Health Outcomes in Sub-Saharan Africa Countries: An Analysis of Key Determinants

The poor health outcomes (low longevity and high mortalities) in developing countries has been great concern for citizens and policy makers alike. Although, numerous studies have focus on socio-economic drivers (like education, age of mothers, income levels, and poverty) of health outcomes in developing nations; however, the same is not true for important exogenous determinants. Therefore, this study investigated the effects of access to clean drinkable water, sanitation, fertility rate, prevalence of HIV/AIDS, health financing, and child immunization on health outcomes in sub-Sahara African (SSA) region. To achieve this, the study explored Pooled OLS, Fixed and Random Effects covering 46 countries in the region from 2000 to 2015. The findings reveal that population health outcomes - as measured by infant and under-five mortalities rates are related negatively with increase public health financing, timely children immunization, quality drinkable water supply, but directly associated with higher fertility rate, and HIV prevalence. For life expectancy at birth, increase government health spending, timely children immunization, and quality drinkable water supply are positively predicted, while relate inversely with higher fertility rate, and HIV prevalence. The findings therefore suggest that for SSA countries to achieve the United Nations’ Sustainable Development Goal three of ensuring healthy lives before 2030; emphasis should on increasing public health financing, and provision of infrastructural facilities like clean water supply and sanitation. Again, greater attention should be on enhancing child immunization, reducing fertility rates and HIV prevalence in the region.

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Public Health Expenditures and Health Outcomes: New Evidence from Ghana

Economies ◽

10.3390/economies6040058 ◽

2018 ◽

Vol 6 (4) ◽

pp. 58 ◽

Cited By ~ 4

Author(s):

Micheal Kofi Boachie ◽

K. Ramu ◽

Tatjana Põlajeva

Keyword(s):

Public Health ◽

Health Outcomes ◽

Least Squares ◽

Health Expenditure ◽

Government Intervention ◽

Health Sector ◽

Health Expenditures ◽

Public Health Expenditure ◽

Life Expectancy At Birth ◽

The Cost

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.

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Exploring the Relationship between ICTs and Public Health at Country Level

International Journal of Healthcare Information Systems and Informatics ◽

10.4018/jhisi.2013070101 ◽

2013 ◽

Vol 8 (3) ◽

pp. 1-22 ◽

Cited By ~ 12

Author(s):

Viju Raghupathi ◽

Wullianallur Raghupathi

Keyword(s):

Public Health ◽

Mortality Rate ◽

Life Expectancy ◽

Health Indicators ◽

Fertility Rate ◽

Child Immunization ◽

The Public ◽

Country Level ◽

Public Health Indicators ◽

The Relationship

The authors use a health analytics approach to investigate the relationship between information and communication technology (ICT) and public health at a country level. The research uses the ICT factors of accessibility, usage, quality, affordability, trade, and applications, as well as the public delivery indicators of adolescent fertility rate, child immunization for DPT, child immunization for measles, tuberculosis detection rate, life expectancy, adult female mortality rate, and adult male mortality rate. ICT data was collected from the International Telecommunication Union ICT Indicator database. The public health data was collected from the World Bank website. Results of the analytics indicate that ICT factors are positively associated with some public health indicators. Nearly all of the ICT factors are positively associated with the public health indicators of immunization rates, TB detection rates, and life expectancy. The association with adult mortality is negative, which is also favorable. However, the association of ICT with fertility rate is negative, which is an unfavorable effect. These results offer insight into the importance of understanding the positive and adverse impacts of ICT on public health so as to guide national policy decisions in the future.

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Seropositivity of Human Immunodeficiency Virus among Intending Blood Donors in Rivers State, Nigeria

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2020/v4i330149 ◽

2020 ◽

pp. 22-29

Author(s):

B. A. Abeni ◽

N. Frank- Peterside ◽

O. E. Agbagwa ◽

S. A. Adewuyi ◽

T. I. Cookey ◽

...

Keyword(s):

Public Health ◽

Human Immunodeficiency Virus ◽

Blood Donors ◽

Hiv Prevalence ◽

Sub Saharan Africa ◽

Enzyme Linked Immunosorbent Assay ◽

Strict Adherence ◽

Immunodeficiency Virus ◽

Safe Blood ◽

Rivers State

Aims: Provision of constant and safe blood has been a public health challenge in Sub-Saharan Africa with a high prevalence of transfusion-transmissible infections (TTIs). This study aimed at determining the seroprevalence of the Human Immunodeficiency Virus (HIV) among prospective blood donors at two Hospitals (government and private-owned) in Rivers State, and also to relate some demographic studies to the screening results. Study Design: Cross-sectional study. Place and Duration of Study: Two Hospitals (a government-owned and private-owned) in Rivers State, Nigeria, between January 2018 and April 2019. Methodology: Two hundred and eighty-two (185 males and 97 females) blood donors were recruited for this study. Sera samples were screened for antibodies to HIV-1 and -2 using enzyme-linked immunosorbent assay (ELISA) based kits following the manufacturer’s description. Results: Of the 282 screened prospective donors (males and females) in this study, the overall prevalence of HIV from both hospitals was 6.0% with a seronegativity of 94.0%. There was a significant relationship (p <0.05) between the overall seroprevalence of HIV concerning gender (p-0.006) all other demographics had no significant association with HIV. Age group 21-30 had the highest prevalence of HIV (53.80%). Donors with tertiary education had the highest prevalence rate (52.90%) of HIV. About marital status, the unmarried donors had higher HIV prevalence (64.70%) when compared with the married donors (35.30%). However, family donors had the highest prevalence of HIV (52.90%). Finally, concerning occupation, students had a higher HIV prevalence (47.10%). Conclusion: The seroprevalence of HIV in Port Harcourt, Rivers State, Nigeria was high. This shows that HIV remains a threat to safe blood transfusion and public health in Nigeria. Strict adherence to selection criteria and algorithm of donor screening is hereby advocated.

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OP134 Predictors Of Public Health Outcomes: A Case Study From Turkey

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317001933 ◽

2017 ◽

Vol 33 (S1) ◽

pp. 62-63

Author(s):

Songul Cinaroglu ◽

Onur Baser

Keyword(s):

Public Health ◽

Health Outcome ◽

Life Expectancy ◽

Health Outcomes ◽

Outcome Indicators ◽

Random Forest Classification ◽

Life Expectancy At Birth ◽

Forest Classification ◽

Province Level ◽

Public Health Outcome

INTRODUCTION:In Turkey, there is a scarcity of knowledge about the predictors of health outcomes at a national level, and it is well known that there is a gap between rural and urban parts of developing countries in terms of the level of health outcomes. This study aims to find out predictor factors of the public health outcomes at a province level in Turkey.METHODS:Life expectancy at birth and mortality are used as public health outcome indicators. Logistic regression and Random Forest classification generated by using 50, 100, and 150 trees were used to compare prediction performance of health outcomes. The results of different prediction methods were recorded changing the “k” parameter from 3 to 20 in k-fold cross validation. The Area Under the ROC Curve (AUC) was used as a measure of prediction accuracy. Prediction performance differences were tested using Kruskall-Wallis analysis and visualized on a heatmap. Finally, predictor variables of public health outcomes were shown on a decision tree.RESULTS:Study results revealed that Logistic regression outperformed Random Forest classification. The difference between all prediction methods to predict public health outcome indicators was statistically significant (p<.000). The heatmap shows that AUC values to predict mortality have superior performance when compared with life expectancy at birth. Decision tree graphs present that the most important predictor variables were total number of beds for mortality and percentage of higher education graduates for life expectancy at birth.CONCLUSIONS:The results of this study represent a preliminary attempt to determine public health outcome indicators. It is hoped that the results of this study serve as a basis to understand the determinants of health care outcomes at province level with focus on a developing country. This study illustrates that there is a need to spend extra effort for future studies to analyze public health outcomes to improve social welfare functions in health systems.

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The relationship between development assistance for health and public health financing in 134 countries between 2000 and 2015

Health Policy and Planning ◽

10.1093/heapol/czab004 ◽

2021 ◽

Author(s):

Bryan N Patenaude

Keyword(s):

Public Health ◽

Health Outcomes ◽

Development Assistance ◽

Health Sector ◽

Health Spending ◽

Health Financing ◽

World Health ◽

Public Financing ◽

Development Assistance For Health ◽

The Relationship

Abstract This paper utilizes causal time-series and panel techniques to examine the relationship between development assistance for health (DAH) and domestic health spending, both public and private, in 134 countries between 2000 and 2015. Data on 237 656 donor transactions from the Institute for Health Metrics and Evaluation’s DAH and Health Expenditure datasets are merged with economic, demographic and health data from the World Bank Databank and World Health Organization’s Global Health Observatory. Arellano–Bond system GMM estimation is used to assess the effect of changes in DAH on domestic health spending and health outcomes. Analyses are conducted for the entire health sector and separately for HIV, TB and malaria financing. Results show that DAH had no significant impact on overall domestic public health investment. For HIV-specific investments, a $1 increase in on-budget DAH was associated with a $0.12 increase in government spending for HIV. For the private sector, $1 in DAH is associated with a $0.60 and $0.03 increase in prepaid private spending overall and for malaria, with no significant impact on HIV spending. Results demonstrate that a 1% increase in public financing reduced under-5 mortality by 0.025%, while a 1% increase in DAH had no significant effect on reducing under-5 mortality. The relationships between DAH and public health financing suggest that malaria and HIV-specific crowding-in effects are offset by crowding-out effects in other unobserved health sectors. The results also suggest policies that crowd-in public financing will likely have larger impacts on health outcomes than DAH investments that do not crowd-in public spending.

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The nexus between improved water supply and water-borne diseases in urban areas in Africa: a scoping review

AAS Open Research ◽

10.12688/aasopenres.13225.1 ◽

2021 ◽

Vol 4 ◽

pp. 27

Author(s):

Nyamai Mutono ◽

Jim A Wright ◽

Henry Mutembei ◽

Josphat Muema ◽

Mair L.H Thomas ◽

...

Keyword(s):

Water Supply ◽

Health Outcomes ◽

Scoping Review ◽

Urban Areas ◽

Sub Saharan Africa ◽

Waterborne Diseases ◽

Cross Sectional ◽

Piped Water ◽

Study Designs ◽

Water Sufficiency

Background: The sub-Saharan Africa has the fastest rate of urbanisation in the world. However, infrastructure growth in the region is slower than urbanisation rates, leading to inadequate provision and access to basic services such as piped safe drinking water. Lack of sufficient access to safe water has the potential to increase the burden of waterborne diseases among these urbanising populations. This scoping review assesses how the relationship between waterborne diseases and water sufficiency in Africa has been studied. Methods: In April 2020, we searched the Web of Science, PubMed, Embase and Google Scholar databases for studies of African cities that examined the effect of insufficient piped water supply on selected waterborne disease and syndromes (cholera, typhoid, diarrhea, amoebiasis, dysentery, gastroneteritis, cryptosporidium, cyclosporiasis, giardiasis, rotavirus). Only studies conducted in cities that had more than half a million residents in 2014 were included. Results: A total of 32 studies in 24 cities from 17 countries were included in the study. Most studies used case-control, cross-sectional individual or ecological level study designs. Proportion of the study population with access to piped water was the common water availability metrics measured while amounts consumed per capita or water interruptions were seldom used in assessing sufficient water supply. Diarrhea, cholera and typhoid were the major diseases or syndromes used to understand the association between health and water sufficiency in urban areas. There was weak correlation between the study designs used and the association with health outcomes and water sufficiency metrics. Very few studies looked at change in health outcomes and water sufficiency over time. Conclusion: Surveillance of health outcomes and the trends in piped water quantity and mode of access should be prioritised in urban areas in Africa in order to implement interventions towards reducing the burden associated with waterborne diseases and syndromes.

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The effect of health expenditure on selected maternal and child health outcomes in Sub-Saharan Africa

International Journal of Social Economics ◽

10.1108/ijse-08-2015-0199 ◽

2016 ◽

Vol 43 (12) ◽

pp. 1386-1399 ◽

Cited By ~ 9

Author(s):

Ashiabi Nicholas ◽

Nketiah-Amponsah Edward ◽

Senadza Bernardin

Keyword(s):

Public Health ◽

Child Health ◽

Health Outcomes ◽

Health Expenditure ◽

Sub Saharan Africa ◽

Maternal Child Health ◽

Public Health Expenditure ◽

Content Type ◽

Child Health Outcomes ◽

Maternal Child

Purpose The purpose of this paper is to investigate the effect of public and private health expenditures on selected maternal-child health outcomes in Sub-Saharan Africa (SSA). Design/methodology/approach The study utilizes panel data on 40 SSA countries spanning the period 2000-2010. The data are analyzed using the fixed effects estimation technique. Findings The results indicate that public health expenditure is inversely and significantly related to infant (IMRR) and under-five (U5MR) mortalities in SSA. Though public health expenditure has the a priori negative sign, it has no significant effect on maternal mortality (MMR) in SSA. Further, private health expenditure did not prove to be significant in improving maternal-child health outcomes (IMRR, U5MR and MMR) in SSA. Practical implications The implication of the findings is that a percentage point increase in public health expenditure (as a share of GDP) across the region will result in saving the lives of about 7,040 children every year. Hence, it is important for governments in SSA to increase their shares of health expenditure (public health expenditure) in order to achieve improved health outcomes. Originality/value Previous studies have not adequately explored the effect of various components of health expenditures – public and private – on health outcomes in the context of SSA. In addition to the focus on maternal-child health variables such as infant, under-five and maternal mortalities, the study accounts for the possibility of a non-linear and non-monotonic relationship between healthcare expenditures and health outcomes.

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