Gender Inequalities in the burden of Non-Communicable Diseases in Botswana: A Differences-in-Decomposition Approach
64th ISI World Statistics Congress - Ottawa, Canada
Format: CPS Abstract
Keywords: "differential", non-communicable
Session: CPS 35 - Official statistics: Gender inequality
Monday 17 July 5:30 p.m. - 6:30 p.m. (Canada/Eastern)
Background: While Botswana has made progress in reducing inequality, the country’s Gini coefficient of 0.522 still remains among the highest in the southern African Customs Union (SACU) region as well as among the rest of the world. Within the country, problems of unemployment, poverty and inequality continue to affect women more than men. Unemployment rate among females is estimated at 19 percent relative to 16 percent among males. In addition, females are not only poorer (54.2 percent) than males (45.8 percent) but, are also less likely to transition out of poverty. This paper demonstrates how the pattern of susceptibility to, or the burden of non-communicable diseases (NCDs) and mortality arising thereof is very similar to the patterns of unemployment and poverty in Botswana. In Botswana, NCD accounts for 52 percent of mortality followed by communicable diseases (43 percent) and injuries (5 percent) in Botswana. Available data also estimate that 23 percent of females are overweight and 19 percent are obese compared to 14 percent and 5 percent of males respectively. Taking the risk factors of NCDs as an aggregate, 28 percent of females compared to 24 percent of males have three or more risk factors. Methods: The study employs concentration curves and indices on the 2009-10 Botswana Core Welfare Indicators Survey and the 2015-16 Botswana Multi-Topic Household Survey to examine the socio-economic related inequality in NCDs with a focus on gender. The study also uses the Blinder-Oaxaca decompositions, which separately partitions the gender gap from 2009-10 and 2015-16 into differences in both observed and unobserved factors. Subsequently, the changes in the gender gap are partitioned into changes in both observed and unobserved factors, using the differences-in-decompositions method. This way, the analysis permitted an examination on whether or not there have been changes in the factors associated with the prevalence of NCDs among females and males over time. Such information is important in Botswana where progressive effort has been made in the development of policies aimed at reducing gendered health inequalities associated with socio-economic factors. To the best of our knowledge, no study has applied the same approach on NCDs in Botswana yet, the rise in NCDs has some gendered disparities that if understood, could aid in proper targeting of healthcare interventions to ensure the attainment of universal health coverage. Results: This paper will present study findings that suggest that in both periods of 2009/10 and 2015/16, a higher proportion of NCDs are reported amongst both poor male and female households. Considering that the Sustainable Development Goals encourage all countries to ensure gender equality while leaving nobody behind through achieving universal health coverage, this paper will present findings that suggest that in strengthening existing policies, it is of importance to ensure that poverty alleviation policies are integrated with NCDs prevention and management strategies to ensure that they reach all households by level of wealth status.