scholarly journals Do Political Factors affect Government Health Spending? Empirical Evidence from Sub-Sahara African Countries

2020 ◽  
Vol 3 (2) ◽  
pp. p57
Author(s):  
Issa Dianda
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Expenditure ◽  
Public Spending ◽  
Health Spending ◽  
Political Stability ◽  
Sub Saharan Africa ◽  
Political Factors ◽  
Government Health ◽  
Out Of Pocket Payments

In Sub-Saharan Africa (SSA), access to essential health care services remains problematic. The financing of health care is mainly provided by private sources, mainly out-of-pocket payments which represent respectively 53.12% and 36.73% of total health expenditure in 2016. As for public health expenditure, essential for ensuring universal health coverage, it represents only about 35% of health expenditure. Thus, the increase in public spending on health from domestically sources proves to be a major challenge for the countries of the region in the prospect of reaching the SDG relating to health by 2030. This paper aims to analyse the determinants of domestic government health spending in SSA by focusing on political factors. We use data from 39 SSA countries covering the period 2010-2016 and panel-corrected standard errors method for empirical investigation. The results show that democracy favours an increase in government health spending. Furthermore, a political competitive environment, the guarantee and the protection of civil liberties and political right, accountability, government effectiveness and political stability are decisive for increasing government health spending. The results also showed that political participation does not affect public health spending. These results indicate that improving political factors is essential to increase public spending in SSA.

scholarly journals Assessing medical impoverishment and associated factors in health care in Ethiopia

2019 ◽  
Author(s):  
Amarech Guda Obse ◽  
John E. Ataguba
Keyword(s):  
Rural Areas ◽  
Health Expenditure ◽  
Significant Proportion ◽  
Health Spending ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Financial Protection ◽  
Health Coverage ◽  
Current Health ◽  
Out Of Pocket Payments

Abstract Background About 5% of the global population, predominantly in low- and middle-income countries, is forced into poverty because of out-of-pocket (OOP) health spending. In most countries in sub-Saharan Africa, the share of OOP health spending in current health expenditure exceeds 35%, increasing the likelihood of impoverishment. In Ethiopia, OOP payments remained high at 37% of current health expenditure in 2016. This study aims to assess impoverishment resulting from OOP health spending in Ethiopia and examine the factors associated with this impoverishment.Methods This paper uses data from the Ethiopian Household Consumption Expenditure Survey (HCES) 2010/11. The HCES covered 10,368 rural and 17,664 urban households. OOP health spending includes spending on various outpatient and inpatient services. Impoverishing impact of OOP health spending was estimated by comparing poverty estimates before and after OOP health spending. A probit model was used to assess factors that are associated with impoverishment.Results Using the Ethiopian national poverty line of Birr 3,781 per person per year (equivalent to US$2.10 per day), OOP health spending pushed about 1.19% of the population (i.e. over 957,169 individuals) into poverty. Living in rural areas (highland, moderate, or lowland) increased the likelihood of impoverishment compared to residing in an urban area. Households headed by males and adults with formal education are less likely to be impoverished by OOP health spending, compared to their counterparts.Conclusion In Ethiopia, OOP health spending impoverishes a significant number of the population. Although the country had piloted and initiated many reforms, e.g. the fee waiver system and community-based health insurance, a significant proportion of the population still lacks financial protection. The estimates of impoverishment from out-of-pocket payments reported in this paper do not consider individuals that are already poor before paying out-of-pocket for health services. It is important to note that this population may either face deepening poverty or forgo healthcare services if a need arises. More is therefore required to provide financial protection to achieve universal health coverage in Ethiopia, where the informal sector is relatively large.

Health Expenditures in Latin America 1995-2010

2013 ◽  
Vol 3 (2) ◽  
pp. 46-63 ◽  
Author(s):  
Jesus Salgado-Vega ◽  
Fatima Y. Salgado-Naime
Keyword(s):  
Latin American ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Dynamic Models ◽  
Health Spending ◽  
Health Expenditures ◽  
Government Health ◽  
Out Of Pocket Payments ◽  
Out Of Pocket Expenses ◽  
Government Health Expenditure

The authors examine the trajectory of health expenditures in Latin American countries. The authors apply standard fixed effects and dynamic models to explore the factors associated with the growth of total health expenditures as well as its main components namely, government health expenditures and out-of-pocket payments. Their results suggest that, after taking other factors into consideration, health expenditures in general do not grow faster than the Gross National Product (GNP). The authors confirm the existence of fungibility, where external aid for health reduces government health spending and out-of-pocket expenses from domestic sources. The study also finds that government health expenditure and out-of-pocket payments follow the same paths in time but vary for countries at different levels of economic development; the same is true for health expenditure growth.

scholarly journals Assessing medical impoverishment and associated factors in health care in Ethiopia

2020 ◽  
Author(s):  
Amarech Guda Obse ◽  
John E. Ataguba
Keyword(s):  
Rural Areas ◽  
Health Expenditure ◽  
Addis Ababa ◽  
Significant Proportion ◽  
Health Spending ◽  
Sub Saharan Africa ◽  
Financial Protection ◽  
Health Coverage ◽  
Current Health ◽  
Out Of Pocket Payments

Abstract Background: About5% of the global population, predominantly in low- and middle-income countries, is forced into poverty because of out-of-pocket (OOP) health spending. In most countries in sub-Saharan Africa, the share of OOP health spending in current health expenditure exceeds 35%, increasing the likelihood of impoverishment. In Ethiopia, OOP payments remained high at 37% of current health expenditure in 2016. This study aims to assess impoverishment resulting from OOP health spending in Ethiopia and examine the factors associated with this impoverishment. Methods: This paper uses data from the Ethiopian Household Consumption Expenditure Survey (HCES) 2010/11. The HCES covered 10,368 rural and 17,664 urban households. OOP health spending includes spending on various outpatient and inpatient services. Impoverishing impact of OOP health spending was estimated by comparing poverty estimates before and after OOP health spending. A probit model was used to assess factors that are associated with impoverishment. Results: Using the Ethiopian national poverty line of Birr 3,781 per person per year (equivalent to US$2.10 per day), OOP health spending pushed about 1.19% of the population (i.e. over 957,169 individuals) into poverty. At regional level, impoverishment ranged between 2.35% in Harari and 0.35% in Addis Ababa. Living in rural areas (highland, moderate, or lowland) increased the likelihood of impoverishment compared to residing in an urban area. Households headed by males and adults with formal education are less likely to be impoverished by OOP health spending, compared to their counterparts. Conclusion:In Ethiopia, OOP health spending impoverishes a significant number of the population. Although the country had piloted and initiated many reforms, e.g. the fee waiver system and community-based health insurance, a significant proportion of the population still lacks financial protection. The estimates of impoverishment from out-of-pocket payments reported in this paper do not consider individuals that are already poor before paying out-of-pocket for health services. It is important to note that this population may either face deepening poverty or forgo healthcare services if a need arises. More is therefore required to provide financial protection to achieve universal health coverage in Ethiopia, where the informal sector is relatively large.

Health Expenditure

2018 ◽  
pp. 268-292
Author(s):  
Jesus Salgado-Vega ◽  
Fatima Y. Salgado-Naime
Keyword(s):  
Latin American ◽  
Health Expenditure ◽  
Health Spending ◽  
Health Financing ◽  
Government Health ◽  
Long Run ◽  
Out Of Pocket Payments ◽  
Short Run ◽  
Government Health Expenditure ◽  
Main Components

This chapter explores the factors associated with the growth of total health expenditure, in addition to its main components, government health expenditure and out-of-pocket payments. Results suggest that health expenditure in general does not grow faster than gross national product (GNP). No difference is found in health expenditure between tax-based and insurance-based health financing mechanisms. The authors confirm the existence of fungibility, where external aid for health reduces government health spending and out-of-pocket payments from domestic sources. The study also finds that government health expenditure and out-of-pocket payments follow the same paths in time, but are different for countries at different levels of economic development and the same for health expenditure growth. In Latin American countries, the relationship between health expenditure and GNP per capita is positive; there is a quick adjustment in the short run to obtain long-run behavior.

Health Expenditure

2015 ◽  
Vol 3 (2) ◽  
pp. 27-50
Author(s):  
Jesus Salgado-Vega ◽  
Fatima Y. Salgado-Naime
Keyword(s):  
Latin American ◽  
Health Expenditure ◽  
Health Spending ◽  
Health Financing ◽  
Government Health ◽  
Long Run ◽  
Out Of Pocket Payments ◽  
Short Run ◽  
Government Health Expenditure ◽  
Main Components

This chapter explores the factors associated with the growth of total health expenditure, in addition to its main components, government health expenditure and out-of-pocket payments. Results suggest that health expenditure in general does not grow faster than gross national product (GNP). No difference is found in health expenditure between tax-based and insurance-based health financing mechanisms. The authors confirm the existence of fungibility, where external aid for health reduces government health spending and out-of-pocket payments from domestic sources. The study also finds that government health expenditure and out-of-pocket payments follow the same paths in time, but are different for countries at different levels of economic development and the same for health expenditure growth. In Latin American countries, the relationship between health expenditure and GNP per capita is positive; there is a quick adjustment in the short run to obtain long-run behavior.

scholarly journals Effects of the COVID-19 Pandemic on the Budgetary Mechanism Established to Cover Public Health Expenditure. A Case Study of Romania

2021 ◽  
Vol 18 (3) ◽  
pp. 1134
Author(s):  
Mihaela Onofrei ◽  
Elena Cigu ◽  
Anca-Florentina Gavriluta (Vatamanu) ◽  
Ionel Bostan ◽  
Florin Oprea
Keyword(s):  
Public Health ◽  
Health Care ◽  
Retrospective Analysis ◽  
Health Expenditure ◽  
Health Spending ◽  
Health Care Spending ◽  
Long Run ◽  
System Resilience ◽  
New Evidence

The COVID-19 pandemic stressed the importance of understanding the sources of vulnerabilities that can lead to a financial crisis and highlighted the predominant impact on health systems. Firstly, the paper aims to conduct a retrospective analysis of the Romanian health care system, over the period of time 1985–2019, based on our own computed sustainability index for public health. Secondly, using the Gregory-Hansen cointegration method, we provide new evidence on the causal relationship between health expenditure and GDP for Romania over the period of time 1985–2017. Based on the retrospective analysis of the long-run co-movement between health spending and GDP, the study allows one to prospectively examine not only the effects of the COVID-19 pandemic on health care spending, but also to reveal the government’s fiscal position and vulnerabilities. Our results highlight the intergenerational costs related to the policy incoherence roadmap and regulatory fragmentation, stressing the importance of economic system resilience through fiscal diligence and the consolidation of the institutional context.

scholarly journals Exploring country-wide equitable government health care facility access in Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Dowhaniuk
Keyword(s):  
Health Care ◽  
Random Forest ◽  
Health Center ◽  
Travel Time ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Walking Distance ◽  
Laboratory System ◽  
Government Health ◽  
Sub Saharan

Abstract Background Rural access to health care remains a challenge in Sub-Saharan Africa due to urban bias, social determinants of health, and transportation-related barriers. Health systems in Sub-Saharan Africa often lack equity, leaving disproportionately less health center access for the poorest residents with the highest health care needs. Lack of health care equity in Sub-Saharan Africa has become of increasing concern as countries enter a period of simultaneous high infectious and non-communicable disease burdens, the second of which requires a robust primary care network due to a long continuum of care. Bicycle ownership has been proposed and promoted as one tool to reduce travel-related barriers to health-services among the poor. Methods An accessibility analysis was conducted to identify the proportion of Ugandans within one-hour travel time to government health centers using walking, bicycling, and driving scenarios. Statistically significant clusters of high and low travel time to health centers were calculated using spatial statistics. Random Forest analysis was used to explore the relationship between poverty, population density, health center access in minutes, and time saved in travel to health centers using a bicycle instead of walking. Linear Mixed-Effects Models were then used to validate the performance of the random forest models. Results The percentage of Ugandans within a one-hour walking distance of the nearest health center II is 71.73%, increasing to 90.57% through bicycles. Bicycles increased one-hour access to the nearest health center III from 53.05 to 80.57%, increasing access to the tiered integrated national laboratory system by 27.52 percentage points. Significant clusters of low health center access were associated with areas of high poverty and urbanicity. A strong direct relationship between travel time to health center and poverty exists at all health center levels. Strong disparities between urban and rural populations exist, with rural poor residents facing disproportionately long travel time to health center compared to wealthier urban residents. Conclusions The results of this study highlight how the most vulnerable Ugandans, who are the least likely to afford transportation, experience the highest prohibitive travel distances to health centers. Bicycles appear to be a “pro-poor” tool to increase health access equity.

Recognition and Analysis of the Drivers and Key Factors Affecting Exposure Households with Catastrophic and Impoverishing Health Expenditure in Iran with the Futures Study Approach Protocol (Preprint)

2021 ◽  
Author(s):  
Maryam Hedayati ◽  
Iravan Masoudi Asl ◽  
Mohammad Reza Maleki ◽  
Salime Goharinezhad ◽  
Ali Akbar Fazaeli
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Financial Protection ◽  
Key Factors ◽  
Healthcare Expenditures ◽  
Financial Barriers ◽  
Out Of Pocket Payments ◽  
The Future ◽  
Key Drivers ◽  
Hierarchy Process

BACKGROUND Health expenditure is a vital issue for policymakers not as it were due to the health outcome significance, but moreover since of the gradual total health expenditure rises that has ended up a major concern. To survey the financial related burden due to out-of-pocket payments, two commonly elite approaches have been utilized: catastrophic and impoverishing health expenditures. Catastrophic healthcare expenditures and impoverishment both can prevent individuals from accessing effective healthcare services. In Iran, the high out-of-pocket and increase in the share of the population experiencing catastrophic healthcare expenditures and poor financial protection of households against catastrophic healthcare expenditures are among the major public health concerns. To identify the drivers, key factors, and the trends of catastrophic and impoverishing healthcare expenditures among Iranian households, this study will be conducted by futures studies approach. OBJECTIVE - To identify the key drivers affecting the future of catastrophic and impoverishing healthcare expenditure in Iran. - To assess the trend in the incidence and intensity of CHE in Iran. - To categorize the key drivers - To prioritize main promoter factors in terms of importance, effectiveness and lack of uncertainty. METHODS This study will conduct in four steps. The drivers of the future of Exposure Households with Catastrophic and Impoverishing Health Expenditure will be listed by analyzing the results of a scoping review and then semi-structured interviews with health financial experts. Afterward, key drivers will be categorized using Porter's five forces (social, technical, economic, environmental, and political) for the macro environment and prioritized using the Fuzzy Analytical Hierarchy Process (FAHP) formulated in excel software. Further, cross-impact analysis of promoter factors and analytic hierarchy process will be used to determine main promoter factors in terms of importance, effectiveness, and lack of uncertainty. RESULTS We anticipate that the results of this protocol study will provide a comprehensive overview of the evidence on the determinants of unfairness and payments that expose the Iranian households to catastrophic and impoverishing health care expenditures and identify research gaps. CONCLUSIONS In our study, we will examine the rates of catastrophic health expenditure and impoverishment from medical expenses and its drivers in Iran. This will provide insight into the level of financial protection that a healthcare financing system provides for its citizens. It reflects the financial burden shouldered by families and the financial barriers that reduce their access to health care.

scholarly journals The COVID-19 Pandemic and Non-communicable Diseases—A Wake-up Call for Primary Health Care System Strengthening in Sub-Saharan Africa

2020 ◽  
Vol 11 ◽  
pp. 215013272094694
Author(s):  
Christian Kraef ◽  
Pamela Juma ◽  
Per Kallestrup ◽  
Joseph Mucumbitsi ◽  
Kaushik Ramaiya ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Systems ◽  
Health Spending ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Primary Health Care System ◽  
Health Coverage ◽  
Non Communicable Diseases ◽  
Primary Health

Strengthening Primary Health Care Systems is the most effective policy response in low-and middle-income countries to protect against health emergencies, achieve universal health coverage, and promote health and wellbeing. Despite the Astana declaration on primary health care, respective investment is still insufficient in Sub-Sahara Africa. The SARS-CoV-2019 pandemic is a reminder that non-communicable diseases (NCDs), which are increasingly prevalent in Sub-Sahara Africa, are closely interlinked to the burden of communicable diseases, exacerbating morbidity and mortality. Governments and donors should use the momentum created by the pandemic in a sustainable and effective way by pivoting health spending towards primary health care.

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