An analysis of the potential for achieving the fourth millennium development goal in SSA with domestic resources

O’Hare, Bernadette Ann-Marie; Makuta, Innocent

doi:10.1186/s12992-015-0092-1

Cited by 12 publications

(12 citation statements)

References 20 publications

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“…National income (Gross Domestic Product/capita) is an important determinant of child survival44 and, along with the level of governance, it determines how well a country can provide for their citizens with the essential social determinants of health (SDH) 45. Stopping leaks from government revenue, including tax avoidance by domestic companies, multinational companies and wealthy residents and tax incentives which do not promote economic growth, is essential if LMICs are to retain resources necessary to reduce poverty 46. International and local action to end wars, use of scarce resources to buy armaments47 and debt repayment, all of which are promoted by HICs, can contribute to ending these drains on essential government revenue.…”

Section: Introductionmentioning

confidence: 99%

Addressing inequities in child health and development: towards social justice

Spencer

Raman

O’Hare

et al. 2019

bmjpo

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Inequities have a profound impact on the health and development of children globally. While inequities are greatest in the world’s poorest countries, even in rich nations poorer children have poorer health and developmental outcomes. From birth through childhood to adolescence, morbidity, mortality, growth and development are socially determined, resulting in the most disadvantaged having the highest risk of poor health outcomes. Inequities in childhood impact across the life course. We consider four categories of actions to promote equity: strengthening individuals, strengthening communities, improving living and working conditions, and promoting healthy macropolicies. Inequities can be reduced but action to reduce inequities requires political will. The International Society for Social Paediatrics and Child Health (ISSOP) calls on governments, policy makers, paediatricians and professionals working with children and their organisations to act to reduce child health inequity as a priority. ISSOP recommends the following: governments act to reduce child poverty; ensure rights of all children to healthcare, education and welfare are protected; basic health determinants such as adequate nutrition, clean water and sanitation are available to all children. Paediatric and child health organisations ensure that their members are informed of the impact of inequities on children’s well-being and across the life course; include child health inequities in curricula for professionals in training; publish policy statements relevant to their country on child health inequities; advocate for evidence-based pro-equity interventions using a child rights perspective; advocate for affordable, accessible and quality healthcare for all children; promote research to monitor inequity as well as results of interventions in their child populations. Paediatricians and child health professionals be aware of the impact of social determinants of health on children under their care; ensure their clinical services are accessible and acceptable to all children and families within the constraints of their country’s health services; engage in advocacy at community and national level.

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Section: Introductionmentioning

confidence: 99%

Addressing inequities in child health and development: towards social justice

Spencer

Raman

O’Hare

et al. 2019

bmjpo

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“…to reduce the under-five mortality rate by two-thirds between 1990 and 2015) in Sub-Saharan Africa (SSA) countries. In addition, O’Hare et al [ 18 ] provided evidence on the time needed for the SSA region countries to reach this target if national resources had been fully mobilized (i.e. in the absence of leaks, such as IFFs, corruption, and debt service).…”

Section: Introductionmentioning

confidence: 99%

Illicit financial flows and the provision of child and maternal health services in low- and middle-income countries

Ortega

Sanjuán

Casquero

2020

BMC Int Health Hum Rights

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Background Illicit financial flows (IFFs) drain domestic resources with harmful social effects, especially in countries which are too poor to mobilise the revenues required to finance the provision of essential public goods and services. In this context, this article empirically examined the association between IFFs and the provision of essential health services in low- and middle-income countries. Methods Firstly, a set of indicators was selected to represent the overall coverage of essential health services at the country level. Next, a linear multivariate regression model was specified and estimated for each indicator using cross-sectional data for 72 countries for the period 2008–2013. Results After controlling for other relevant factors, the main result of the regression analysis was that an annual 1 percentage point (p.p.) increase in the ratio of IFFs to total trade was associated with a 0.46 p.p. decrease in the level of family planning coverage, a 0.31 p.p. decrease in the percentage of women receiving antenatal care, and a 0.32 p.p. decrease in the level of child vaccination coverage rates. Conclusions These findings suggest that, for the whole sample of countries considered, at least 3.9 million women and 190,000 children may not receive these basic health care interventions in the future as a consequence of a 1 p.p. increase in the ratio of IFFs to total trade. Moreover, given that family planning, reproductive health, and child immunisation are foundational components of health and long-term development in poor countries, the findings show that IFFs could be undermining the achievement of the 2030 Agenda for Sustainable Development.

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“…At these rates of progress, SSA as a whole will miss the MDG targets on both of these goals. It has been estimated only nine countries in the region, out of a samples of 36, will achieve their targets on MDG number 4 at the current rates of reduction [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of governance, public spending on health and health status in Sub Saharan Africa: a panel data regression analysis

2015

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BackgroundThe population in Sub Saharan Africa (SSA) suffers poor health as manifested in high mortality rates and low life expectancy. Economic growth has consistently been shown to be a major determinant of health outcomes. However, even with good economic growth rates, it is not possible to achieve desired improvements in health outcomes. Public spending on health (PSH) has long been viewed as a potential complement to economic growth in improving health. However, the relationship between PSH and health outcomes is inconclusive and this inconclusiveness may, in part, be explained by governance-related factors which mediate the impact of the former on the latter. Little empirical work has been done in this regard on SSA. This paper investigates whether or not the quality of governance (QoG) has a modifying effect on the impact of public health spending on health outcomes, measured by under-five mortality (U5M) and life expectancy at birth (LE), in SSA.MethodsUsing two staged least squares regression technique on panel data from 43 countries in SSA over the period 1996–2011, we estimated the effect of public spending on health and quality of governance U5M and LE, controlling for GDP per capita and other socio-economic factors. We also interacted PSH and QoG to find out if the latter has a modifying effect on the former’s impact on U5M and LE.ResultsPublic spending on health has a statistically significant impact in improving health outcomes. Its direct elasticity with respect to under-five mortality is between −0.09 and −0.11 while its semi-elasticity with respect to life expectancy is between 0.35 and 0.60. Allowing for indirect effect of PSH spending via interaction with quality of governance, we find that an improvement in QoG enhances the overall impact of PSH. In countries with higher quality of governance, the overall elasticity of PSH with respect to under-five mortality is between −0.17 and −0.19 while in countries with lower quality of governance, it is about −0.09. The corresponding semi elasticities with respect to life expectancy are about 6 in countries with higher QoG and about 3 in countries with lower QoG.DiscussionPublic spending on health improves health outcomes. Its impact is mediated by quality of governance, having the higher impact on health outcomes in countries with higher quality of governance and lower impact in countries with lower quality of governance. This may be due to increased efficiency in the use of available resources and better allocation of the same as QoG improves.ConclusionImproving QoG would improve health outcomes in SSA. The same increase in PSH is twice as effective in reducing U5M and increasing LE in countries with good QoG when compared with countries with poor QoG.

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An analysis of the potential for achieving the fourth millennium development goal in SSA with domestic resources

Cited by 12 publications

References 20 publications

Addressing inequities in child health and development: towards social justice

Addressing inequities in child health and development: towards social justice

Illicit financial flows and the provision of child and maternal health services in low- and middle-income countries

Quality of governance, public spending on health and health status in Sub Saharan Africa: a panel data regression analysis

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