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Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015
INTRODUCTION: Government health spending is a primary source of funding in the health sector across the world. However, in sub-Saharan Africa, only about a third of all health spending is sourced from the government. The objectives of this study are to describe the growth in government health spendi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350738/ https://www.ncbi.nlm.nih.gov/pubmed/30775007 http://dx.doi.org/10.1136/bmjgh-2018-001159 |
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author | Micah, Angela E Chen, Catherine S Zlavog, Bianca S Hashimi, Golsum Chapin, Abigail Dieleman, Joseph L |
author_facet | Micah, Angela E Chen, Catherine S Zlavog, Bianca S Hashimi, Golsum Chapin, Abigail Dieleman, Joseph L |
author_sort | Micah, Angela E |
collection | PubMed |
description | INTRODUCTION: Government health spending is a primary source of funding in the health sector across the world. However, in sub-Saharan Africa, only about a third of all health spending is sourced from the government. The objectives of this study are to describe the growth in government health spending, examine its determinants and explain the variation in government health spending across sub-Saharan African countries. METHODS: We used panel data on domestic government health spending in 46 countries in sub-Saharan Africa from 1995 to 2015 from the Institute for Health Metrics and Evaluation. A regression model was used to examine the factors associated with government health spending, and Shapley decomposition was used to attribute the contributions of factors to the explained variance in government health spending. RESULTS: While the growth rate in government health spending in sub-Saharan Africa has been positive overall, there are variations across subgroups. Between 1995 and 2015, government health spending in West Africa grew by 6.7% (95% uncertainty intervals [UI]: 6.2% to 7.0%) each year, whereas in Southern Africa it grew by only 4.5% (UI: 4.5% to 4.5%) each year. Furthermore, per-person government health spending ranged from $651 (Namibia) in 2017 purchasing power parity dollars to $4 (Central African Republic) in 2015. Good governance, national income and the share of it that is government spending were positively associated with government health spending. The results from the decomposition, however, showed that individual country characteristics made up the highest percentage of the explained variation in government health spending across sub-Saharan African countries. CONCLUSION: These findings highlight that a country’s policy choices are important for how much the health sector receives. As the attention of the global health community focuses on ways to stimulate domestic government health spending, an understanding that individual country sociopolitical context is an important driver for success will be key. |
format | Online Article Text |
id | pubmed-6350738 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-63507382019-02-15 Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 Micah, Angela E Chen, Catherine S Zlavog, Bianca S Hashimi, Golsum Chapin, Abigail Dieleman, Joseph L BMJ Glob Health Research INTRODUCTION: Government health spending is a primary source of funding in the health sector across the world. However, in sub-Saharan Africa, only about a third of all health spending is sourced from the government. The objectives of this study are to describe the growth in government health spending, examine its determinants and explain the variation in government health spending across sub-Saharan African countries. METHODS: We used panel data on domestic government health spending in 46 countries in sub-Saharan Africa from 1995 to 2015 from the Institute for Health Metrics and Evaluation. A regression model was used to examine the factors associated with government health spending, and Shapley decomposition was used to attribute the contributions of factors to the explained variance in government health spending. RESULTS: While the growth rate in government health spending in sub-Saharan Africa has been positive overall, there are variations across subgroups. Between 1995 and 2015, government health spending in West Africa grew by 6.7% (95% uncertainty intervals [UI]: 6.2% to 7.0%) each year, whereas in Southern Africa it grew by only 4.5% (UI: 4.5% to 4.5%) each year. Furthermore, per-person government health spending ranged from $651 (Namibia) in 2017 purchasing power parity dollars to $4 (Central African Republic) in 2015. Good governance, national income and the share of it that is government spending were positively associated with government health spending. The results from the decomposition, however, showed that individual country characteristics made up the highest percentage of the explained variation in government health spending across sub-Saharan African countries. CONCLUSION: These findings highlight that a country’s policy choices are important for how much the health sector receives. As the attention of the global health community focuses on ways to stimulate domestic government health spending, an understanding that individual country sociopolitical context is an important driver for success will be key. BMJ Publishing Group 2019-01-13 /pmc/articles/PMC6350738/ /pubmed/30775007 http://dx.doi.org/10.1136/bmjgh-2018-001159 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Research Micah, Angela E Chen, Catherine S Zlavog, Bianca S Hashimi, Golsum Chapin, Abigail Dieleman, Joseph L Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 |
title | Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 |
title_full | Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 |
title_fullStr | Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 |
title_full_unstemmed | Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 |
title_short | Trends and drivers of government health spending in sub-Saharan Africa, 1995–2015 |
title_sort | trends and drivers of government health spending in sub-saharan africa, 1995–2015 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350738/ https://www.ncbi.nlm.nih.gov/pubmed/30775007 http://dx.doi.org/10.1136/bmjgh-2018-001159 |
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