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Article
Publication date: 4 October 2019

Chamunorwa Nyamuranga and Jaeun Shin

The purpose of this paper is to empirically assess the effect of public health expenditure on child mortality in the Southern African Development Community (SADC) region…

Abstract

Purpose

The purpose of this paper is to empirically assess the effect of public health expenditure on child mortality in the Southern African Development Community (SADC) region in comparison to the developing world as a whole and the region of Sub-Saharan Africa (SSA).

Design/methodology/approach

This study used panel data extracted from the World Development Indicators database for the period 2000–2013 for 98 developing countries including 15 SADC countries. A dynamic panel data model of child mortality was estimated using the system generalized method of moments technique.

Findings

Results indicate that public health expenditure has a statistically significant effect on reducing infant and under-five mortality rates in the developing world, and that this effect is strongest in the SADC. Immunization and female literacy contributed significantly to the prevention of deaths of infants and children under five in developing countries. In the region of SSA, improved water sources and the reduction in the prevalence of HIV were found to be effective in reducing childhood mortality. There was little evidence for the benefit of higher GDP per capita.

Practical implications

The findings of this study suggest four policy areas which should be prioritized in public health spending to achieve better health among children: ensuring that females have better access to education, providing immunizations, intensifying interventions against the spread of HIV/AIDS, and improving water and sanitation infrastructure.

Originality/value

This study, which shows that the benefits of public health expenditure may be augmented by regional collaborations like the SADC, is one of the first to explore regional heterogeneity in the effectiveness of public health expenditure for the improvement of children’s health across the developing world.

Details

International Journal of Social Economics, vol. 46 no. 9
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 1 July 2021

Abhishek Singh and Kshipra Jain

Children are the most vulnerable group owing to long lasting impact of the violation of human rights in term of proper nutrition and their right to live. The purpose of…

Abstract

Purpose

Children are the most vulnerable group owing to long lasting impact of the violation of human rights in term of proper nutrition and their right to live. The purpose of this paper is to assess the risk of child mortality associated with size of child at birth and mother’s anemia level in northern India.

Design/methodology/approach

The data were used from 2015–2016 National Family Health Survey (NFHS). The participants (n = 41,412) were children aged under-five years from north Indian state of Uttar Pradesh. The main outcome measure was child deaths defined by under-five mortality. The univariate, bivariate and multivariate analyses were used in data analysis. Kaplan–Meier analyses, Log-rank tests and Cox’s regression analyses were performed to fulfill the objective of the study.

Findings

There were a total of 2,835 deaths out of 41,412 births in the past five years preceding the survey period. Children of very small size at birth were significantly two and half times more likely to die than children of average size at birth. The estimated adjusted hazard ratio indicated that the children of severely anemic mothers were significantly 1.5 times more likely to die compared to children of not anemic mothers. Size of child at birth, mother’s anemia level, mother’s age at time of her first birth, wealth index and mother’s education were significantly associated with the under-five mortality in northern India.

Research limitations/implications

The limitation of this study is recall errors arising from the dates of birth and death given by women interviewed in the survey were minimized by restricting the analyses to births within the five-year period preceding the survey.

Practical implications

This study advocates the promotion of comprehensive prevention strategies through appropriate institutional mechanism would be the best intervention or adaptive mechanism to reduce the adverse impact of size of child at birth, mother’s anemia level on under-five mortality in Uttar Pradesh, India.

Originality/value

This research is original. This study enjoys a unique importance by exploring effect of size of child at birth and mother’s anemia on child survival in developing countries like India.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 24 December 2020

Mustapha Immurana

Ghana is one of the countries instituting several measures toward attracting more Foreign Direct Investment (FDI) inflows. This is because, FDI is largely viewed as…

Abstract

Purpose

Ghana is one of the countries instituting several measures toward attracting more Foreign Direct Investment (FDI) inflows. This is because, FDI is largely viewed as essential to socioeconomic development. However, while population health can influence FDI inflows, it has received very little attention. This study, therefore, investigates empirically, as to focusing on population health could be a useful tool in Ghana’s attempt to attract more FDI inflows.

Design/methodology/approach

The study uses time series data on Ghana from 1980 to 2018 to achieve its objective. Life expectancy, death rate, infant mortality rate, under-five mortality rate and incidence of malaria are used as proxies for population health, while the Ordinary Least Square (OLS) and the Instrumental Variable Two-Stage Least Square (IV2SLS) regressions are employed as empirical estimation techniques.

Findings

Using the OLS regression, except the incidence of malaria, the study finds all the other population health indicators to significantly influence FDI inflows. However, after controlling for endogeneity using the IV2SLS regression, all population health indicators are found to be significant as regards their effects on FDI inflows.

Practical implications

Paying attention to population health could be an effective strategy that can be employed by policymakers in the quest to get more FDI inflows into Ghana.

Originality/value

This study, to the best of our knowledge, is the first study solely devoted to Ghana, which doing so helps in devising country-specific policies with regard to the effect of population health on FDI inflows. Further, this study becomes the first to use death rate, infant mortality rate and under-five mortality rate in examining the effect of population health on FDI inflows. Thus, since there are various causes of deaths, using indicators that capture deaths from all factors helps in giving a much broader picture with regard to the FDI population health nexus. Also, this study is the first to use up to five different population health indicators in examining the effect of population health on FDI inflows, which aids in revealing whether FDI is sensitive to the population health indicator used.

Details

International Journal of Social Economics, vol. 48 no. 2
Type: Research Article
ISSN: 0306-8293

Keywords

Content available
Book part
Publication date: 6 May 2019

Heather Gage and Ekelechi MacPepple

The 30 MOCHA (Models of Child Health Appraised) countries are diverse socially, culturally and economically, and differences exist in their healthcare systems and in the…

Abstract

The 30 MOCHA (Models of Child Health Appraised) countries are diverse socially, culturally and economically, and differences exist in their healthcare systems and in the scope and role of primary care. An economic analysis was undertaken that sought to explain differences in child health outcomes between countries. The conceptual framework was that of a production function for health, whereby health outputs (or outcomes) are assumed affected by several ‘inputs’. In the case of health, inputs include personal (genes, health behaviours) and socio-economic (income, living standards) factors and the structure, organisation and workforce of the healthcare system. Random effects regression modelling was used, based on countries as the unit of analysis, with data from 2004 to 2016 from international sources and published categorisations of healthcare system. The chapter describes the data deficiencies and measurement conundrums faced, and how these were addressed. In the absence of consistent indicators of child health outcomes across countries, five mortality measures were used: neonatal, infant, under five years, diabetes (0–19 years) and epilepsy (0–19 years). Factors found associated with reductions in mortality were as follows: gross domestic product per capita growth (neonatal, infant, under five years), higher density of paediatricians (neonatal, infant, under five years), less out-of-pocket expenditure (neonatal, diabetes 0–19), state-based service provision (epilepsy 0–19) and lower proportions of children in the population, a proxy for family size (all outcomes). Findings should be interpreted with caution due to the ecological nature of the analysis and the limitations presented by the data and measures employed.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

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Article
Publication date: 4 December 2017

Jeffrey Kentor and Andrew Jorgenson

Recent sociological research highlights the growth of military expenditures in hi-tech, capital-intensive armaments and technology. The purpose of this paper is to examine…

Abstract

Purpose

Recent sociological research highlights the growth of military expenditures in hi-tech, capital-intensive armaments and technology. The purpose of this paper is to examine the impact of these capital-intensive expenditures on two related health outcomes: under-five mortality and life expectancy.

Design/methodology/approach

This research utilizes a series of cross-national panel models estimated for a diverse sample of developed and less-developed countries from 1975 to 2000.

Findings

The authors find that hi-tech military expenditures increase under-five mortality and reduce life expectancy over the period studied, by reducing the number and type of soldiers able to take advantage of increased health-related resources obtained in the military and indirectly, by increasing income inequality, which negatively impacts these health outcomes.

Research limitations/implications

This cross-national study should be supplemented by case studies to better understand the processes being examined.

Practical implications

The increase in capital-intensive military expenditures found worldwide reduces the total number of soldiers in the military and raises their enlistment requirements. This makes it difficult for people with limited human capital to take advantage of the military’s traditional pathway for upward mobility. New pathways for mobility will have to be developed to avoid the creation of a new permanent underclass.

Social implications

There are significant social policy implications for the findings. Hi-tech military expenditures have a significant negative impact on the short- and long-term health outcomes of children and adults, in both developed and less-developed countries, which must be addressed by public policy planners.

Originality/value

This is one of a handful of sociological studies on the impact of military establishment on society. These findings highlight the importance of “bringing the military back in” to the forefront of sociological research.

Details

International Journal of Sociology and Social Policy, vol. 37 no. 13/14
Type: Research Article
ISSN: 0144-333X

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Article
Publication date: 11 December 2009

Diddy Antai, Sara Wedrén, Rino Bellocco and Tahereh Moradi

Each ethnic group has its own peculiar cultural practices that may widen inequalities in child health and survival among ethnic groups. This study estimated ethnic…

Abstract

Each ethnic group has its own peculiar cultural practices that may widen inequalities in child health and survival among ethnic groups. This study estimated ethnic disparities in mortality of under‐five‐year‐olds, controlling for individual and community level characteristics. Using multilevel multivariable regression analysis on a nationally representative sample drawn from 7,864 households in the 2003 Nigeria Demographic and Health Survey, we estimated the risks of deaths under‐five‐year‐olds for 6,029 children nested within 2,735 mothers aged 15‐49 years old, who were in turn nested within 365 communities. Results were expressed as odds ratios with 95% confidence intervals. The observed risk of under‐five death was highest among children of Hausa/Fulani/Kanuri mothers and lowest among children of Yoruba mothers. The mother's affiliation to the Yoruba ethnic group, compared to Hausa/Fulani/Kanuri, was still significantly associated with decreased under‐five mortality (OR = 0.66, 95% CI = 0.45 ‐ 0.96) after adjustment for individual and community level factors. Under‐five mortality was significantly related to socio‐economic and demographic factors (birth order/birth interval, mother's age, and mother's education), which explained much but not all of the ethnic disparities. Findings underscore the need for measures aimed at improving female education and the socio‐economic standard of women, changing short birth spacing norms and reducing inequitable distribution of maternal and child health services.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 2 no. 4
Type: Research Article
ISSN: 1757-0980

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Article
Publication date: 5 December 2016

Ashiabi Nicholas, Nketiah-Amponsah Edward and Senadza Bernardin

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).

Abstract

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.

Details

International Journal of Social Economics, vol. 43 no. 12
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 26 July 2021

Tahmina Sultana, Faroque Ahmed and Mohammad Tareque

Bangladesh is applauded for its achievement in various health and social outcomes though criticized for its failure in properly dealing with governance issues. The purpose…

Abstract

Purpose

Bangladesh is applauded for its achievement in various health and social outcomes though criticized for its failure in properly dealing with governance issues. The purpose of this paper is intends to see how the health outcomes (in case of life expectancy, under-five mortality and adolescent fertility) are impacted by health expenditure (both public and private), per capita income in presence of overall governance and female education. This paper assumes that rapid progress in female education reflects the Bangladeshis’ social responsiveness to change.

Design/methodology/approach

This paper uses autoregressive distributed lag technique to estimate the models with data ranges from 1990 to 2016 under two different scenarios.

Findings

This study has found that all the explanatory variables exert significant impact on health outcomes. Furthermore, public health expenditure is augmented with a composite governance issue, and this enhances robustness as well as statistical significance of the models. These suggest that the governance issues play a very crucial role to achieve the expected health outcomes. Female secondary enrolment ratio appears with improved coefficients in terms of sign and magnitude for all the health indicators.

Originality/value

This paper contributes to the existing literature showing econometric evidence that highlights the importance of governance and female education in improving health outcomes of Bangladesh apart from health expenditure and per capita gross domestic product.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 27 January 2021

Cleopatra Oluseye Ibukun

Despite the global attempt at achieving goal 3 of the Sustainable Development Goals by improving health outcomes, some countries (West African countries inclusive) still…

Abstract

Purpose

Despite the global attempt at achieving goal 3 of the Sustainable Development Goals by improving health outcomes, some countries (West African countries inclusive) still do not spend a significant proportion of their income on health and they exhibit health outcomes that are still far below that of developed countries. Besides countries like Nigeria, Chad and Guinea-Bissau are experiencing worsening insecurity and political instability. This study, therefore, examines the effect of health expenditure on three health outcomes in the West African sub-region, while investigating the effect of the quality of governance in this nexus.

Design/methodology/approach

This study conducts an instrumental variable approach (two-stage least squares regression) on a panel of 15 West African countries over the period 2000–2018. This study uses three proxies to measure health outcomes and six measures of the quality of governance were also considered.

Findings

The result of this study shows that all forms of health expenditures significantly influenced health outcomes. That is, there is a negative relationship between health expenditure, infant mortality and under-five mortality, but a positive relationship between health expenditure and life expectancy at birth. Besides, the general effect of the same quantity of public health spending is subject to the quality of governance because countries with a higher quality of governance benefit better from their public health spending.

Originality/value

This study, to the authors' knowledge, is the first empirical attempt to examine the role of governance in the health expenditure-health outcomes nexus in 15 ECOWAS countries, using different measures of health outcomes and governance.

Details

International Journal of Social Economics, vol. 48 no. 4
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 20 October 2020

Anand Sharma

The 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

Abstract

Purpose

The 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/approach

The 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).

Findings

The 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/implications

This 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 implications

The 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/value

Extant 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.

Details

International Journal of Social Economics, vol. 47 no. 12
Type: Research Article
ISSN: 0306-8293

Keywords

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