The role of governance in the health expenditure–health outcomes nexus: insights from West Africa

2021 ◽  
Vol 48 (4) ◽  
pp. 557-570
Author(s):  
Cleopatra Oluseye Ibukun
Keyword(s):  
Health Outcomes ◽  
Health Expenditure ◽  
Health Spending ◽  
West African ◽  
African Countries ◽  
Content Type ◽  
Public Health Spending ◽  
Quality Of Governance

PurposeDespite the global attempt at achieving goal 3 of the Sustainable Development Goals by improving health outcomes, some countries (West African countries inclusive) still do not spend a significant proportion of their income on health and they exhibit health outcomes that are still far below that of developed countries. Besides countries like Nigeria, Chad and Guinea-Bissau are experiencing worsening insecurity and political instability. This study, therefore, examines the effect of health expenditure on three health outcomes in the West African sub-region, while investigating the effect of the quality of governance in this nexus.Design/methodology/approachThis study conducts an instrumental variable approach (two-stage least squares regression) on a panel of 15 West African countries over the period 2000–2018. This study uses three proxies to measure health outcomes and six measures of the quality of governance were also considered.FindingsThe result of this study shows that all forms of health expenditures significantly influenced health outcomes. That is, there is a negative relationship between health expenditure, infant mortality and under-five mortality, but a positive relationship between health expenditure and life expectancy at birth. Besides, the general effect of the same quantity of public health spending is subject to the quality of governance because countries with a higher quality of governance benefit better from their public health spending.Originality/valueThis study, to the authors' knowledge, is the first empirical attempt to examine the role of governance in the health expenditure-health outcomes nexus in 15 ECOWAS countries, using different measures of health outcomes and governance.

scholarly journals Developing entrepreneurship in Africa: investigating critical resource challenges

2018 ◽  
Vol 25 (4) ◽  
pp. 644-666 ◽  
Author(s):  
Victor Yawo Atiase ◽  
Samia Mahmood ◽  
Yong Wang ◽  
David Botchie
Keyword(s):  
Institutional Theory ◽  
Contract Enforcement ◽  
African Countries ◽  
Content Type ◽  
Entrepreneurship Development ◽  
Access To Credit ◽  
State Institutions ◽  
Political Governance

Purpose By drawing upon institutional theory, the purpose of this paper is to investigate the role of four critical resources (credit, electricity, contract enforcement and political governance) in explaining the quality of entrepreneurship and the depth of the supporting entrepreneurship ecosystem in Africa. Design/methodology/approach A quantitative approach based on ordinary least squares regression analysis was used. Three data sources were employed. First, the Global Entrepreneurship Index (GEI) of 35 African countries was used to measure the quality of entrepreneurship and the depth of the entrepreneurial ecosystem in Africa which represents the dependent variable. Second, the World Bank’s data on access to credit, electricity and contract enforcement in Africa were also employed as explanatory variables. Third, the Ibrahim Index of African Governance was used as an explanatory variable. Finally, country-specific data on four control variables (GDP, foreign direct investment, population and education) were gathered and analysed. Findings To support entrepreneurship development, Africa needs broad financial inclusion and state institutions that are more effective at enforcing contracts. Access to credit was non-significant and therefore did not contribute to the dependent variable (entrepreneurship quality and depth of entrepreneurial support in Africa). Access to electricity and political governance were statistically significant and correlated positively with the dependent variables. Finally, contract enforcement was partially significant and contributed to the dependent variable. Research limitations/implications A lack of GEI data for all 54 African countries limited this study to only 35 African countries: 31 in sub-Saharan Africa and 4 in North Africa. Therefore, the generalisability of this study’s findings to the whole of Africa might be limited. Second, this study depended on indexes for this study. Therefore, any inconsistencies in the index aggregation if any could not be authenticated. This study has practical implications for the development of entrepreneurship in Africa. Public and private institutions for credit delivery, contract enforcement and the provision of utility services such as electricity are crucial for entrepreneurship development. Originality/value The institutional void is a challenge for Africa. This study highlights the weak, corrupt nature of African institutions that supposedly support MSME growth. Effective entrepreneurship development in Africa depends on the presence of a supportive institutional infrastructure. This study engages institutional theory to explain the role of institutional factors such as state institutions, financial institutions, utility providers and markets in entrepreneurship development in Africa.

scholarly journals Remittances and health outcomes in Sub-Saharan African countries: Understanding the role of financial development and institutional quality

2021 ◽  
Vol 66 (229) ◽  
pp. 119-144
Author(s):  
Uweis Bare ◽  
Yasmin Bani ◽  
Normaz Ismail ◽  
Anitha Rosland
Keyword(s):  
Health Outcomes ◽  
Financial Development ◽  
Institutional Quality ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Dynamic Panel ◽  
Sub Saharan ◽  
Ssa Countries

Sub-Saharan Africa (SSA) is one of the highest recipients of remittances; however, this is inconsistent with the region?s growth and the state of its weak healthcare systems. This paper therefore analyses the effect of remittances on health outcomes for 39 selected SSA countries over the period 1996 to 2016. It considers the channels through which remittances affect health outcomes, including financial development and institutional quality. Using dynamic panel estimation, we find that remittances sustain health outcomes, while both financial development and institutional quality complement remittances in this respect. SSA countries should therefore continue to improve their financial sectors and develop the quality of institutions to an adequate level. Achieving sound financial systems and institutions would both allow and attract a substantial amount of remittances, benefitting human capital and health outcomes and alleviating poverty.

Assessing the Role of Governance in West African Fiscal Performance

2019 ◽  
Vol 65 (1) ◽  
pp. 97-122
Author(s):  
Fisayo Fagbemi
Keyword(s):  
West African ◽  
African Countries ◽  
Fiscal Performance ◽  
Dynamic Relationship ◽  
Pooled Mean Group ◽  
Long Run ◽  
Short Run ◽  
Fiscal Prudence

The article analyzes the short-run and long-run dynamic relationship between the quality of institutions and fiscal performance in 12 West African countries over the period of 1984 to 2016 using Pooled Mean Group and Mean Group estimator. The results show that, in the long run as well as in the short run, improved governance appears to lead to decreasing deficits. In comparison with other measures, in the long run, democratic accountability dimension seems to have the most significant effect on West African fiscal performance. However, the empirical evidence further reveals that, in the short run, the institutional dimensions are found to be insignificant in explaining West African fiscal performance. Hence, given that increased public debt could harm the quality of sustainable fiscal measures, the study suggests that creating incentives for the building of sound institutions and securing enabling governance would enhance fiscal prudence and sustainability in West Africa. JEL Classifications: G, H

Public health spending and health outcome in Nigeria: the role of governance

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Uche Abamba Osakede
Keyword(s):  
Public Health ◽  
Health Outcome ◽  
Health Status ◽  
Developing Economies ◽  
Health Spending ◽  
Political Stability ◽  
Series Data ◽  
Content Type ◽  
Public Health Spending

Purpose This paper aims to analyze the relationship between public health spending and health outcome using time series data in Nigeria over the period 1980 to 2017, taking into account the role of governance by assessing how the quality of governance directly affects health status and indirectly as a mediator for the effectiveness of public health spending. Design/methodology/approach Using the Hausman statistical tests to check for the existence of endogeneity, the proper method for estimating the model for this study is the two-stage least square regression model. The two-stage least squares regression model addresses the problem of endogeneity using instrumental variables. The mediating role of governance on the effectiveness of public health spending on health was considered by an interaction of governance indicators with public health spending. Findings The results showed that public health spending had no significant effect on health outcome except when interacted with governance quality. The interaction of government health spending with governance effectiveness as well as that for control of corruption improved health by inducing a fall in maternal deaths, whereas government health expenditure interacted with rule of law raised maternal mortality. Public health spending interacted with regulatory quality improved life expectancy while that for political stability with public health spending induced a fall in life expectancy, poor maternal and infant health. Political stability and the control of corruption had direct influence on maternal health. Practical implications Given the predominance of public health spending in promoting access to health care and population health status for developing economies, the effectiveness of such spending should be top priority in policy makers’ agenda. This again is important because for developing economies, government revenue is generated from a small tax base due to their highly informal nature. To improve health status from public intervention in the health sector, there is indeed need for improvement in the overall state of governance in Nigeria. Originality/value This paper is one of the few country case studies which uses time series data to examine the role of governance on the efficacy of public health spending with extension of findings to maternal health and covering more measures of governance quality. The results fundamentally illuminate the importance of governance in fostering development in health and consequently enhancing economic development and growth.

scholarly journals Per capita income and public health expenditure: what makes good child health outcomes in Tanzania? a comparison of Frequentist and Bayesian approach (1995-2013)

2017 ◽  
Vol 5 (1) ◽  
pp. 74
Author(s):  
Mwoya Byaro ◽  
Patrick Musonda
Keyword(s):  
Public Health ◽  
Child Health ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Health Spending ◽  
Public Health Expenditure ◽  
Under Five ◽  
Public Health Spending ◽  
Child Health Outcomes ◽  
Per Capita

Using data for World Bank Development Indicators (2015) database from 1995 to 2013, this paper explores the impact of public health expenditure on national health outcomes in Tanzania while GDP per capita and improved sanitation facilities as explanatory variables were controlled for. Two national health outcomes indicators namely, infant and under-five mortality were used as dependent variables. With separate modeling approach, Frequentist and Bayesian based on time series and Markov Chain Monte Carlo (MCMC) respectively, empirical evidence shows that income, represented by real GDP per capita lower infant and under-five mortality in Tanzania. Under both methodological approach regardless of the sample size, we failed to support evidence that, public health expenditure and improved sanitation facilities had an impact on child health outcomes. Our results imply that, public health spending in Tanzania is poorly targeted to bring good child health outcomes. The paper draws attention to policy makers in Tanzania to focus either within public health spending composition or beyond to other close determinants of infant and under-five mortality.

scholarly journals Subjective Well-Being and the 2008 Recession in European Regions: The Moderating Role of Quality of Governance

2019 ◽  
Vol 2 (2) ◽  
pp. 111-133 ◽  
Author(s):  
Efstratia Arampatzi ◽  
Martijn J. Burger ◽  
Spyridon Stavropoulos ◽  
Frank G. van Oort
Keyword(s):  
Well Being ◽  
Subjective Well Being ◽  
European Regions ◽  
Quality Of Governance ◽  
Moderating Role

Great minds think alike: does leader-follower similarity in construal level of the work enhance leader-member exchange quality?

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sevgi Emirza ◽  
Alev Katrinli
Keyword(s):  
Mental Representation ◽  
Current Knowledge ◽  
Interpersonal Relationship ◽  
Survey Study ◽  
Construal Level ◽  
Leader Member Exchange ◽  
Content Type ◽  
Member Exchange

PurposeThe purpose of this study is to investigate whether leader-follower similarity in construal level of the work, which indicates the degree of abstraction applied to mental representation of the work, influences the quality of interpersonal relationship at work.Design/methodology/approachFirst, an interview study was conducted to adapt the work-based construal-level (WBCL) scale. Then, a survey study was conducted for hypothesis testing. Data collected from 245 matched supervisor-subordinate dyads were analyzed using multi-level modeling.FindingsResults revealed that dyadic similarity in work-domain construal level is positively related to leader-member exchange (LMX) quality. As a leader and a follower become similar to each other in terms of mental representation (i.e. construal level) of work, they experience higher relationship quality.Originality/valueThis study enhances the current knowledge of the role of cognition and cognitive similarity in leadership processes.

The role of transformative healthcare technology on quality of life during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammad Asif Salam ◽  
Saleh Bajaba
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Saudi Arabia ◽  
Service Delivery ◽  
Health Care System ◽  
Service System ◽  
Content Type ◽  
Care System

Purpose The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL). Design/methodology/approach A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model. Findings The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process. Research limitations/implications One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement. Originality/value This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.

scholarly journals Understanding coaching efficacy in education through activity systems: privileging the nuances of provision

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rachel M. Lofthouse ◽  
Anthea Rose ◽  
Ruth Whiteside
Keyword(s):  
Activity Systems ◽  
Content Type ◽  
Coaching Efficacy ◽  
Range Of Functions ◽  
Cultural Historical Activity ◽  
The Individual ◽  
Specific Challenge

PurposeThe research demonstrates the role of activity systems based in Cultural Historical Activity Theory as a means of analysing characteristics and efficacy of specific provisions of coaching in education.Design/methodology/approachThree examples of coaching in education were selected, involving 51 schools in England. The three examples were re-analysed using activity systems. This drew on existing evaluation evidence, gathered through interviews, questionnaires, focus groups and recordings of coaching.FindingsIn each example, the object of the coaching was to address a specific challenge to secure the desired quality of education. Using activity systems it is possible to demonstrate that coaching has a range of functions (both intended and consequential). The individual examples illustrate the potential of coaching to support change in complex and diverse education settings.Research limitations/implicationsThe use of existing data from evaluations means that direct comparisons between examples are not made. While data were collected throughout the duration of each coaching programme no follow-up data was available.Practical implicationsThe analysis of the examples of coaching using activity systems provides evidence of the efficacy of specific coaching provision in achieving individually defined objectives related to sustaining and improving specific educational practices.Originality/valueThe research offers insights into how coaching in education might be better tuned to the specific needs of contexts and the challenges experienced by the individuals working in them. In addition, it demonstrates the value of activity systems as an analytical tool to make sense of coaching efficacy.

Mapping the contours of fairness

2014 ◽  
Vol 1 (2) ◽  
pp. 191-204 ◽  
Author(s):  
Lilian Otaye ◽  
Wilson Wong
Keyword(s):  
Job Satisfaction ◽  
Factor Analysis ◽  
Regression Analysis ◽  
Turnover Intention ◽  
Content Type ◽  
Mediating Role ◽  
The Uk ◽  
The Relationship

Purpose – The purpose of this paper is to explore the contours of fairness by showing how different facets of fairness impact three important employee outcomes (job satisfaction, turnover intention and employer advocacy) and examining the mediating role of quality of management and leadership (through perceptions of both senior management and the quality of exchange with immediate supervisors) in attenuating negative impacts of unfairness on these outcomes. The study extends the concept of fairness beyond the traditional focus on organizational justice and models the mediating role of leadership on the relationship between (un)fairness and the three employee-level outcomes in a sample of employees representative of the UK workforce. Design/methodology/approach – Data were obtained from a nationally representative sample of 2,067 employees in the UK. Exploratory factor analysis and then confirmatory factor analysis is used to refine three unfairness factors and address their dimensionality of the unfairness scale and then multiple regression analysis is used to test a fairness-leadership-employee performance outcome model. Findings – Results of multiple regression analysis revealed that both trust in leadership and leader-member exchange partially mediate the relationship between organizational (un)fairness and job satisfaction, advocacy and turnover intention, respectively. Practical implications – The findings highlight the important role that leaders play in influencing the relationship between perception of unfairness and employee outcomes. This has implications for both theory and practice as it suggests that the pattern of inclusion that leaders create through the relationships that they develop with their followers has a significant impact on the relationship between unfairness and the work outcomes. They not only must manage traditional perceptions of justice, but also the assessments employees make about trust in management judgements and the perceived consequences of such judgements. Originality/value – In an environment where perceptions of unfairness are becoming both more endemic but also more complex, the study shows that both senior leaders and immediate supervisors have important agency in managing negative consequences. Through the measurement of satisfaction, turnover intention and employer advocacy it also provides potential links to link fairness into the engagement literature.

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