Medicine and democracy: The importance of institutional quality in the relationship between health expenditure and health outcomes in the MENA region

Health Policy ◽  
2016 ◽  
Vol 120 (8) ◽  
pp. 928-935 ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Bruno Ventelou ◽  
Mohammad Abu-Zaineh
Keyword(s):  
Health Outcomes ◽  
Health Expenditure ◽  
Institutional Quality ◽  
Mena Region ◽  
The Relationship

scholarly journals Relationship between Public Debt Burden and Health Expenditure in Sub-Saharan African Countries: The Role of Institutional Quality

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Rusmawati Said ◽  
Abdullahi Sani Morai
Keyword(s):  
Public Debt ◽  
Health Expenditure ◽  
Institutional Quality ◽  
Sub Saharan Africa ◽  
African Countries ◽  
The Public ◽  
Debt Burden ◽  
Sub Saharan ◽  
The Relationship

The historically lower level of public health expenditure of sub-Saharan African (SSA) countries could be partly explained by the mounting debt burden of this region. This consumes a sizable proportion of their domestic resources to debt servicing and potentially decreases their overall budgetary allocations to various sectors in the economy and health expenditure in particular. Using the Generalized Method of Moments (GMM) approach on a sample of 43 sub-Saharan African countries, we examined the relationship between the public debt burden and health expenditure highlighting the role of institutional quality for the period 2000 – 2014. The empirical result confirms that the relationship between public debt burden and health expenditure in sub-Saharan Africa is negative. Interestingly, however, the marginal effect of the relationship between the public debt burden and health expenditure has shown that such a negative relationship turns out to be positive when the quality of the institutions is at maximum. This suggests that the relationship between the public debt burden and health expenditure in sub-Saharan Africa is a function of institutional quality.  Therefore, to minimize the negative impact of public debt on health expenditure in sub-Saharan Africa, governments should take determine stand to minimize its debt accumulation and intensify efforts toward the improvement of institutional quality in the region comprehensively.

scholarly journals Health Expenditure, Institutions, and Economic Growth: Insights From Selected MENA Countries

2021 ◽  
Author(s):  
Bashir Umar Faruk ◽  
Mohammad Imdadul Haque ◽  
Mohammad Rumzi Tausif ◽  
Md Riyazuddin Khan
Keyword(s):  
Economic Growth ◽  
Health Expenditure ◽  
Institutional Quality ◽  
Granger Causality Test ◽  
Causality Test ◽  
Mena Countries ◽  
Health Investments ◽  
Long Run ◽  
The Relationship

Abstract Health expenditure plays an important role in nation-building. Moreover, the current wave of the COVID-19 pandemic highlights the importance of health investments in maintaining a healthier economy across the world. Quite a significant number of empirical research undertaken on the relationship between health expenditure and economic growth produce mixed results. The study plans to study the relationship between health expenditure and economic growth and the role of institutions in causing health expenditure to promote growth. The study analyses this relationship using the case of seven selected MENA countries between 2000 and 2017. The Pedroni cointegration test reports a long-run cointegrating relationship between the variables. However, the Granger Causality test finds no casual relationships between health expenditure and economic growth. The study further applies panel OLS, FMOLS, and DOLS, and the result from all three models shows that health expenditure does not directly contribute to higher economic growth in the MENA countries. The study argues that this is possibly due to inadequate institutional quality. However, it is understandable that there must be indirect effects of health expenditure on economic growth through better human capital. Finally, the study discusses policy options to improve institutional quality indicators to tap the benefits and contribute positively to economic growth in the region.

scholarly journals Responding to the Pandemic: A Multicountry Study on Social-Political Factors and Health Outcomes of COVID-19

2021 ◽  
Author(s):  
◽  
Lan Yao ◽  
Keyword(s):  
Systematic Review ◽  
Population Density ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Political Factors ◽  
Healthcare Workforce ◽  
The Relationship

Introduction. Coronavirus Disease 2019 (COVID-19) poses a major global threat to human beings, which has caused devastating consequences of population health, political, and economic crises in many countries. This dissertation was composed of three research activities to study the following aims: (1) review the existing literature focusing on political factors and health outcomes of COVID-19; (2) assess the relationship between democracy and case fatality rate of COVID-19 by controlling for the effect of age, comorbidity, health expenditure, healthcare workforce, and population density; and (3) identify the trajectory pattern cases peak days, deaths peak days, and peak periods. Methods. We accessed data from the World Health Organization (WHO), World Bank, Johns Hopkins University, and the Democracy Index 2019 database. First, we conducted a systematic review that searched three databases and synthesized the articles about democracy and health outcomes of COVID-19. Second, we analyzed data from 148 countries with at least 2,000 confirmed cases of COVID-19 by October 25, 2020. Multiple linear regression was used to examine the association between the Democracy Index and case fatality rate of COVID-19 while controlling for other variables, most notably the age distribution of the population. Lastly, we used the patterns of data at the early onset of COVID-19 from seven countries to estimate the time lag between peak days of cases and deaths. Results. Our first research found that of 170 publications in the databases search, 12 publications were screened for systematic review. Among them, one study reported no association between democracy and health outcomes of COVID-19. Eleven articles claimed there was a relationship between democracy level and outcomes of COVID-19. Two papers reported negative associations between democracy and adverse outcomes of the population, while the other nine articles claimed there were positive associations between democracy and the poor health status of populations. When examining the relationship between democracy and health outcomes of COVID-19, the second research demonstrated that the number of hospital beds, the proportion of population above age 65, and current health expenditure as a percentage of the gross domestic product (GDP) are significantly related to the case fatality rates of COVID-19 across 148 countries (p < 0.05). The Democracy Index was not statistically related to the case fatality rates of COVID-19 when considering all 148 countries analyzed but was negatively associated with case fatality rates among 47 high-income countries. In addition, the healthcare workforce, population density, and comorbidity were not statistically significant among the 148 countries. Finally, the findings in the last research suggested that comparative analyses of data from different regions and countries reveal the differences between peaks of cases and deaths caused by COVID-19 and the incomplete and underestimated cases in Wuhan. Different countries may show different patterns of cases peak days, deaths peak days, and peak periods. Error in the early COVID-19 statistics in Brazil was identified. Conclusions. This research is the first to our knowledge to study the relationship between democracy and health outcomes of COVID-19 across countries with large sample sizes. According to the multicountry data, the cross-sectional study suggests that enhancing healthcare system facilities is vital to improving clinical outcomes. Protecting the population older than 65 and adjusting the health expenditure budget may need to be considered. The findings suggest that in high-income countries the higher democracy index is associated with more deaths from COVID-19, perhaps due to the decreased ability of the government to control the movement and behavior of its citizens. Besides, the simulated graphical trajectory method identifies statistical biases in surveillance data. This approach incorporates all sources of available data and provides a robust method to characterize the time course of an infectious disease. Regions and countries beginning with high mortality rates from the COVID-19 epidemic will suffer a long, painful period of the disease epidemic. Where the mortality rate is relatively high, healthcare professionals should prepare for a longer period of fighting this pandemic. Data quality is key to case fatality rate estimation which is needed by policymakers to make correct and timely critical decisions.

scholarly journals Politics, government health expenditure and infant mortality: does political party orientation matter?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Constantinos Alexiou ◽  
Emmanouil Trachanas
Keyword(s):  
Infant Mortality ◽  
Health Outcomes ◽  
Political Party ◽  
Health Expenditure ◽  
Mediating Effect ◽  
Content Type ◽  
Government Health ◽  
Government Health Expenditure ◽  
The Impact ◽  
The Relationship

PurposeMotivated by the scant available evidence, this paper explores the relationship between government political party orientation and infant mortality.Design/methodology/approachA panel quantile methodology is applied to a data set that consists of 15 countries of the G20 group over the period 2000–2018. The authors control for heterogeneous parameters across countries and quantiles and obtain estimates across the different points of the conditional distribution of the dependent variable.FindingsThe findings support the hypothesis that political party orientation has a significant effect on a population health indicator such as infant mortality. The analysis suggests that, to a great extent, left-wing government parties contribute to better health outcomes – when compared to right and centre political parties – both individually as well as interacted with government health expenditure. Moreover, the impact of redistributing policies appears to be of a paramount importance in alleviating infant mortality, while more education and lower unemployment can also contribute to better health outcomes.Originality/valueThe authors explore the relationship between the nature of government political party orientation (i.e. right, centre and left) and infant mortality whilst at the same time gauging the mediating effect of party orientation via government health expenditure on infant mortality. Additional aspects of the impact of other control variables, such as income inequality, unemployment and education on infant mortality are also investigated.

scholarly journals The power-trust cycle in global health: Trust as belonging in relations of dependency

2021 ◽  
pp. 1-21
Author(s):  
Emma-Louise Anderson ◽  
Laura Considine ◽  
Amy S. Patterson
Keyword(s):  
Global Health ◽  
Health Outcomes ◽  
Positive Health ◽  
Global Health Initiatives ◽  
Health Initiatives ◽  
Power Trust ◽  
Trust And Power ◽  
Positive Health Outcomes ◽  
Exercise Of Discretion ◽  
The Relationship

Abstract Trust between actors is vital to delivering positive health outcomes, while relationships of power determine health agendas, whose voices are heard and who benefits from global health initiatives. However, the relationship between trust and power has been neglected in the literatures on both international politics and global health. We examine this relationship through a study of relations between faith based organisations (FBO) and donors in Malawi and Zambia, drawing on 66 key informant interviews with actors central to delivering health care. From these two cases we develop an understanding of ‘trust as belonging’, which we define as the exercise of discretion accompanied by the expression of shared identities. Trust as belonging interacts with power in what we term the ‘power-trust cycle’, in which various forms of power undergird trust, and trust augments these forms of power. The power-trust cycle has a critical bearing on global health outcomes, affecting the space within which both local and international actors jockey to influence the ideologies that underpin global health, and the distribution of crucial resources. We illustrate how the power-trust cycle can work in both positive and negative ways to affect possible cooperation, with significant implications for collective responses to global health challenges.

scholarly journals Hispanic/Latino Ethnic Identity and Diabetes: An Examination of Underlying Acculturation Processes and the Hispanic/Latino Health Advantage

2021 ◽  
Vol 48 (3) ◽  
pp. 285-294
Author(s):  
Jeannie B. Concha ◽  
Kristen Kelly ◽  
Briana Mezuk
Keyword(s):  
Ethnic Identity ◽  
Confidence Interval ◽  
Health Outcomes ◽  
Physical Health ◽  
Odds Ratio ◽  
Well Being ◽  
The United States ◽  
Diabetes Prevalence ◽  
Physical Health Outcomes ◽  
The Relationship

Background. Hispanics/Latinos in the United States experience both a health advantage and disadvantage in developing diabetes. Ethnic identity, a predictor of psychological well-being, has not been widely applied to physical health outcomes. The objective of this study is to apply what is known regarding ethnic identity and psychological health to physical health outcomes (diabetes) and to explore the moderating effect of education as a possible underlying mechanism of the Hispanic Health Advantage/Disadvantage. Specifically, this study examines (a) the association between ethnic identity and diabetes prevalence among adult Hispanics/Latinos and (b) determines whether education modifies this relationship. Method. Data come from the nationally representative adult U.S. household study, National Latino and Asian American Study (NLAAS), collected in 2001 to 2003 ( N = 1,746). Multiple logistic regression was conducted to examine the relationship between ethnic identity, education, and their interaction with likelihood of diabetes. Results. Hispanics/Latinos with high ethnic identity have a higher odds of reporting diabetes among those with 13 to 15 years of education (odds ratio: 1.84; 95% confidence interval: 1.16–2.92) and a lower odds among those with 16+ years of education (odds ratio: 0.53; 95% confidence interval: 0.34–0.84). Ethnic identity is associated with diabetes prevalence and the relationship is moderated by educational attainment. Conclusion. Given the growth, diversity, and diabetes disparities among Hispanics/Latinos, our buffering and exacerbating findings exemplify the complexity and fluidity of theory in understanding psychological/behavioral processes. The findings highlight the importance of designing targeted health interventions that take into account the diverse psychosocial and educational experiences of Hispanics/Latinos.

scholarly journals Institutional quality and the capital structure of microfinance institutions: the moderating role of board gender diversity

2021 ◽  
pp. 1-21
Author(s):  
Michael Adusei ◽  
Beatrice Sarpong-Danquah
Keyword(s):  
Capital Structure ◽  
Institutional Environment ◽  
Gender Diversity ◽  
Institutional Quality ◽  
Microfinance Institutions ◽  
Female Representation ◽  
Long Run ◽  
Board Gender Diversity ◽  
The Relationship

Abstract We test the effect of institutional quality on capital structure in the microfinance setting. In doing this, we rely on data from 532 microfinance institutions (MFIs) located in 73 countries dotted across the six microfinance regions in the world. We observe that institutional quality exhibits a robust negative and statistically significant relationship with capital structure in both the short and long run, implying that MFIs in countries with a better institutional environment are less likely to utilize more debt. Our moderation analysis furnishes us with evidence that the presence of women on the board of an MFI significantly moderates the relationship between institutional quality and its capital structure. We show that in the presence of more female representation on the boards of MFIs, the tendency of MFIs using less debt is higher.

scholarly journals Impact of child development at primary school entry on adolescent health—protocol for a participatory systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Michelle Black ◽  
Amy Barnes ◽  
Mark Strong ◽  
David Taylor-Robinson
Keyword(s):  
Systematic Review ◽  
Child Development ◽  
Health Outcomes ◽  
Primary School ◽  
Adolescent Health ◽  
Health Inequalities ◽  
Starting School ◽  
Children's Development ◽  
The Relationship ◽  
Children’S Development

Abstract Background Reducing child health inequalities is a global health priority and evidence suggests that optimal development of knowledge, skills and attributes in early childhood could reduce health risks across the life course. Despite a strong policy rhetoric on giving children the ‘best start in life’, socioeconomic inequalities in children’s development when they start school persist. So too do inequalities in child and adolescent health. These in turn influence health inequalities in adulthood. Understanding how developmental processes affect health in the context of socioeconomic factors as children age could inform a holistic policy approach to health and development from childhood through to adolescence. However, the relationship between child development and early adolescent health consequences is poorly understood. Therefore the aim of this review is to summarise evidence on the associations between child development at primary school starting age (3–7 years) and subsequent health in adolescence (8–15 years) and the factors that mediate or moderate this relationship. Method A participatory systematic review method will be used. The search strategy will include; searches of electronic databases (MEDLINE, PsycINFO, ASSIA and ERIC) from November 1990 onwards, grey literature, reference searches and discussions with stakeholders. Articles will be screened using inclusion and exclusion criteria at title and abstract level, and at full article level. Observational, intervention and review studies reporting a measure of child development at the age of starting school and health outcomes in early adolescence, from a member country of the Organisation for Economic Co-operation and Development, will be included. The primary outcome will be health and wellbeing outcomes (such as weight, mental health, socio-emotional behaviour, dietary habits). Secondary outcomes will include educational outcomes. Studies will be assessed for quality using appropriate tools. A conceptual model, produced with stakeholders at the outset of the study, will act as a framework for extracting and analysing evidence. The model will be refined through analysis of the included literature. Narrative synthesis will be used to generate findings and produce a diagram of the relationship between child development and adolescent health. Discussion The review will elucidate how children’s development at the age of starting school is related to subsequent health outcomes in contexts of socioeconomic inequality. This will inform ways to intervene to improve health and reduce health inequality in adolescents. The findings will generate knowledge of cross-sector relevance for health and education and promote inter-sectoral coherence in addressing health inequalities throughout childhood. Protocol Registration This systematic review protocol has been registered with PROSPERO CRD42020210011.

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