Development of a Conceptual System Based on the Explanation of Social Inequalities in Health Related to Household Health Expenditure in a Context of Vulnerability to Multidimensional Poverty in Benin

Reducing social inequalities in health (SSI) is an essential issue for promoting the well-being of populations in developing countries like Benin. Achieving this objective must result from the establishment of effective economic and health policies that better meet the real needs of the populations. These different policies can only be effective with an understanding, in-depth knowledge and mastery of the determinants of SIH. Thus, to meet this challenge, the present study has set itself the objective of proposing an explanatory model of SIH based on health spending in a context of multidimensional household poverty. It was carried out in three months in three communes of Benin, which are Cotonou (richer commune), Savè (middle commune) and Karimama (poorer commune) on a sample of 1261 households constituted by the formula of Sloven. Additional descriptive and explanatory analyzes resulting from the censored Tobit and simple Logit econometric regression models made it possible to estimate household health expenditure, assess their weight and weight effect, but also analyze the links between household expenditure health and social inequalities in health. The Social Dominance Theory of Sidanius and Pratto (1993) and the Feedback Theory of Evans et al. (1999) facilitated the development of a new explanatory theory of SIH. The results of this study show that for all the populations studied, a small part of the monthly budget is allocated to health. Households do not even devote 5 % of their total expenditure to it (budget coefficient = 4.28 %), which is equivalent on average to around 1008 FCFA. Likewise, in the presence of other factors, according to the full model, if health expenditure increases by 1 %, the chance of being in good health increases by 0.4 %. These same results indicate that even if in monetary terms the rich spend more than the poor, in terms of weight on income, the poor bear the expenses more than the rich. Consequently, it was noted that the variab