Health expenditure in sub-Saharan Africa: Is it mean reversion? A Fourier unit root test approach

2021 ◽  
Vol 66 (4) ◽  
pp. 25-44
Author(s):  
Gbenga A. Olalude ◽  
Hammed A. Olayinka ◽  
Oluwadare O. Ojo
Keyword(s):  
Health Outcome ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Unit Root ◽  
Health Expenditure ◽  
Unit Root Test ◽  
Mean Reversion ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Sub Saharan

The aim of the paper is to examine the mean reversion in health expenditure of 45 sub-Saharan African countries. The series on current health expenditure (percent of GDP in total), obtained from the World Development Indicators, each spanned the years 2000–2017. We employed the Fourier unit root test, which allows modelling structural breaks, to deal with any such breaks that could arise as a result of a small sample size (18 years) of data available on health expenditure of the selected countries. The results showed evidence of mean reversion in the health spending pattern of 27 sub-Saharan African countries. There is evidence of nonmean reversion in the health expenditure pattern of the remaining 18 countries considered. We further investigate the link between health expenditure and health outcome, using infant mortality rate and under-five mortality rate as health outcome variables. An inverse association could be observed between the infant mortality rate and health expenditure and between the under-five mortality rate and health expenditure in 24 sub-Saharan African countries. On the other hand, in 13 other sub-Saharan African countries we observed a positive association between the variables. The findings of this study could be of great importance to healthcare delivery programmes in the studied countries.

scholarly journals The effect of the quality of institutions on the relationship between public health expenditure and the infant mortality rate: evidence from the PVAR (X) and PSTR approaches

2021 ◽  
Vol 1 (1) ◽  
pp. 16-35
Author(s):  
Arthur Evariste KOUASSI ◽  
Ya Assanhoun Guillaume KOUASSI ◽  
Nogbou Andetchi Aubin AMANZOU
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Important Indicator ◽  
Institutional Variables ◽  
Public Health Expenditure ◽  
Sub Saharan

Infant mortality is a major health problem in developing countries. It is an important indicator of a country's public health as it goes hand in hand with socio-economic conditions and many others. Public health spending has been committed to reducing this scourge. This has led to the completion of numerous studies which have yielded mixed results. The main objective of this study is to test the effect of public health expenditure (% GDP) on the infant mortality rate, taking into account the role that institutional quality can play. To achieve this, we use two approaches which are the autoregressive vector panel model with exogenous variables (PVAR (X)) and the smooth threshold regression model (PSTR) on annual data covering the period 2002-2016 and covering 37 African countries. Sub-Saharan. Our main results through the PVAR (X) reveal that in the absence of institutional variables, public health expenditure has a negative and significant effect on the infant mortality rate, whereas, in the presence of the various institutional variables, this effect is still negative but is no longer significant. Our results show that the presence of institutions halves the weight of public health expenditure in explaining the infant mortality rate. In addition, our results show through the PSTR that there is a certain level of institutional qualities that these countries must achieve for public health expenditure to positively affect infant mortality rates. These thresholds oscillate for all the institutional variables around 7%. Taking institutional variables into account will help reduce infant mortality in Sub-Saharan African countries.

scholarly journals Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa

2020 ◽  
Vol 117 (8) ◽  
pp. 4027-4033 ◽  
Author(s):  
Emily Smith-Greenaway ◽  
Jenny Trinitapoli
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Age Groups ◽  
Infant Mortality Rate ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Sub Saharan ◽  
Offspring Mortality ◽  
Cumulative Prevalence

We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics.

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 Can Aid Improve People Health in Sub-Saharan African Countries?

2018 ◽  
Vol 3 (2) ◽  
pp. 91
Author(s):  
W. Jean Marie Kébré
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Prevalence Rate ◽  
Health Indicators ◽  
Hiv Prevalence ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Crude Mortality ◽  
Sub Saharan ◽  
Hiv Aids

<p><em>This paper analyzes the effects of aid on health of people in Sub-Saharan African Countries. Used as health indicators for infant mortality rate, crude mortality rate and HIV/AIDS prevalence rate, this analysis uses panel data for a sample of 43 countries over the period of 1990 to 2014. Through assessing the effect of aid on reducing mortality and HIV prevalence, the article examines a central issue with regard to the new global development agenda: Can we still promote health through increased aid? The results tend to show that aid significantly reduces crude mortality and infant mortality rates and HIV/AIDS prevalence rate. They do not validate the presence of decreasing marginal returns. However, the impact of aid on health indicators is not linear. This non-linearity suggests that aid is more effective in reducing mortality and HIV prevalence in relatively poorest countries and in those with relatively lower health expenditure. Thus, health promotion in sub-Saharan African countries through increased aid is possible.</em><em></em></p>

Empirical analysis of factors influencing the public health expenditure in Malaysia

2018 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Kok Wooi Yap ◽  
Doris Padmini Selvaratnam
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Price Index ◽  
Infant Mortality Rate ◽  
Public Health Expenditure ◽  
The Public ◽  
Empirical Results ◽  
Per Capita

This study aims to investigate the determinants of public health expenditure in Malaysia. An Autoregressive Distributed Lag (ARDL) approach proposed by Pesaran & Shin (1999) and Pesaran et al. (2001) is applied to analyse annual time series data during the period from 1970 to 2017. The study focused on four explanatory variables, namely per capita gross domestic product (GDP), healthcare price index, population aged 65 years and above, as well as infant mortality rate. The bounds test results showed that the public health expenditure and its determinants are cointegrated. The empirical results revealed that the elasticity of government health expenditure with respect to national income is less than unity, indicating that public health expenditure in Malaysia is a necessity good and thus the Wagner’s law does not exist to explain the relationship between public health expenditure and economic growth in Malaysia. In the long run, per capita GDP, healthcare price index, population aged more than 65 years, and infant mortality rate are the important variables in explaining the behaviour of public health expenditure in Malaysia. The empirical results also prove that infant mortality rate is significant in influencing public health spending in the short run. It is noted that macroeconomic and health status factors assume an important role in determining the public health expenditure in Malaysia and thus government policies and strategies should be made by taking into account of these aspects.

The Effects of Health Expenditures to Decrease Infant Mortality Rates in OECD Countries

2020 ◽  
pp. 357-383 ◽  
Author(s):  
Funda Kara ◽  
İrfan Ersin
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Panel Cointegration ◽  
Mortality Rates ◽  
Oecd Countries ◽  
Infant Mortality Rate ◽  
Annual Data ◽  
Causality Analysis ◽  
Analysis Process

There is a positive relationship between the health level of the society and its economic development. The main reason is that improving quality of the lives and increasing lifetime has lead to higher economic performance. This evaluates the relationship between health expenditure and infant mortality rate in OECD countries. In the analysis process, 20 different countries in the OECD are selected and annual data of these countries for the years between 1980 and 2017 is evaluated with the help of Kao panel cointegration and Dumitrescu-Hurlin causality analysis. The findings show that there is long term relationship between health expenditure and infant mortality rates in OECD countries. Another important conclusion is that there is a causality analysis from health expenditure to the infant mortality rate. While considering these results, it is recommended that OECD countries should take some actions in order to increase health expenditure so that it can be possible to decrease infant mortality rate.

scholarly journals Socioeconomic Determinants of Infant Mortality Rate in Asean: A Panel Data Analysis

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Vita Kartika Sari ◽  
Dwi Prasetyani
Keyword(s):  
Health Status ◽  
Panel Data ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Health Expenditure ◽  
Strong Influence ◽  
Mortality Rates ◽  
Infant Mortality Rate ◽  
Gdp Per Capita ◽  
Per Capita

The infant mortality rate indicates the health status of a country. Previous studies have proven that socioeconomic factors have a significant influence on infant mortality rates in both developed and developing countries. Further studies on infant mortality rates are useful for public service strategic policy in the health sector. The main purpose of this study was to analyze the socioeconomic factors influencing infant mortality rates in ASEAN based on panel data estimates for 2000-2017. The dependent variable for this study was infant mortality rate, while the independent variables were health expenditure, female labor force, maternal fertility rate, and GDP per capita. The authors concluded that the main cause of infant mortality in ASEAN is care during delivery. Other influencing factors include family health status, maternal education level, and socio-economic inequality. This study found that the size of the female workforce has a strong influence on increasing the infant mortality rate in ASEAN. The fertility rate also had a strong influence on increasing infant mortality rate in ASEAN, while GDP per capita had a negative influence on infant mortality rate.  Health expenditure is proven to have no effect on the increase of infant mortality rates in ASEAN.

scholarly journals Estimating the infant mortality rate from DHS birth histories in the presence of age heaping

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259304
Author(s):  
Julio Romero Prieto ◽  
Andrea Verhulst ◽  
Michel Guillot
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Life Table ◽  
Life Tables ◽  
Model Life Table ◽  
Infant Mortality Rate ◽  
Quadratic Model ◽  
Vital Registration ◽  
Age Patterns ◽  
Sub Saharan

Background The infant mortality rate (IMR) is a critical indicator of population health, but its measurement is subject to response bias in countries without complete vital registration systems who rely instead on birth histories collected via sample surveys. One of the most salient bias is the fact that child deaths in these birth histories tend to be reported with a large amount of heaping at age 12 months. Because of this issue, analysts and international agencies do not directly use IMR estimates based on surveys such as Demographic and Health Surveys (DHS); they rely instead on mortality models such as model life tables. The use of model life tables in this context, however, is arbitrary, and the extent to which this approach appropriately addresses bias in DHS-based IMR estimates remains unclear. This hinders our ability to monitor IMR levels and trends in low-and middle-income countries. The objective of this study is to evaluate age heaping bias in DHS-based IMR estimates and propose an improved method for adjusting this bias. Methods and findings Our method relies on a recently-developed log-quadratic model that can predict age-specific mortality by detailed age between 0 and 5. The model’s coefficients were derived from a newly constituted database, the Under-5 Mortality Database (U5MD), that represents the mortality experience of countries with high-quality vital registration data. We applied this model to 204 DHS surveys, and compared unadjusted IMR values to IMR values adjusted with the log-quadratic model as well as with the classic model life table approach. Results show that contrary to existing knowledge, age heaping at age 12 months rarely generates a large amount of bias in IMR estimates. In most cases, the unadjusted IMR values were not deviating by more than +/- 5% from the adjusted values. The model life table approach, by contrast, introduced an unwarranted, downward bias in adjusted IMR values. We also found that two regions, Sub-Saharan Africa and South Asia, present age patterns of under-5 mortality that strongly depart from the experience represented in the U5MD. For these countries, neither the existing model life tables nor the log-quadratic model can produce empirically-supported IMR adjustments. Conclusions Age heaping at age 12 months produces a smaller amount of bias in DHS-based IMR estimates than previously thought. If a large amount of age heaping is present in a survey, the log-quadratic model allows users to evaluate, and whenever necessary, adjust IMR estimates in a way that is more informed by the local mortality pattern than existing approaches. Future research should be devoted to understanding why Sub-Saharan African and South Asian countries have such distinct age patterns of under-five mortality.

scholarly journals Impact of Government Health Expenditure on Health Outcomes in the West African Sub-Region

2021 ◽  
Vol 21 (1) ◽  
pp. 48-59
Author(s):  
Rafiu Ayobanji Mustapha ◽  
Saidat Oluwatoyin Onikosi-Alliyu ◽  
Abdurrouf Babalola
Keyword(s):  
Health Outcome ◽  
Mortality Rate ◽  
Infant Mortality ◽  
West Africa ◽  
Public Expenditure ◽  
Least Square ◽  
Infant Mortality Rate ◽  
The West ◽  
Integration Test ◽  
The Impact

Abstract Research background: Health outcome such as infant mortality rate is an important measure of the standard of living. It is a part of Millennium Development Goals, which all countries of the World strive to achieve, by allocating enormous economic resources to the health sector respectively. Purpose: The study assessed the impact of government expenditure on health and on health outcome (infant mortality rate) in the West Africa Sub-region. Research methodology: Secondary data were collected from 2000 to 2015 on thirteen countries in the Sub-region. Owing to the fact that the nature of the data involved is macro-panel data, the study performed the pre-estimation test (such as panel unit-root test and co-integration test) to ascertain the time series properties of the series. Based on the results of the pre-estimation tests, the work employed the fully modified ordinary least square (FMOLS). Results: It is found in the study that public health spending has an indirect impact on infant mortality rate in the West Africa Sub-region. Novelty: No extant study examined the impact of public expenditure on health and on maternal mortality rate using the West Africa Sub-region as an area of coverage. This study employed a fully modified OLS (FMOLS) to assess the impact of public expenditure on health and on infant mortality rate in the West Africa Sub-region.

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