scholarly journals Immunisation financing and programme performance in the Middle East and North Africa, 2010 to 2017

2019 ◽  
Vol 4 (2) ◽  
pp. e001248
Author(s):  
Helen Saxenian ◽  
Nahad Sadr-Azodi ◽  
Miloud Kaddar ◽  
Kamel Senouci

Immunisation is a cornerstone to primary health care and is an exceptionally good value. The 14 low-income and middle-income countries in the Middle East and North Africa region make up 88% of the region’s population and 92% of its births. Many of these countries have maintained high immunisation coverage even during periods of low or negative economic growth. However, coverage has sharply deteriorated in countries directly impacted by conflict and political unrest. Approximately 1.3 million children were not completely vaccinated in 2017, as measured by third dose of diphtheria–pertussis–tetanus vaccine. Most of the countries have been slow to adopt the newer, more expensive life-saving vaccines mainly because of financial constraints and the socioeconomic context. Apart from the three countries that have had long-standing assistance from Gavi, the Vaccine Alliance, most countries have not benefited appreciably from donor and partner activities in supporting their health sector and in achieving their national and subnational immunisation targets. Looking forward, development partners will have an important role in helping reconstruct health systems in conflict-affected countries. They can also help with generating evidence and strategic advocacy for high-priority and cost-effective services, including immunisation. Governments and ministries of health would ensure important benefits to their populations by investing further in their immunisation programmes. Where possible, the health system can create and expand fiscal space from efficiency gains in harmonising vaccine procurement mechanisms and service integration; broader revenue generation from economic growth; and reallocation of government budgets to health, and from within health, to immunization.

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.


2015 ◽  
Vol 18 (4) ◽  
pp. 449-462 ◽  
Author(s):  
Aye Mengistu Alemu ◽  
Jin-Sang Lee

Previous empirical studies on the effects of foreign aid on economic growth have generated mixed results that make it difficult to draw policy recommendations. The main reason for such mixed results is the choice of a single aggregate list of countries, regardless of the disparities in levels of development. This study therefore fills the development gap by disaggregating the African data into a panel of 20 middle- income and 19 low- income African countries over a period of 15 years between 1995 and 2010, and employing a dynamic generalized method of moments (GMM) model to address the dynamic nature of economic growth as well as the problems of endogeneity. The results of this study support the theoretical hypothesis that a positive relationship between aid and GDP growth exists, but only for low-income African countries, not middle-income ones. On the other hand, the study reveals that middle- income African countries tend to experience a greater impact on their economic growth from foreign direct investment (FDI) and natural resources revenues, mainly oil exports. This implies that the frequent criticism that foreign aid has not contributed to economic growth is flawed, at least in the case of low-income African countries. In fact, foreign aid has played a critical role in stimulating economic growth in such countries through supplementing domestic sources of finance such as savings, thus increasing the amount of investment and capital stock in them.


Infectio ◽  
2019 ◽  
Vol 23 (2) ◽  
pp. 189 ◽  
Author(s):  
Jhon Carlos Castaño Osorio ◽  
Alejandra María Giraldo García

Tropical protozoan diseases are currently a major public health problem throughout the world and are strongly linked with poverty, this combined with a lack of commercial markets for potential drugs has created a large burden on the health and economic development of low-income and middle-income countries in Africa, Asia, and the Americas. Due to the low research interest and the high increase of resistance against the existing treatments, as well as increasing inefficiency, toxicity, prolonged treatment schedules and costs, there is an urgent need for cost-effective, safe and easy-to-administer, new effective compounds with novel mechanisms of action. Several studies of crude plant extracts have already identified potential compounds to treat Chagas’ disease, Leishmaniasis, Toxoplasmosis, Giardiasis, and Malaria among other protozoan parasites. Natural compounds of medicinal plants have shown lower toxicity together with higher specificity, creating an optimistic view of new treatments for diseases. Out of 1010 new active substances approved as drugs for medical conditions by regulatory agencies during the past 25 years, 490(48.5%) were from a natural origin.


2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000890 ◽  
Author(s):  
Kumanan Rasanathan ◽  
Vincent Atkins ◽  
Charles Mwansambo ◽  
Agnès Soucat ◽  
Sara Bennett

Drawing on experiences reviewed in the accompanying supplement and other literature, we present an agenda for the way forward for policy-makers, managers, civil society and development partners to govern multisectoral action for health in low-income and middle-income countries and consider how such an agenda might be realised. We propose the following key strategies: understand the key actors and political ecosystem, including type of multisectoral action required and mapping incentives, interests and hierarchies; frame the issue in the most strategic manner; define clear roles with specific sets of interventions according to sector; use existing structures unless there is a compelling reason not to do so; pay explicit attention to the roles of non-state sectors; address conflicts of interest and manage tradeoffs; distribute leadership; develop financing and monitoring systems to encourage collaboration; strengthen implementation processes and capacity; and support mutual learning and implementation research. To support countries to strengthen governance for multisectoral action, the global community can assist by further developing technical tools and convening peer learning by policy-makers (particularly from beyond the health sector), supporting knowledge management and sharing of experiences in multisectoral action beyond health, developing an agenda for and execution of implementation research and, finally, driving multilateral and bilateral development partners to transcend their own silos and work in a more multisectoral manner.


2018 ◽  
Vol 3 (Suppl 4) ◽  
pp. e000970 ◽  
Author(s):  
Douglas Glandon ◽  
Ankita Meghani ◽  
Nasreen Jessani ◽  
Mary Qiu ◽  
Sara Bennett

IntroductionWhile efforts to achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) have reinvigorated interest in multisectoral collaborations (MSCs) among the global health and development community, there remains a plethora of questions about how best to conceptualise, plan, implement, evaluate and sustain MSCs. The objective of this paper is to present research priorities on MSC for health from researchers and policymakers around the globe, with an emphasis on low-income and middle-income countries.MethodsThe authors identified 30 priority research questions from two sources: (1) 38 review articles on MSC for health, and (2) interviews and focus groups with a total of 81 policymakers, including government officials (largely from ministries of health and state/provincial departments of health, but also offices of planning, public service, social development, the prime minister and others), large multilateral or bilateral organisations, and non-governmental organisations. In a third phase, questions were refined and ranked by a diverse group of researchers from around the globe using an online voting platform.ResultsThe top-ranked questions focused predominantly on pragmatic questions, such as how best to structure, implement and sustain MSCs, as well as how to build stakeholder capacity and community partnerships. Despite substantial variation between review articles, policymakers’ reflections and online ranking by researchers, two topics emerged as research priorities for all three: (1) leadership, partnership and governance structures for MSCs; and (2) MSC implementation strategies and mechanisms. The review articles underscored the need for more guidance on appropriate study designs and methods for investigating MSCs, which may be a prerequisite for other identified research priorities.ConclusionThese findings could inform efforts within and beyond the health sector to better align research objectives and funding with the evidence needs of policymakers grappling with questions about how best to leverage MSCs to achieve UHC and the SDGs.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nicholas M. Odhiambo

PurposeThis study examines the causal relationship between exports and economic growth in sub-Saharan African (SSA) countries during the period 1980 to 2017. The study also examines whether the causality between these two macroeconomic variables depends on the countries' stage of development as proxied by their per capita income.Design/methodology/approachThe study uses a panel cointegration test and panel Granger-causality model to examine the link between exports and growth. The study also incorporates external debt as an intermittent variable in a bivariate setting between exports and economic growth, thereby creating a dynamic multivariate panel Granger-causality model.FindingsAlthough the study found the existence of a long-run relationship between exports and economic growth, the study failed to find any export-led growth response in both low-income and middle-income countries. Instead, the study found evidence of a bidirectional causality and a neutrality response in middle-income and low-income countries, respectively. The study, therefore, concludes that the benefits of an export-led growth hypothesis may have been oversold, and that the strategy may not be desirable to some low-income developing countries.Practical implicationsThese findings have important policy implications as they indicate that the causality between exports and economic growth in SSA countries varies with the countries' stage of development. Consistent with the contemporary literature, the study cautions low-income SSA countries against over-relying on an export-led growth strategy to achieve a sustained growth path as no causality between exports and economic growth has been found to exist in those countries. Instead, such countries should consider pursuing new growth strategies by building the domestic demand side of their economies alongside their export promotion strategies in order to expand the real sector of their economies. For middle-income countries, the study recommends that both export promotion strategies and pro-growth policies should be intensified as economic growth and exports have been found to reinforce each other in those countries.Originality/valueUnlike the previous studies, the current study disaggregated the full sample of SSA countries into two subsets – one comprising of low-income countries and the other consisting of middle-income countries. In addition, the study uses a multivariate Granger-causality model in order to address the emission-of-variable bias. To our knowledge, this may be the first study of its kind in recent years to examine in detail the causal relationship between exports and economic growth in SSA countries using an ECM-based multivariate panel Granger-causality model.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Dennis Boahene Osei ◽  
Yakubu Awudu Sare ◽  
Muazu Ibrahim

AbstractThe existing literature highlights the determinants of trade openness with disregard to the income classifications of countries in examining whether the determinants differ given their income levels. This study, therefore, re-examines the drivers of trade openness in Africa relying on panel data with special focus on the role of economic growth. More specifically, we perform a comparative analysis of the factors influencing trade openness for low-income and lower–middle-income countries using the system generalized method of moments. Our findings suggest that, while economic growth robustly enhances openness in low-income countries, in the case of lower–middle-income countries, the impact is not robust and largely negative suggesting that higher growth is associated with less openness. We also find that, economic growth–openness nexus for the lower-income countries exhibits non-linearities and inverted U-shaped relationship in particular. Thus, while increases in real GDP per capita enhance openness, beyond an estimated threshold point, any increases in economic growth dampen openness. We discuss key implications for policy.


2020 ◽  
Vol 5 (6) ◽  
pp. e002375 ◽  
Author(s):  
Ché L Reddy ◽  
Alexander W Peters ◽  
Desmond Tanko Jumbam ◽  
Luke Caddell ◽  
Blake C Alkire ◽  
...  

Strong surgical systems are necessary to prevent premature death and avoidable disability from surgical conditions. The epidemiological transition, which has led to a rising burden of non-communicable diseases and injuries worldwide, will increase the demand for surgical assessment and care as a definitive healthcare intervention. Yet, 5 billion people lack access to timely, affordable and safe surgical and anaesthesia care, with the unmet demand affecting predominantly low-income and middle-income countries (LMICs). Rapid surgical care scale-up is required in LMICs to strengthen health system capabilities, but adequate financing for this expansion is lacking. This article explores the critical role of innovative financing in scaling up surgical care in LMICs. We locate surgical system financing by using a modified fiscal space analysis. Through an analysis of published studies and case studies on recent trends in the financing of global health systems, we provide a conceptual framework that could assist policy-makers in health systems to develop innovative financing strategies to mobilise additional investments for scale-up of surgical care in LMICs. This is the first time such an analysis has been applied to the funding of surgical care. Innovative financing in global surgery is an untapped potential funding source for expanding fiscal space for health systems and financing scale-up of surgical care in LMICs.


Sign in / Sign up

Export Citation Format

Share Document