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This study aims to investigate the consequence of the quality of governance (QoG) in moderating the effect of healthcare spending on human development.

The authors employ a two-step Windmeijer finite sample-corrected system-generalized method of moments (sys-GMM) estimation technique on a panel dataset of 161 countries from 2005 to 2019. The authors use healthcare expenditure as the main explanatory variable and the Human Development Index (HDI) as the dependent variable and also consider voice and accountability (VnA), political stability and absence of terrorism (PSnAT), governance effectiveness (GoE), regulatory quality (ReQ), rules of law (RLaw) and control of corruption (CoC) dimensions of governance indicators as proxies of good governance. The authors develop a new measure of good governance from these six dimensions of governance using principal component analysis (PCA).

The authors empirically revealed that allocating more healthcare support alone is insufficient to improve human development. Individually, PSnAT has the highest net positive effect on health expenditure that helps to increase human welfare. Further, the corresponding interaction effect between expenditure and the Good Governance Index (GGI) is negative but insignificant for low-income countries (LICs); negative and statistically significant for sub-Saharan African (SSA) economies and positive but insignificant for South Asian nations.

This study is an in-depth analysis of how governance impacts the effectiveness of healthcare expenditure to ensure higher human development, particularly in a large panel of 161 countries. The authors have developed a new index of good governance and later extended the analysis by separating countries based on the income level and geographical location, which are utterly absent in existing literature.

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity of the whole financing system.

Lorenz dominance analysis and Kakwani progressivity index were applied on data from 2010/2011 Household Income, Expenditure, and Consumption Survey and the National Health Accounts 2011 using Stata to evaluate the progressivity of each source of health-care finance and the financing system overall.

The data show that Egypt’s health-care system, which is largely financed by out-of-pocket (OOP) payments, is slightly regressive, with an overall Kakwani index of −0.079. The overall regressive effect was the result of three regressive sources (OOP payments, an earmarked cigarette tax and direct taxes), one proportional finance source (social health insurance) and two slightly progressive sources (indirect taxes and private health insurance). This shows that the burden of financing health care falls more on the poor. These results signal the need for reform of health-care financing in Egypt to reduce dependence on OOP payments to achieve more equitable financing.

The paper seeks to augment the literature on health-care financing in Egypt by calculating specific progressivity estimates for all five sources of financing the Egyptian health-care system and analyzing the overall equity of this financing system. It will, therefore, provide a benchmark for monitoring the equity of finance in the Egyptian health-care system in future studies and allow one to assess the impact of implemented financing reforms in the future on the level of progressivity of health system financing.

This paper examines the contested value of healthy life and wellbeing in a context of severe austerity, exploring how the value of “Public Health” is constructed through and with material-discursive practices and accounting representations. It seeks to explore the political and ethical implications of constructing the valuable through a shared consensus over the “facts” when addressing complex, multi-agency problems with long time horizons and outcomes that are not always easily quantifiable.

The theorisation, drawing on science and technology studies (STS) scholars and Karen Barad's (2007) agential realism, opens up the analysis to the performativity of both material and discursive practices in the period following a major re-organisation of activity. The study investigates two case authorities in England and the national regulator through interviews, observations and documentary analysis.

The paper demonstrates the deeply ethical and political entanglements of accounting representations as objectivity, consensus and collective action are constructed and resisted in practice. It goes on to demonstrate the practical challenges of constructing “alternative accounts” and “intelligent accountabilities” through times of austerity towards a shared sense of public value and suggests austerity measures make such aims both more challenging and all the more essential.

Few studies in the accounting literature have explored the full complexity of valuation practices in non-market settings, particularly in a public sector context; this paper, therefore, extends familiar conceptual vocabulary of STS inspired research to further explore how value(s), ethics and identity all play a crucial role in making things valuable.

Climate change affects the geographic and seasonal range of malaria incidence, especially, in poor tropical countries. This paper aims to attempt to conceptualize the potential economic repercussions of such effects with its focus on Ethiopia.

The paper is conceptual and descriptive in its design. It first reviews existing literature and evidence on the economic burdens of malaria, and the impacts of climate change on malaria disease. It then draws the economic implications of the expected malaria risk under the future climate. This is accompanied by a discussion on a set of methods that can be used to quantify the economic effects of malaria with or without climate change.

A review of available evidence shows that climate change is likely to increase the geographic and seasonal range of malaria incidence in Ethiopia. The economic consequences of even a marginal increase in malaria risk will be substantial as one considers the projected impacts of climate change through other channels, the current population exposed to malaria risk and the country’s health system, economic structure and level of investment. The potential effects have the potency to require more household and public spending for health, to perpetuate poverty and inequality and to strain agricultural and regional development.

This paper sheds light on the economic implications of climate change impacts on malaria, particularly, in Agrarian countries laying in the tropics. It illustrates how such impacts will interact with other impact channels of climate change, and thus evolve to influence the macro-economy. The paper also proposes a set of methods that can be used to quantify the potential economic effects of malaria. The paper seeks to stimulate future research on this important topic which rather has been neglected.

This study aims at evaluating the technical efficiency (TE) of healthcare systems in the Arab region and exploring the key factors that affect the efficiency performance.

The study applies a two-stage Data Envelopment Analysis (DEA) approach to a sample of 20 Arab countries. In the first stage, a DEA model is used to calculate the TE scores of the examined healthcare systems in 2019 and 2010, following both the output and input orientations of efficiency. In the second stage, a censored Tobit model is estimated to investigate the determinants of healthcare efficiency.

DEA results of 2019 indicate that achievable efficiency gains of the Arab countries range from 0.4% to 16% under the output and input orientations, respectively. Six countries are efficient under both orientations. Although the average efficiency scores of the Arab countries have deteriorated between 2010 and 2019, Djibouti and Sudan had the greatest efficiency improvements between the two years. Bahrain, Mauritania, Morocco and Qatar proved to be efficient in 2010 and 2019 under the two orientations of efficiency and according to the two DEA specifications followed. The Tobit model reveals that corruption and government health expenditure tend to have an adverse impact on healthcare efficiency.

The author evaluates healthcare efficiency and healthcare's efficiency determinants in the Arab countries. Regardless Arab countries' diversity, these countries are facing common health challenges, including diminishing role of governments in healthcare financing; increased out-of-pocket healthcare spending; poor healthcare outputs and prevalence of health inequities resulting from weak governance institutions. Comparing the efficiency of healthcare systems between 2010 and 2019 gives insights on the potential impact of the Arab spring uprisings on healthcare efficiency. Moreover, examining the determinants of healthcare efficiency allows for better understanding of how to improve the efficiency of healthcare systems in the region.

The study aims to determine whether there is a bidirectional causality relationship between health expenditures and per capita income in Brazil, Russia, India, China, South Africa and Turkey (BRICS+T).

For that purpose, the 2000–2018 period data of the variables were tested with the Kónya (2006) panel causality test. Additionally, the causality relationships between public and private health expenditures and per capita income were also investigated in the study.

According to the analysis results, there is no statistically significant causality relationship from total health expenditures and public health expenditures to per capita income in the relevant countries. Besides, there is a unidirectional causality relationship from private health expenditures to per capita income only in Turkey. On the other hand, a unidirectional causality relationship from per capita income to total health expenditures in China, Russia, Turkey and South Africa and from per capita income to public health expenditures in India, Russia, Turkey and South Africa were determined. Consequently, a causality relationship from per capita income to private health expenditures was found out in Russia and Turkey.

The variables are tested for the first time for BRICS+T countries, vis-à-vis the period under consideration and the method used.

This study aimed to analyze the role of community health workers (CHWs) called accredited social health activists (ASHAs) in improving maternal health outcomes in the rural community of Punjab, India. The study also examined the expectations of these workers from the community and identified the problems faced by them in carrying out their roles.

Using multistage sampling, a total of 28 villages were selected from seven districts of Punjab, and from these selected villages, a total of 57 ASHAs working as the interface between the rural community and the public health system and 420 women who had delivered a baby were interviewed.

Desire to earn money was the most prominent reason for joining the community work program, but ASHAs felt overburdened and underpaid compared to their work commitments. Not only was the incentive paid to these workers was insufficient and irregular but they also suffered at the hands of medical staff at public hospitals.

While exploring the problems experienced by the CHWs, this study recommends opting for a mix of monetary and nonmonetary incentives for acknowledging the work of CHWs. The study is the first of its kind for the state of Punjab battling with a worsening maternal mortality rate (MMR).

The main aim of the study was to measure and assess the efficiency of the healthcare system in Poland.

An output-oriented Data Envelopment Analysis model with a 2-years window analysis extension was used between 2013 and 2018. The analysis was completed with a determination of the sources of productivity changes (between the first and last year of the study period) and factors that influence efficiency.

Efficient regions have been identified and the spatial diversity in their efficiency was confirmed. The study identified individual efficiency trends together with “all-windows” best and worst performers. Using panel modeling, it was confirmed that the efficiency of health protection is influenced by, among others, accreditation certificates, the length of the waiting list or the number of medical personnel.

Although the analysis was conducted at the voivodeship level (NUTS2), which was fully justified, it would be equally important to analyze data with a lower aggregation level. It would be extremely valuable from the perspective of difficulties faced by the healthcare system in Poland.

The identification of areas and problems affecting the efficiency of the healthcare system in Poland may also be a hint for other countries with similar system solutions that also struggle with the same problems.

The paper explains the efficiency of the country's healthcare system while also paying attention to changes in its level, factors influencing it, spatial diversity and impact on the sector functioning.

Population ageing will bring economic challenges in the future. The purpose of this paper is to examine whether increased educational level could mitigate the consequences of population ageing on economic sustainability, measured as the gap between labour income and consumption.

Using the National Transfer Accounts (NTA) methodology, the authors decompose labour income and consumption by age and educational level (low, medium and high) and compare obtained age profiles with those calculated conventionally. In addition, using the population projections by age and educational level, the authors project both profiles to 2060 for selected EU countries and assess future economic sustainability.

The results show that the highly educated have a significantly higher surplus for a longer period then those with lower and medium education. Therefore, the improved educational level of individuals will have a substantially positive impact on labour income in the future—on average by about 32% by 2060 for all EU countries included. However, as the better educated also consume more, higher production does not fully translate into improved economic sustainability, but the resulting net effect is still positive at about 19%.

The authors present for the first time an NTA by education for 15 EU countries and show the importance of including education in the analysis of the economic life cycle. The authors also show that increased educational level will mitigate the consequences of population ageing on economic sustainability in the future.

Health insurance is one of the major contributors of growth of general insurance industry in India. It alone accounts for around 29% of total general insurance premium income earned in India. The growth of this sector is important from the perspective of overall growth of general insurance Industry. At the same time, problems in this sector are also many which are affecting its performance.

The paper provides an understanding on performance of health insurance sector in India. This study attempts to find out how much claims and commission and management expenses it has to incur to earn certain amount of premium. Methodology used for the study is regression analysis to establish relationship between dependent variable (Profit/Loss) and independent variable (Health Insurance Premium earned).

Findings of the study indicate that there is significant relationship between earned premium and underwriting loss. There has been increase of premium earnings which instead of increasing profit for the sector in fact has increased underwriting loss over the years. The earnings of the sector is growing at compounded annual growth rate of 27% still it is unable to earn underwriting profit.

This study is self-driven based on secondary data obtained from insurance regulatory and development authority site.