scholarly journals The Impact of Health Expenditures on Health Outcomes in Sub-Saharan Africa

2019 ◽  
Vol 35 (1) ◽  
pp. 134-152 ◽  
Author(s):  
Edward Nketiah-Amponsah
Keyword(s):  
Life Expectancy ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Health Expenditures ◽  
Determinants Of Health ◽  
Sub Saharan Africa ◽  
Under Five ◽  
Per Capita ◽  
Sub Saharan

This article investigates the core macroeconomic and social determinants of health expenditures as well as the effect of health expenditures on select critical health outcomes (life expectancy, under-five mortality and maternal mortality) in recent years in sub-Saharan Africa (SSA). The study utilizes data on 46 sub-Saharan African countries covering the period 2000–2015. The results indicate that gross domestic product (GDP) per capita, physician per 1,000 population, population aged above 65 years and under-five mortality rate are the most significant determinants of health expenditure in the region. Overall, health expenditure is less income-elastic, not rising as a portion of GDP in wealthier nations. Health expenditure was found to exert a positive and significant impact on all three health outcomes. Specifically, a 1 percent increase in health expenditure per capita resulted in a 0.5 percent reduction in under-five mortality and a 0.35 percent fall in maternal mortality, while improving life expectancy by 0.06 percent. The results suggest that steady increases in health expenditures over time have the tendency to improve health outcomes in SSA.

scholarly journals The Effect of Healthcare Expenditure on the Health Outcomes in Sub-Saharan African Countries

2019 ◽  
pp. 1-22
Author(s):  
Xing Weibo ◽  
Birhanu Yimer
Keyword(s):  
Health Outcome ◽  
Infant Mortality ◽  
Life Expectancy ◽  
Health Outcomes ◽  
Health Expenditure ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Under Five ◽  
Per Capita ◽  
Sub Saharan

Health is a major component for a fulfilled life that everyone in the world desires to acquire. Governments are expected to play a vital role in providing quality health service to their people. Even though an increased health care expenditure is mostly considered as a primary contributor for an improved health outcome, empirical studies however indicate controversial results. The primary objective of this paper is to examine the effect of health expenditure on the selected health outcomes (Life Expectancy, Infant Mortality, Under-Five Mortality and Crude death) in Sub Saharan Africa. The linear dynamic generalized method of moments instrumental variable (GMM-IV) was used on a panel of 39 Sub-Saharan African Countries for the years 1995-2014. Results of this study showed that health expenditure significantly improves life expectancy and lowers infant mortality, under-five mortality & crude death in Sub Saharan Africa. The separate effects of Public and private health expenditures have also shown a significant positive relationship on life expectancy and negative on infant mortality, under-five mortality & crude death. The one period lag of health expenditure was estimated and the regression results indicated statistically significant relationship with health outcomes. In addition to health expenditure, other determinants like Gross Domestic Product (GDP) per capita, urbanization, immunization and basic drinking water brought improvement on life expectancy, infant mortality, under-five mortality & crude death. In contrast, HIV prevalence and unemployment are factors that reduce life expectancy and increase infant mortality, under-five mortality & crude death. This study indicated that health expenditure is an important element in attaining improved health outcome in Sub-Saharan African Countries. Therefore, increasing the amount of health expenditure allocated to the health sector yields a better health status. More on, revising policies to improve GDP per capita, immunization, urbanization and basic drinking water service, and strategies intended to reduce HIV prevalence and unemployment assure a better health outcome.

scholarly journals Commentary: on the effects of health expenditure on infant mortality in sub-Saharan Africa: evidence from panel data analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mwoya Byaro
Keyword(s):  
Data Analysis ◽  
Panel Data ◽  
Random Effects ◽  
Health Expenditure ◽  
Panel Data Analysis ◽  
Health Expenditures ◽  
Sub Saharan Africa ◽  
Gdp Per Capita ◽  
Per Capita ◽  
Sub Saharan

Abstract Background This commentary assesses critically the published article in the Health Economics Review. 2020; 10 (1), 1–9. It explains the effects of health expenditure on infant mortality in sub-Saharan Africa using a panel data analysis (i.e. random effects) over the year 2000–2015 extracted from the World Bank Development Indicators. The paper is well written and deserve careful attention. Main text The main reasons for inaccurate estimates observed in this paper are due to endogeneity issue with random effects panel estimators. It occurs when two or more variables simultaneously affect/cause each other. In this paper, the presence of endogeneity bias (i.e. education, health, health care expenditures and real GDP per capita variables) and its omitted variable bias leads to inaccurate estimates and conclusion. Random effects model require strict exogeneity of regressors. Moreover, frequentist/classic estimation (i.e. random effects) relies on sampling size and likelihood of the data in a specified model without considering other kinds of uncertainty. Conclusion This comment argues future studies on health expenditures versus health outcomes (i.e. infant, under-five and neonates mortality) to use either dynamic panel (i.e. system Generalized Method of Moments, GMM) to control endogeneity issues among health (infant or neonates mortality), GDP per capita, education and health expenditures variables or adopting Bayesian framework to adjust uncertainty (i.e. confounding, measurement errors and endogeneity of variables) within a range of probability distribution.

Does economic freedom improve health outcomes in sub-Saharan Africa?

2020 ◽  
Vol 47 (12) ◽  
pp. 1633-1649
Author(s):  
Anand Sharma
Keyword(s):  
Mortality Rate ◽  
Life Expectancy ◽  
Health Outcomes ◽  
Economic Freedom ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Content Type ◽  
The World ◽  
Sub Saharan ◽  
The Impact

PurposeThe purpose of this study is to examine the impact of economic freedom on four key health indicators (namely, life expectancy, infant mortality rate, under-five mortality rate and neonatal mortality rate) by using a panel dataset of 34 sub-Saharan African countries from 2005 to 2016.Design/methodology/approachThe study obtains data from the World Development Indicators (WDI) of the World Bank and the Fraser Institute. It uses fixed effects regression to estimate the effect of economic freedom on health outcomes and attempts to resolve the endogeneity problems by using two-stage least squares regression (2SLS).FindingsThe results indicate a favourable impact of economic freedom on health outcomes. That is, higher levels of economic freedom reduce mortality rates and increase life expectancy in sub-Saharan Africa. All areas of economic freedom, except government size, have a significant and positive effect on health outcomes.Research limitations/implicationsThis study analyses the effect of economic freedom on health at a broad level. Country-specific studies at a disaggregated level may provide additional information about the impact of economic freedom on health outcomes. Also, this study does not control for some important variables such as education, income inequality and foreign aid due to data constraints.Practical implicationsThe findings suggest that sub-Saharan African countries should focus on enhancing the quality of economic institutions to improve their health outcomes. This may include policy reforms that support a robust legal system, protect property rights, promote free trade and stabilise the macroeconomic environment. In addition, policies that raise urbanisation, increase immunisation and lower the incidence of HIV are likely to produce a substantial improvement in health outcomes.Originality/valueExtant economic freedom-health literature does not focus on endogeneity problems. This study uses instrumental variables regression to deal with endogeneity. Also, this is one of the first attempts to empirically investigate the relationship between economic freedom and health in the case of sub-Saharan Africa.

scholarly journals Gender inequality, health expenditure and maternal mortality in sub-Saharan Africa: A secondary data analysis

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Frank Chirowa ◽  
Stephen Atwood ◽  
Marc Van der Putten
Keyword(s):  
Maternal Mortality ◽  
Gender Inequality ◽  
Health Expenditure ◽  
Labour Force ◽  
Maternal Mortality Ratio ◽  
Three Dimensions ◽  
Sub Saharan Africa ◽  
Inequality Index ◽  
Depth Analysis ◽  
Sub Saharan

Background: This article provided an analysis of gender inequality, health expenditure and its relationship to maternal mortality.Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA). A unique analysis was used to correlate the Gender Inequality Index (GII), Health Expenditure and Maternal Mortality Ratio (MMR). The GII captured inequalities across three dimensions – Reproductive health, Women empowerment and Labour force participation between men and women. The GII is a composite index introduced by the UNDP in 2010 and corrects for the disadavanatges of the other gender indices. Although the GII incorporates MMR in its calculation, it should not be taken as a substitute for, but rather as complementary to, the MMR.Method: An exploratory and descriptive design to a secondary documentary review using quantitative data and qualitative information was used. The article referred to sub-Saharan Africa, but seven countries were purposively selected for an in-depth analysis based on the availability of data. The countries selected were Angola, Botswana, Malawi, Mozambique,South Africa, Zambia and Zimbabwe.Results: Countries with high gender inequality captured by the gender inequality index were associated with high maternal mortality ratios as compared with countries with lower gender inequality, whilst countries that spend less on health were associated with higher maternal deaths than countries that spend more.Conclusion: A potential relationship exists between gender inequality, health expenditure, and maternal mortality. Gender inequalities are systematic and occur at the macro, societal and household levels.

The Determinants of Health Status in Sub-Saharan Africa (Ssa)

2005 ◽  
Vol 49 (2) ◽  
pp. 60-66 ◽  
Author(s):  
Bichaka Fayissa ◽  
Paulos Gutema
Keyword(s):  
Health Status ◽  
Life Expectancy ◽  
Food Availability ◽  
Random Effect Model ◽  
Carbon Dioxide Emission ◽  
Determinants Of Health ◽  
Sub Saharan Africa ◽  
Life Expectancy At Birth ◽  
Per Capita ◽  
Availability Index

This study examines the determinants of health status (as measured by life expectancy at birth) in SSA based on the Grossman (1972) theoretical model which considers the economic (the ratio of health expenditure to GDP and the per capita food availability index), social (the illiteracy rate and alcohol consumption), and environmental factors (urbanization rate and carbon dioxide emission per capita index). The coefficients of the health status function are estimated by one-way and two-way panel data analyses. The two-way random-effect model results suggest that a decrease in illiteracy rate and an increase in the food availability index are well positively associated with improvements in life expectancy at birth. Overall results also suggest that a health policy that may focus on the provision of health services, family planning programs, and emergency aids to the exclusion of other demographic issues may serve little in schemes aimed at improving the current health status of the region.

scholarly journals Exploring the Impact of Healthcare on Economic Growth in Africa

2019 ◽  
Vol 6 (3) ◽  
pp. 45
Author(s):  
Juste Somé ◽  
Selsah Pasali ◽  
Martin Kaboine
Keyword(s):  
Economic Growth ◽  
Life Expectancy ◽  
Health Outcomes ◽  
Health Expenditures ◽  
Gdp Per Capita ◽  
Real Gdp ◽  
Cent Increase ◽  
Real Gdp Per Capita ◽  
Per Capita ◽  
The Impact

This paper empirically investigates the relationship between health expenditures, health outcomes and economic growth in Africa using data from 48 African countries over the period 2000-2015 in a panel data regression framework. In line with wider literature on economic growth as well as health economics, the paper first finds that maternal, infant and child mortality rates are all negatively and significantly associated with economic growth in Africa. In addition, life expectancy at birth is positively associated with economic growth. A 9.4-year increase in life expectancy leads to 1 per cent increase in real GDP per capita. Second, the paper finds that health expenditures have direct and indirect effects on economic growth that are positive and economically meaningful. In particular, a 10 per cent increase in health expenditures leads to an increase in annual average real GDP per capita by 0.24 per cent. Third, education emerges as a strong determinant of both economic growth and health outcomes in Africa, particularly when female education is considered. The main policy implication of this paper is that governments should aim at spending more and efficiently on the overall health system to progress over health outcomes and benefit from the positive externalities leading to economic growth. In addition, it is crucial that governments partner with private sector for resource mobilization and effective service delivery.

scholarly journals A Competing Risk Analysis of Women Dying of Maternal, Infectious, or Non-Communicable Causes in the Kintampo Area of Ghana

2021 ◽  
Vol 2 ◽  
Author(s):  
Sulemana Watara Abubakari ◽  
Delali Margaret Badasu ◽  
Edward Anane Apraku ◽  
Seeba Amenga-Etego ◽  
Kwaku Poku Asante ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Maternal Mortality ◽  
Causes Of Death ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Major Health Problem ◽  
Relative Risks ◽  
International Statistical Classification ◽  
Sub Saharan

Background: Maternal, infectious, and non-communicable causes of death combinedly are a major health problem for women of reproductive age (WRA) in sub-Saharan Africa (SSA). Little is known about the relative risks of each of these causes of death in their combined form and their demographic impacts. The focus of studies on WRA has been on maternal health. The evolving demographic and health transitions in low- and middle-income countries (LMICs) suggest a need for a comprehensive approach to resolve health challenges of women beyond maternal causes.Methods: Deaths and person-years of exposure (PYE) were calculated by age for WRA within 15–49 years of age in the Kintampo Health and Demographic Surveillance System (KHDSS) area from January 2005 to December 2014. Causes of death were diagnosed using a standard verbal autopsy questionnaire and the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Identified causes of death were categorized into three broad areas, namely, maternal, infectious, and non-communicable diseases. Multiple decrements and associated single decrement life table methods were used.Results: Averting any of the causes of death was seen to lead to improved life expectancy, but eliminating infectious causes of death leads to the highest number of years gained. Infectious causes of death affected all ages and the gains in life expectancy, assuming that these causes were eliminated, diminished with increasing age. The oldest age group, 45–49, had the greatest gain in reproductive-aged life expectancy (RALE) if maternal mortality was eliminated.Discussion: This study demonstrated the existence of a triple burden. Infectious causes of death are persistently high while deaths from non-communicable causes are rising and the level of maternal mortality is still unacceptably high. It recommends that attention should be given to all the causes of death among WRA.

Sign in / Sign up

Export Citation Format

Share Document