Corrigendum to: Variation in financial protection and its association with health expenditure indicators: an analysis of low- and middle-income countries

2020 ◽

Vol 5 (1) ◽

pp. 54-73

Author(s):

Micheal Kofi Boachie ◽

Tatjana Põlajeva ◽

Albert Opoku Frimpong

Keyword(s):

Infant Mortality ◽

Health Outcomes ◽

Health Expenditure ◽

Fixed Effects ◽

Health Sector ◽

Health Spending ◽

Middle Income ◽

Government Health ◽

Middle Income Countries ◽

Low And Middle Income

The issue of whether government health spending improves health outcomes has been a matter of contention over the years. There have been calls for governments to reduce their financing role in the health sector since such funding do not produce better health. This article examines the effect of public (i.e., government) health expenditure on infant mortality, a proxy of health outcomes, in low- and middle-income countries. We use data from the World Bank’s World Development Indicators database and employ fixed effects estimation technique, with three-stage least squares as a robustness check. The data cover the period 1995–2014. We find that public health expenditure improves health outcomes significantly, as it reduces infant mortality. The results further show that rising income and access to safe water are some of the reasons for improved health outcomes in low- and middle-income countries. Based on these results and the expected redistributive impact of government spending, governments in low- and middle-income countries may consider increasing health spending for better healthcare systems and improved health.

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Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress

Health Research Policy and Systems ◽

10.1186/1478-4505-11-36 ◽

2013 ◽

Vol 11 (1) ◽

Cited By ~ 41

Author(s):

Di McIntyre ◽

Michael K Ranson ◽

Bhupinder K Aulakh ◽

Ayako Honda

Keyword(s):

Financial Protection ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Evolution of catastrophic health expenditure in a high income country: incidence versus inequalities

International Journal for Equity in Health ◽

10.1186/s12939-019-1044-9 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Carlota Quintal

Keyword(s):

Health Expenditure ◽

Catastrophic Health Expenditure ◽

High Income ◽

Income Country ◽

High Income Country ◽

Extensive Literature ◽

Financial Protection ◽

Middle Income ◽

Middle Income Countries ◽

Catastrophic Payments

Abstract Background Catastrophic health expenditure (CHE) is well established as an indicator of financial protection on which there is extensive literature. However, most works analyse mainly low to middle income countries and do not address the different distributional dimensions of CHE. We argue that, besides incidence, the latter are crucial to better grasp the scope and nature of financial protection problems. Our objectives are therefore to analyse the evolution of CHE in a high income country, considering both its incidence and distribution. Methods Data are taken from the last three waves of the Portuguese Household Budget Survey conducted in 2005/2006, 2010/2011 and 2015/2016. To identify CHE, the approach adopted is capacity to pay/normative food spending, at the 40% threshold. To analyse distribution, concentration curves and indices (CI) are used and adjusted odds ratios are calculated. Results The incidence of CHE was 2.57, 1.79 and 0.46%, in 2005, 2010 and 2015, respectively. CHE became highly concentrated among the poorest (the respective CI evolved from − 0.390 in 2005 to − 0.758 in 2015) and among families with elderly people (the absolute CI evolved from 0.520 in 2005 to 0.740 in 2015). Absolute CI in geographical context also increased over time (0.354 in 2015, 0.019 in 2005). Medicines represented by far the largest share of catastrophic payments, although, in this case concentration decreased (the median share of medicines diminished from 93 to 43% over the period analysed). Contrarily, the weight of expenses incurred with consultation fees has been growing (even for General Practitioners, despite the NHS coverage of primary care). Conclusions The incidence of CHE and inequality in its distribution might progress in the same direction or not, but most importantly policy makers should pay attention to the distributional dimensions of CHE as these might provide useful insight to target households at risk. Greater concentration of CHE can actually be regarded as an opportunity for policy making, because interventions to tackle CHE become more confined. Monitoring the distribution of payments across services can also contribute to early detection of emerging (and even, unexpected) drivers of catastrophic payments.

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Does government expenditure reduce inequalities in infant mortality rates in low- and middle-income countries?: A time-series, ecological analysis of 48 countries from 1993 to 2013

Health Economics Policy and Law ◽

10.1017/s1744133118000269 ◽

2018 ◽

Vol 14 (2) ◽

pp. 249-273 ◽

Cited By ~ 2

Author(s):

Peter Baker ◽

Thomas Hone ◽

Aaron Reeves ◽

Mauricio Avendano ◽

Christopher Millett

Keyword(s):

Infant Mortality ◽

Health Expenditure ◽

Fixed Effects ◽

Government Expenditure ◽

Health Expenditures ◽

Mortality Rates ◽

Demographic And Health Surveys ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

AbstractInequalities in infant mortality rates (IMRs) are rising in some low- and middle-income countries (LMICs) and decreasing in others, but the explanation for these divergent trends is unclear. We investigate whether government expenditures and redistribution are associated with reductions in inequalities in IMRs. We estimated country-level fixed-effects panel regressions for 48 LMICs (142 country observations). Slope and Relative Indices of Inequality in IMRs (SII and RII) were calculated from Demographic and Health Surveys between 1993 and 2013. RII and SII were regressed on government expenditure (total, health and non-health) and redistribution, controlling for gross domestic product (GDP), private health expenditures, a democracy indicator, country fixed effects and time. Mean SII and RII was 39.12 and 0.69, respectively. In multivariate models, a 1 percentage point increase in total government expenditure (% of GDP) was associated with a decrease in SII of −2.468 [95% confidence intervals (CIs): −4.190, −0.746] and RII of −0.026 (95% CIs: −0.048, −0.004). Lower inequalities were associated with higher non-health government expenditure, but not higher government health expenditure. Associations with inequalities were non-significant for GDP, government redistribution, and private health expenditure. Understanding how non-health government expenditure reduces inequalities in IMR, and why health expenditures may not, will accelerate progress towards the Sustainable Development Goals.

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Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project

BJPsych Open ◽

10.1192/bjo.2019.24 ◽

2019 ◽

Vol 5 (5) ◽

Cited By ~ 8

Author(s):

Dan Chisholm ◽

Sumaiyah Docrat ◽

Jibril Abdulmalik ◽

Atalay Alem ◽

Oye Gureje ◽

...

Keyword(s):

Mental Health ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Health Financing ◽

Financial Protection ◽

Middle Income ◽

Middle Income Countries ◽

Mental Health Financing ◽

Low And Middle Income

Background Current coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment. Aims To identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. Method In the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options. Results Key challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries. Conclusions Including mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities. Declaration of interest D.C. is a staff member of the World Health Organization.

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