
from Demographic and Household Surveys in 42 Countries. Acta Obstetricia Et Gynecologica
Scandinavica, 91(9): 1114–1118. Retrieved on 30 June 2020, from https://doi.org/10.1111/j.1600–
2012.01467.x.
O’Donnell, O., S. O’neill, T. B. Ourti & Van Walsh. 2016. Conindex: Estimation of Concentration
Indices. Stata Journal, 16(1): 112–138.
O’Donnell, O., E. Van Doorslaer, A. Wagstaff & M. Lindelow. 2008. Analyzing Health Equity Using
Household Survey Data: A Guide to Techniques and Their Implementation. in WBI Learning
Resources Series. Retrieved on 4 June 2020, from https://doi.org/10.2471/blt.08.052357.
Omani-Samani, R., M. A. Rarani, M. Sepidarkish, E. K. Morasae, S. Maroufizade & A. Almasi-Hashiani.
Socioeconomic Inequality of Unintended Pregnancy in the Iranian Population: A
Decomposition Approach. BMC Public Health, 18(607): 1–8. Retrieved on 15 July 2020, from
https://doi.org/https://doi.org/10.1186/s12889–018–5515–5.
Penman-Aguilar, A., M. Carter, M. Christine Snead & A. P. Kourtis. 2013. Socioeconomic
Disadvantage as a Social Determinant of Teen Childbearing in the U.S. Public Health Reports, 128
(SUPPL. 1): 5–22. Retrieved on 15 July 2020, from https://doi.org/10.1177/00333549131282s102.
Poudel, S., N. Upadhaya, R. B. Khatri & R. Ghimire. 2018. Trends and Factors Associated With
Pregnancies Among Adolescent Women in Nepal : Pooled Analysis of Nepal Demographic and
Health Surveys ( 2006. 2011 and 2016. Plos ONE, 13(8): 1–13. Retrieved on 15 July 2020, from
https://doi.org/https://doi.org/10.1371/journal. pone.0202107.
Ramirez-Valles, J., M. A. Zimmerman & L. Juarez. 2002. Gender Differences of Neighborhood and
Social Control Processes: A Study of the Timing of First Intercourse Among Low-Achieving,
Urban, African American Youth. Youth and Society, 33(3): 418–441. Retrieved on 16 December
, from https://doi.org/10.1177/0044118x02033003004.
Sahn, D. E. & D. Stifel. 2003. Exploring Alternative Measures of Welfare in the Absence of
Expenditure Data. Review of Income and Wealth, 49(4): 463–489.
Singh, S., J. E. Darroch, J. J. Frost, M. Barrett, A. Mckay, E. Maticka-Tyndale, … & V. Woog. 2001.
Socioeconomic Disadvantage and Adolescent Women’s Sexual and Reproductive Behavior: The
Case of Five Developed Countries. Family Planning Perspectives, 33(6): 251–258 & 289. Retrieved
on 15 July 2020, from https://doi.org/10.2307/3030192.
Thornton, A. & D. Camburn. 1987. The Influence of the Family on Premarital Sexual Attitudes and
Behaviour. Demography, 24(3): 323–340.
Uganda Bureau of Statistics (UBOS) & ICF International. 2018. Uganda Demographic and Health Survey
Retrieved on 8 December 2020, from http://dhsprogram.com/pubs/pdf/fr333/fr333.pdf.
United Nations Population Fund (UNFPA). 2015. Girlhood, Not Motherhood: Preventing Adolescent
Pregnancy. Retrieved on 15 April 2020 from https://www.unfpa.org/sites/default/files/pubpdf/girlhood_not_motherhood_final_web.pdf.
—. 2018. Fact Sheet: Teenage Pregnancy. Retrieved on 22 November 2020, from https:// tanzania.
unfpa.org/en/publications/fact-sheet-teenage-pregnancy.
United Nations Children’s Fund (UNICEF). 2014. Ending Child Marriage: Progress and Prospects. in
Ending Child Marriage: Progress and Prospects, UNICEF (Issue New York). Retrieved on 15 July 2020
—. 2019. Adolescent Demographics. Retrieved on 6 May 2020 from https://data.unicef. org/ topic/
adolescents/demographics/.
United Republic of Tanzania (URT). 2017. Tanzania Statistical Abstract 2016. Retrieved on 18
November 2020, from https://nbs.go.tz/nbs/takwimu/abstracts/statistical_abstract_2016.pdf.
Van Doorslaer, E. & T. Van Ourti. 2012. Measuring Inequality and Inequity in Health and Health
Care. In Oxford Handbook of Health Economics. Retrieved on 16 June 2020, from
https://doi.org/10.1093/oxfordhb/9780199238828.013.0035.
Viner, R. M., E. M. Ozer, S. Denny, M. Marmot, M. Resnick, A. Fatusi & C. Currie. 2012. Adolescence
and the Social Determinants of Health. The Lancet, 379, 1641–1652. Retrieved on 15 July 2020,
from https://doi.org/10.1016/s0140–6736(12)60149–4.
Wado, Y. D., E. A. Sully & J. N. Mumah. 2019. Pregnancy and Early Motherhood Among Adolescents
in Five East African Countries : A Multi-Level Analysis of Risk and Protective Factors. BMC
Pregnancy and Childbirth. 19(59): 1–11. Retrieved on 15 July 2020, from https://doi. org/
https://doi.org/10.1186/s12884–019–2204–zWagstaff, A., E. Van Doorslaer & P. Paci. 1989. Equity in the Finance and Delivery of Health Care:
Some Tentative Cross-Country Comparisons. Oxford Review of Economic Policy, 5(1): 89–112.
retrieved on 13 august 2020, from https://doi.org/10.1093/oxrep/5.1.89.
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