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What we do

The core research focus of Equitap is to compare inequality and inequity in health and healthcare across countries and territories in the Asia-Pacific region, using standard and comparable methods. This is done through concerted actions, in which standard technical protocols are developed for each type of analysis, and then applied by each individual team to their own data, before collating the results for joint publication. To ensure comparability of final results, designated lead investigators in Equitap take responsibility for coordinating, reviewing and guiding all teams for any specific analysis.

In Equitap's first phase of work or Equitap 1 (2001-2006), the focus was on equity in financing, risk protection and government health spending. In Equitap 2, the current second phase (2007- ), these analyses are being updated, and in addition equity in health outcomes and utilization is being examined. Major thematic areas of analysis in Equitap include:

Equity in healthcare finance
Countries rely on a diverse mix of financing sources to pay for healthcare: taxation, out-of-pocket expenditure, social and private insurance, etc. In developing Asia, there is greater reliance on out-of-pocket financing than in the developed economies, and greater dependence on indirect taxation in tax systems. Equitap examines the distribution of financing payments across households, both by type of payment mechanism and also between countries. Equitap findings indicate the importance of the mix of financing on overall equity or progressivity in financing, as well as the extent to which individual mechanisms vary in the impact between countries.

Equity in government health spending (benefit incidence analysis)
In all countries, governments use public financing to pay for healthcare. Equitap uses benefit-incidence analysis to examine the inequalities in how such government spending is distributed across households, and how this varies between types of care and between countries.

Inequalities and inequity in healthcare utilization
For the most part, in almost all countries in the region, poorer people have worse access to healthcare than the wealthy, and make less use of healthcare services. Equitap examines the utilization of healthcare across households, and the extent of inequality and how this varies by type or source of care. In addition, in a few territories which have the necessary data, Equitap examines whether people in equal need of healthcare are treated the same, or horizontal equity.

Financial risk protection
Substantial reliance on of out-of-pocket expenditures on health can have significant negative impacts on households. Equitap examines the extent to which out-of-pocket spending impoverishes households in different countries, as well as the extent to which it causes households to incur catastrophic expenditures.

Inequalities in health
A key policy question is whether and by how much the poor experience worse health than the better-off. This was not the focus of Equitap's first phase as much of the potential analyses had been done by others, but in its second phase, Equitap is testing the feasibility of using measuring inequalities in mortality in several countries and territories.

The policy environment for equity in health systems
The overall equity of health systems reflects both the resources available to societies, as well as the policy choices made. Equitap has examined this aspect of equity by looking at public opinions on health equity in a few countries, as well as undertaking systematic analysis of the interpretation and importance of equity in national policy frameworks.

Capacity building
Equitap recognizes that domestic capacity to analyse available data and national ownership of research is a critical element in assisting countries to make use of evidence to improve policy and eventual health outcomes. Almost all Equitap analyses are done by research teams based in the relevant countries. Consequently, Equitap stresses the building of local capacity for health equity analysis. This has been done by investments in training staff in Equitap partner institutions, sharing expertise and mentoring, and developing regional courses.