Inequality of Health Opportunity Among Children Aged Under 5 Years in Togo

The proved influence of inequality of opportunity (luck) and efforts (behavior in relation to health) on the health status and mortality of individuals bring up the problem of the unequal distribution of health in a given population. This subject is relatively little discussed in the literature on public health in developing countries including Togo. By focusing on health inequalities of opportunity, we analyze the evolution of their contribution to the health of children (as measured by the standardized height) in Togo using data from Demographic and Health Survey (DHS 1998 and 2013). The methodological approach is based on decomposable general entropy measures like the Theil-T index to measure the total inequality after dealing with natural variation in the height of children. This inequality is decomposed into within opportunities inequality and the between-opportunity (inequality of opportunity) by using a non-parametric approach after building the opportunity groups with the selected circumstances variables.The results showed that the total health inequality experienced a decline between 1998 and 2013 from 0.65 to 0.26 in 15 years. This decrease is also observed for the inequality in within- opportunity while an increase is observed for the inequality of opportunity. The contribution from inequality of opportunity (inter-group inequality of opportunity) has increased over the period 1998-2013. It goes from 0.14 to 0.18 respectively in 1998 and 2013. These relatively low levels of inequality of opportunity are interpreted as an estimate of the lower bound of the set of variables in circumstances that may influence the children's health. Results show that inequality of opportunity is a reality and contributes to inequality in the distribution of children’s health status (measured by height for age index) in Togo. To significantly reduce inequality of opportunity and improve the health of children, it is important to have a better understanding of the circumstances in which children live and which impact negatively their health