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Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)

BACKGROUND: Despite the increasing interest in China’s development assistance for health (DAH) in African countries, little is known regarding the distribution and determinants of China’s DAH project allocation among the principle subdivisions (provinces & states) within African countries. METHO...

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Autores principales: Yang, Hao-min, Liu, Pei-long, Guo, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307275/
https://www.ncbi.nlm.nih.gov/pubmed/30587238
http://dx.doi.org/10.1186/s40249-018-0510-8
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author Yang, Hao-min
Liu, Pei-long
Guo, Yan
author_facet Yang, Hao-min
Liu, Pei-long
Guo, Yan
author_sort Yang, Hao-min
collection PubMed
description BACKGROUND: Despite the increasing interest in China’s development assistance for health (DAH) in African countries, little is known regarding the distribution and determinants of China’s DAH project allocation among the principle subdivisions (provinces & states) within African countries. METHODS: We mapped the distribution of China’s DAH projects in 670 principle subdivisions of 50 African countries during 2006–2015 using web-based information. The political, demographic, health and socioeconomic indicators of DAH allocation were analyzed using conditional logistic regression models. The national capital city and political leader’s birth place were selected as the main political indicators, and health indicators were selected according to different fields of the DAH projects. RESULTS: China’s DAH projects (mainly China medical teams [CMTs], hospitals and anti-malaria centers) were mostly allocated to the western and eastern coasts of Africa, although CMTs were also dispatched to northern Africa. National capital cities were significantly associated with the allocation of China’s DAH projects (P <  0.001). Anti-malaria centers were more likely to be allocated to principle subdivisions with larger populations (OR = 1.35), and CMTs were allocated to subdivisions with high population densities (OR = 79.01). No health-related indicators were identified to affect project allocation except for the facility delivery rate and under-five mortality rate, which were associated with hospital allocation. We also found an association between CMT allocation and the use of artemisinin-based combination therapy in children. CONCLUSIONS: Allocation of China’s DAH projects is strongly affected by political and demographic factors. Implementation of China’s new DAH projects should target health and socio-economic indicators and impact metrics in scaling up tailored and cost-effective programs in Africa. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40249-018-0510-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-63072752019-01-02 Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015) Yang, Hao-min Liu, Pei-long Guo, Yan Infect Dis Poverty Research Article BACKGROUND: Despite the increasing interest in China’s development assistance for health (DAH) in African countries, little is known regarding the distribution and determinants of China’s DAH project allocation among the principle subdivisions (provinces & states) within African countries. METHODS: We mapped the distribution of China’s DAH projects in 670 principle subdivisions of 50 African countries during 2006–2015 using web-based information. The political, demographic, health and socioeconomic indicators of DAH allocation were analyzed using conditional logistic regression models. The national capital city and political leader’s birth place were selected as the main political indicators, and health indicators were selected according to different fields of the DAH projects. RESULTS: China’s DAH projects (mainly China medical teams [CMTs], hospitals and anti-malaria centers) were mostly allocated to the western and eastern coasts of Africa, although CMTs were also dispatched to northern Africa. National capital cities were significantly associated with the allocation of China’s DAH projects (P <  0.001). Anti-malaria centers were more likely to be allocated to principle subdivisions with larger populations (OR = 1.35), and CMTs were allocated to subdivisions with high population densities (OR = 79.01). No health-related indicators were identified to affect project allocation except for the facility delivery rate and under-five mortality rate, which were associated with hospital allocation. We also found an association between CMT allocation and the use of artemisinin-based combination therapy in children. CONCLUSIONS: Allocation of China’s DAH projects is strongly affected by political and demographic factors. Implementation of China’s new DAH projects should target health and socio-economic indicators and impact metrics in scaling up tailored and cost-effective programs in Africa. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40249-018-0510-8) contains supplementary material, which is available to authorized users. BioMed Central 2018-12-19 /pmc/articles/PMC6307275/ /pubmed/30587238 http://dx.doi.org/10.1186/s40249-018-0510-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Yang, Hao-min
Liu, Pei-long
Guo, Yan
Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)
title Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)
title_full Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)
title_fullStr Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)
title_full_unstemmed Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)
title_short Determinants of China’s development assistance for health at the sub-national level of African countries (2006–2015)
title_sort determinants of china’s development assistance for health at the sub-national level of african countries (2006–2015)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307275/
https://www.ncbi.nlm.nih.gov/pubmed/30587238
http://dx.doi.org/10.1186/s40249-018-0510-8
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