Inequality in health and food expenditure, study of Iranian urban and rural households

Background and Purpose: Inequality in health is a challenging issue in developed and developing countries. In modern health care system, the justiceand attainment to it in all aspectsof health is a principal affair. The inequality in health care and food expenditure is one of the influential factors on household's health status.This articleexamined the distribution of rural and urban health and food expenditure by using Gini coefficient from1998 to 2009

Methods and Material: All data has been collected from Iranian Households Income- Expenditure Report which published by Iranian Statistics Center annually, thenwereanalyzed by DASP package 2 in STATA10 environment

Results: The Gini coefficient calculated 0.13 and 0.28 for rural food expenditure and 0.13 and 0.22 for rural health expenditure in 1998 and 2009 respectively. Also these calculations were 0.11 and 0.21 for urban food expenditure and 0.18 And 0.14 for urban health expenditure in 1998 and 2009 respectively. All calculations were based on constant price

Conclusion: The distribution of health and food expenditure wasfavorable relativelyfor both rural and urban households

[ survey on present status of health services priority setting in Iran]

To analyze the process of priority setting at different levels of Iran's health system. In this qualitative study, 19 Experts of different levels of health system were interviewed. The semi-structured interview guide was designed based on literature review and four initial in depth interviews. Framework analysis method was used for the analysis of qualitative data. Eight themes and 22 sub-themes regarding health priority setting were identified: Health priority at macro-level; Priority setting between and within medical universities; Priority setting criteria; Measuring costs and outcomes; Resource shift; Public participation; and Resource allocation decision rule. Health sector share of public budget was unrealistic and was based on historical patterns. Political factors and lobbying influenced resource allocation between and within medical universities. Resource allocation was mainly structure based and health factors were least influential. Although resource shifting was possible within programs but it was impossible within them, Public participation in priority setting was not sufficient and systematic, decision making on resource allocation was mainly based on needs and judgment. Some priority setting activities are in progress, but they do not tend to be either comprehensive or systematic. In order to improve priority setting, developing an approach which enables stakeholders' involvement is suggested