Population Research and Policy Review 22: 267–295, 2003.
© 2003 Kluwer Academic Publishers. Printed in the Netherlands.
267
Gender bias in the allocation of curative health care in Minia,
Egypt
KATHRYN M. YOUNT
Departments of International Health and Sociology, Emory University
Abstract. Research indicates that girls’ disadvantage in 1–4 mortality is unusually high in
Egypt, yet the relevance of intra-family differences in power for the distribution of health
resources is debated. This analysis compares effects of the involvement of various family
members on choice of provider, place of care, and total expenditures for curative care among
129 girls and boys with diarrhea in Minia, Egypt. Girls have lower odds than boys of visiting
doctors versus lay providers and private versus informal facilities, and the involvement of
fathers in prior discussions about care may be important to reduce this disparity. Median
expenditures for curative care also are lower for girls than boys, particularly when fathers
are never involved in choice of care. Future research should examine the extent to which these
disparities in care reflect differences in the quality of care received.
Keywords: access to care, child survival, Egypt, gender differences
Introduction
Girls’ disadvantage in early childhood mortality persists in all regions and
in over half of countries with data available (United Nations 1998; Hill &
Upchurch 1995; Tabutin & Willems 1993, 1995). Countries in South-Central
Asia have shown the greatest female disadvantage in early child mortality
(U.N. 1998), and a vast literature documents persistent gender differences
in early child mortality in specific countries of the region (Pande 1999;
Fauveau et al. 1991; Bhuiya et al. 1987; Koenig & D’Souza 1986; Sabir
& Ebrahim 1984; Miller 1981; D’Souza & Chen 1980; Wyon & Gordon
1971). An absolute excess mortality of girls also is detectable in 12 of 28
countries in Sub-Saharan Africa (U.N. 1998; LeGrand & Mbacke 1995), 8
of 23 countries in Latin America (U.N. 1998; Gomez Gomez 1993) and 4 of
10 countries in South-East Asia (U.N. 1998). In only 10 countries in these re-
gions, however, does girls’ excess mortality exceed 10 per cent (Burkina Faso,
Burundi, Cameroon, Namibia, the Niger, Togo, Guatemala, Haiti, China, and
the Philippines).
Trends in absolute gender differences in mortality between the 1970s and
1980s have varied by region. Girls’ absolute excess mortality increased from