Does economic shocks influence household's healthcare expenditure? Evidence from rural Nigeria

Drivers of healthcare expenditure growth in West Africa: A panel data investigation

Per capita health expenditure in West African countries appears to have assumed a growing trend over the years. This may not be unconnected with the critical role played by health in economic growth, sustainable development and human capital formation. This study analysed drivers of healthcare expenditure in West Africa, using panel data analysis. Random Effects estimating technique was preferred to pooled Ordinary Least Squares and Fixed Effects techniques based on Hausman and Breusch-Pagan Lagrangian multiplier tests. Data employed were sourced from World Bank's world development indicators. The findings indicated that number of people using at least basic sanitation services, incidence of tuberculosis, malaria incidence, and per capita GDP, significantly increased healthcare expenditure in West Africa within the study period. Infant and under-five mortality (UFM) rates raised healthcare expenditure but insignificantly in the sub-region. The study recommends the need to reduce malaria and tuberculosis incidences as well as UFM rate in West Africa through appropriate policy enactment. Such policies should include adequate investment in education, increased per capita income, development of malaria vaccines, maintenance of hygienic environment and free treatment of tuberculosis patients.

COVID-19 induced shocks and its implications for human capital development

BACKGROUND

COVID-19 has delivered an enormous shock to the global economy, triggering the deepest recession in eight decades, almost three times as deep as the 2009 global recession. Of all the nations in Africa, Nigeria remains one of the nations with a huge and significant impact on the human capital.

METHODS

Hence, here we employed the recent nationally representative data from Nigeria - the COVID-19 National Longitudinal Phone Survey 2020-World Bank Living Standards Measurement Study Integrated Agriculture Survey (LSMS-ISA), a harmonized dataset to explore how the COVID-19 induced shocks affected households' human capital development (using health and education outcomes).

RESULTS

The results indicate that the COVID-19 induced shocks impact on both health and education in Nigeria. Interestingly, access to social safety nets had a positive association with the health and education outcomes. The study concludes that households' access to social safety nets, particularly during the COVID-19 pandemic aids in the development of the nation's human capital. Therefore, effectively enhancing household's resilience and strengthening human capital development require positive and considerable innovation, maybe over a period of years. Hence, just an access to the national social safety nets programs or social programs may not be as effective as expected. Therefore, it may not be as successful as intended to just have access to national social safety net programs or social programs that contribute or transfer negligible amounts to the vulnerable recipients over short time frames.

Can nutrition-sensitive intervention and programmes reduce household's food insecurity among the communities affected by Boko-Haram insurgency in Nigeria?

Dwindling food security situations that arose from Boko-haram insurgence experienced in the northeast of Nigeria has led to an urgent need to respond to the food and livelihood requirements of families who were affected by the conflicts in this region. This is necessary in order to enhance their food and nutritional security and livelihood activities. Thus, examining the status of malnutrition of households in the intervening communities is imperative. Therefore, primary data were collected from some selected households within the region using multi-stage sampling procedure. Descriptive statistics, Dietary Diversity Score (DSS), Heckman and Tobit Models were the analytical tools employed. The study revealed that food aid constitutes an integral proportion of the total expenditure of households on food in the intervening communities. Level of malnutrition also reduces from 40.58 to 16.7% due to the impact of the sensitization programme on households' consumption of nutritious foods. However, there is still a high level of malnutrition (68.79%) among the children that are 5 years and below. Social capital formation and group-specific nutritional policy strategies directed at the internally displaced persons (IDPs) and children that are 5 years and below are panacea to reducing malnutrition in the region.

Does family medicine reduce household health expenditures: evidence from Türkiye

Türkiye introduced a family medicine-centered primary healthcare model in 2005 as part of the Health Transformation Program, which aimed to reduce household healthcare expenditures, improve access to health services, and reduce the crowding-out effect in first-stage hospital institutions. We investigate the impact of the family medicine program on household healthcare expenditures in Türkiye, focusing on doctor visits, medication prescriptions, and hospitalization expenditures. Using data from a large representative household survey, we employ a difference-in-differences approach combined with the entropy-balancing matching technique. Our robust findings show that living in a province exposed to the family medicine program reduced household doctor visit expenditures by over 40 percent. We also find a significant negative association between the family medicine program and expenditures regarding doctor visits and medication prescriptions in the long run. Greater efforts are now needed to ensure the quality of services offered by family health centers, such as improving the doctor-to-patient ratio.

Effect of economic uncertainty on public health expenditure in Economic Community of West African States: Implications for sustainable healthcare financing

This study investigates the dynamic effect of economic uncertainty on public health expenditure in the Economic Community of West African States region. The investigation is motivated by the recent volatilities in the global economy in the face of increasing demand for adequate funding of health systems in the region, and the need to fill the existing gap in the literature. The study employs the panel autoregressive distributed lag model to express the theoretical relationship between public health expenditure per capita, economic uncertainty and population growth rate, and estimates the model parameters using the mean group and the pooled mean group estimators, after accounting for stationarity and cointegration. Results reveal that on the aggregate, economic uncertainty and population growth are significant determinants of per capita health spending in the long run. When the countries are disaggregated by income groups, evidence suggests that in low-income countries, economic uncertainty is negatively associated with health spending in the short run, while a growing population reduces health spending per capita in the long run. In lower-middle-income countries, economic uncertainty increases health spending in the short run, but reduces it in the long run as uncertainty persists, while population growth negatively impacts health spending in the long run. We conclude that the dependence on public funding of the health system in the region appears unsustainable. Thus, health financing policies need to explore alternative funding mechanisms that entrench cost-sharing between the public and private financiers.

The Effect of Big Data-Based Digital Payments on Household Healthcare Expenditure

Whether families using big data-based digital payments will increase household healthcare expenditure is a subject that needs to be investigated in the era of big data. Based on the data from China Family Panel Studies (CFPS), 24,126 samples from 2014 to 2018 are used to examine the impact and mechanism of big data-based digital payments on household healthcare expenditure. The empirical results of this paper show that the use of digital payments by households can significantly increase household healthcare expenditure with the empowerment of big data. This research employs the instrumental variable method to verify and produce consistent estimation results in order to address potential endogeneity issues such as measurement error and missing variables. We learn via mechanism analysis that household adoption of big data-driven digital payments can remove credit limitations and build social capital, resulting in higher household health-care spending. We also perform a heterogeneity analysis. The findings reveal that when a family's traditional financial accessibility is high, the head of the household is young or middle-aged, and the head of the household has a higher level of education, digital payment will play a larger role in encouraging household healthcare expenditure. The conclusions of this paper are still solid after changing the indicators of household healthcare expenditure substituting the indicators of digital payment, and adjusting the variables. As a result, this article provides micro-evidence for the usage of digital payments by households to enhance healthcare spending.