ABSTRACT
This chapter reviews the growing body of literature on tackling inequality in the health sector,1
with a specific focus on inequality in the use of health services, and on the evidence to date of successful policies addressing health inequalities in low-and middle-income countries (LMIC).
The development of an innovation in calculating proxy measures of wealth (Filmer and Pritchett 2001) resulted in a flood of data and research on health sector inequalities (Goldman et al. 2009; Gwatkins et al. 2007). While some of what the data revealed is not surprising, the consistent nature of inequalities across 56 LMIC (representing over 2.8 billion in population), and the size of the gap between the poorest and wealthiest in most countries, is sobering. This is exemplified in Figure 11.1, which captures the gaps in infant mortality rates (IMR) between the richest and poorest segments of the population across six regions. The data shows a consistent and sizable gap in IMR between the richest and poorest 20 per cent of the populations. Latin America and East Asia show the largest levels of inequality in IMRs, as measured by the concentration index, despite having, on average, lower levels of mortality than regions like Africa and South Asia.
