scholarly journals Public health expenditure and health system responsiveness for low-income individuals: results from 63 countries

2016 ◽  
pp. czw127
Author(s):  
Chetna Malhotra ◽  
Young Kyung Do
2021 ◽  
pp. 001946622098182
Author(s):  
Saswata Ghosh ◽  
Arup Kumar Das ◽  
Akhilesh Yadav

India has gradually increased its testing capacity of COVID-19 by mid-September 2020. However, the level of testing is substantially low in comparison with many high- and middle-income countries. Evidently, the pandemic in India is likely to be prolonged and affect millions in comparison to other countries, due to its huge population size. The possibility of a sudden upsurge of infections may turn overwhelming, jeopardising the health system, if an appropriate testing policy is not immediately adopted, given that the public health expenditure capacity of India has remained at a suboptimal level. Against this backdrop, a descriptive analysis has been carried out using the published data of the number of infections, tests and daily COVID-19 cases and public health expenditure data published by different sources and available in the public domain. The analysis suggests that a differential strategy is required to deal with the situation, which varies across states and depends upon the health spending capacity of individual states and their population size, among other factors. The specific strategy recommendations would be as follows. First, the testing rate should not be too high or too low, and this can be assessed using a marker: marginal return on testing. Second, India should follow the upper-middle-income-country standard in assessing the testing rate. Third, as a long-term strategy, there is a need to strengthen the public health system to avert a future catastrophe in the form of such pandemic.


2018 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Kok Wooi Yap ◽  
Doris Padmini Selvaratnam

This study aims to investigate the determinants of public health expenditure in Malaysia. An Autoregressive Distributed Lag (ARDL) approach proposed by Pesaran & Shin (1999) and Pesaran et al. (2001) is applied to analyse annual time series data during the period from 1970 to 2017. The study focused on four explanatory variables, namely per capita gross domestic product (GDP), healthcare price index, population aged 65 years and above, as well as infant mortality rate. The bounds test results showed that the public health expenditure and its determinants are cointegrated. The empirical results revealed that the elasticity of government health expenditure with respect to national income is less than unity, indicating that public health expenditure in Malaysia is a necessity good and thus the Wagner’s law does not exist to explain the relationship between public health expenditure and economic growth in Malaysia. In the long run, per capita GDP, healthcare price index, population aged more than 65 years, and infant mortality rate are the important variables in explaining the behaviour of public health expenditure in Malaysia. The empirical results also prove that infant mortality rate is significant in influencing public health spending in the short run. It is noted that macroeconomic and health status factors assume an important role in determining the public health expenditure in Malaysia and thus government policies and strategies should be made by taking into account of these aspects.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Gadija Khan ◽  
Nancy Kagwanja ◽  
Eleanor Whyle ◽  
Lucy Gilson ◽  
Sassy Molyneux ◽  
...  

Abstract Background The World Health Organisation framed responsiveness, fair financing and equity as intrinsic goals of health systems. However, of the three, responsiveness received significantly less attention. Responsiveness is essential to strengthen systems’ functioning; provide equitable and accountable services; and to protect the rights of citizens. There is an urgency to make systems more responsive, but our understanding of responsiveness is limited. We therefore sought to map existing evidence on health system responsiveness. Methods A mixed method systemized evidence mapping review was conducted. We searched PubMed, EbscoHost, and Google Scholar. Published and grey literature; conceptual and empirical publications; published between 2000 and 2020 and English language texts were included. We screened titles and abstracts of 1119 publications and 870 full texts. Results Six hundred twenty-one publications were included in the review. Evidence mapping shows substantially more publications between 2011 and 2020 (n = 462/621) than earlier periods. Most of the publications were from Europe (n = 139), with more publications relating to High Income Countries (n = 241) than Low-to-Middle Income Countries (n = 217). Most were empirical studies (n = 424/621) utilized quantitative methodologies (n = 232), while qualitative (n = 127) and mixed methods (n = 63) were more rare. Thematic analysis revealed eight primary conceptualizations of ‘health system responsiveness’, which can be fitted into three dominant categorizations: 1) unidirectional user-service interface; 2) responsiveness as feedback loops between users and the health system; and 3) responsiveness as accountability between public and the system. Conclusions This evidence map shows a substantial body of available literature on health system responsiveness, but also reveals evidential gaps requiring further development, including: a clear definition and body of theory of responsiveness; the implementation and effectiveness of feedback loops; the systems responses to this feedback; context-specific mechanism-implementation experiences, particularly, of LMIC and fragile-and conflict affected states; and responsiveness as it relates to health equity, minority and vulnerable populations. Theoretical development is required, we suggest separating ideas of services and systems responsiveness, applying a stronger systems lens in future work. Further agenda-setting and resourcing of bridging work on health system responsiveness is suggested.


Economies ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 58 ◽  
Author(s):  
Micheal Kofi Boachie ◽  
K. Ramu ◽  
Tatjana Põlajeva

The effect of government spending on population’s health has received attention over the past decades. This study re-examines the link between government health expenditures and health outcomes to establish whether government intervention in the health sector improves outcomes. The study uses annual data for the period 1980–2014 on Ghana. The ordinary least squares (OLS) and the two-stage least squares (2SLS) estimators are employed for analyses; the regression estimates are then used to conduct cost-effectiveness analysis. The results show that, aside from income, public health expenditure contributed to the improvements in health outcomes in Ghana for the period. We find that, overall, increasing public health expenditure by 10% averts 0.102–4.4 infant and under-five deaths in every 1000 live births while increasing life expectancy at birth by 0.77–47 days in a year. For each health outcome indicator, the effect of income dominates that of public spending. The cost per childhood mortality averted ranged from US$0.20 to US$16, whereas the cost per extra life year gained ranged from US$7 to US$593.33 (2005 US$) during the period. Although the health effect of income outweighs that of public health spending, high (and rising) income inequality makes government intervention necessary. In this respect, development policy should consider raising health sector investment inter alia to improve health conditions.


Author(s):  
Mirela Cristea ◽  
Gratiela Georgiana Noja ◽  
Petru Stefea ◽  
Adrian Lucian Sala

Population aging and public health expenditure mainly dedicated to older dependent persons present major challenges for the European Union (EU) Member States, with profound implications for their economies and labor markets. Sustainable economic development relies on a well-balanced workforce of young and older people. As this balance shifts in favor of older people, productivity tends to suffer, on the one hand, and the older group demands more from health services, on the other hand. These requisites tend to manifest differently within developed and developing EU countries. This research aimed to assess population aging impacts on labor market coordinates (employment rate, labor productivity), in the framework of several health dimensions (namely, health government expenditure, hospital services, healthy life years, perceived health) and other economic and social factors. The analytical approach consisted of applying structural equation models, Gaussian graphical models, and macroeconometric models (robust regression and panel corrected standard errors) to EU panel data for the years 1995–2017. The results show significant dissimilarities between developed and developing EU countries, suggesting the need for specific policies and strategies for the labor market integration of older people, jointly with public health expenditure, with implications for EU labor market performance.


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