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NEWS: Adrian O’Dowd Cash incentives might help to change behaviour, MPs told BMJ 2008; 336: 1036-a [Full text]

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Socioeconomic status and seeking care for health

Dewan S. Billal, Assistant Professor Muneki Hotomi, Professor Noboru Yamanaka   (9 May 2008)

Socioeconomic status and seeking care for health 9 May 2008
Dewan S. Billal, Postdoctoral Fellow Department of Otolaryngology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan, Assistant Professor Muneki Hotomi, Professor Noboru Yamanaka Send response to journal: Re: Socioeconomic status and seeking care for health	In News Adrian O'Dowd1 stated that the United Kingdom MPs s agreed to encourage people to change their behavior to end health inequalities by cash incentives. I also agree that cash incentives may resolve the health inequalities in developed country like UK as well as developing countries. But how long will the cash incentives program continue to end health inequalities in UK? During the last decade, countries with transitional and middle-income economies have introduced some programmes that incentives money to poor households on the condition that they comply with a set of requirements, including attendance for health care, food and nutritional supplementation, and enrolment of children in school. In a recent study Lia CH Fernald and colleagues2 also showed that a doubling of conditional cash transfer (CCT) was associated with higher height-for-age, low prevalence of stunting, lower body-mass index for age percentile and low prevalence of being overweight. A study conducted in four rural areas in Bangladesh and collected 1511 women who had live birth during 1996-1998 showed that 87% of the mothers sought care for their newborns and seeking care was found to be associated with the gender of the neonate, birth order, antenatal care of the mother from trained providers, father's education and monthly expenditure of the family 3. In another study showed that monthly expenditure TK. 4000(US$ 60) or more were likely to seek care of their newborns than families with monthly expenditure less that TK. 2000 (US$ 60)4. Socioeconomic status also associated improving of sanitation, drinking safe water, taking balance diet, education and mental growth in communities. In conclusion, to satisfy the Millennium Development Goals 4 by 2015 world leader should be made efforts regarding better financial access for the poor, poverty reduction, awareness about health, and food security for all, are essential to sustain the success. We need to improve the total socioeconomic status rather than money incentives for a while s to end health inequalities in the developed and developing counties. We declare that we have no conflict of interest *Dewan Sakhawat Billal, Ph.D, Postdoctoral fellow Assistant Professor Munuki Hotomi ,MD, Ph.D Professor Noboru Yamanaka, MD, Ph.D billalds@wakayama-med.ac.jp Division of Infection and Immunity research Center, Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama 641-8509, Japan References 1.O'Down A. Cash might help to change unhealthy behavior, MPs told. BMJ 2008;1036. 2. Fernald LCH, Gertler PJ, Neufeld LM. Role of cash in conditional cash transfer programmes for child health, growth, and development: an analysis of Mexico's Oportunidades. Lancet 2008; 371: 828�E7. 3. Mercer A, Haseen F, Huq NL, Uddin N, Hossain Khan M, Larson CP. Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme. Health Policy Plan 2006;21:432-43. 4. Ahmed S, Sobhan F, Islam A, Barkat-e-Khuda. Neonatal morbidity and care-seeking behaviour in rural Bangladesh. J Trop Pediatr 2001 ; 47:98- 105. Competing interests: None declared