Effect of healthcare spending on the relationship between the Human Development Index and maternal and neonatal mortality

Public health spending in Sub-Saharan Africa: exploring transmission mechanisms using the latent growth curve mediation model

In response to the imperatives of universal health coverage, structural factors that may hinder the effectiveness of increased spending in sub-Saharan Africa (SSA) need attention. This study assessed the mediating role of these factors in domestic general government health expenditure (DGGHE) effects to propose solutions for improving population health outcomes (PHO). The analysis used the Latent Growth Curve Mediation Model (LGCMM) approach within the structural equation model (SEM) framework for panel data from 42 SSA countries from 2015 to 2018. The findings were that malaria and female education formed a channel through which DGGHE imparted its effects on DALY in SSA, and these effects were achieved via the specific path from the DGGHE slope to the DALY slope, via malaria and female education slopes. However, the paper found no evidence of immunization coverage mediating the relationship between DGGHE and DALY in SSA. The paper concludes that structural factors affect the effectiveness of DGGHE on PHO, implying that governments should emphasize existing programs to fight against malaria and increase immunization coverage.

Effects of healthcare spending on public health status: An empirical investigation from Bangladesh

The escalation of healthcare spending in many nations, particularly in emerging countries such as Bangladesh, may be largely attributed to the growing demand for healthcare services. Evidently, there has been a significant expansion in the public funding allocated to the health sector in Bangladesh, intending to enhance health outcomes. Therefore, the purpose of this study was to examine the impact of healthcare expenditure on health outcomes, specifically focusing on the reduction in different mortality rates and the transmission of various infectious diseases. A total of 30 years of data (1990-2019) on the health sector of Bangladesh were collected from different national and international sources. The Vector Autoregression with Exogenous Variables (VARX) model was employed to determine the effects of healthcare expenditure on health outcomes. Results revealed that the per capita health expenditure and the number of doctors showed a significant positive impact on life expectancy and maternal and child health. Also, the government's annual budget on the health sector and number of doctors had a significant positive impact on lowering deaths by Diphtheria, Cholera, Tuberculosis, and Malaria diseases. In order to develop a sustainable healthcare system within the nation, it is imperative for the government to prioritize the allocation of sufficient and effective healthcare funding to cater to the needs of the populace.

Estimating geographic access to healthcare facilities in Sub-Saharan Africa by Degree of Urbanisation

Measuring rates of coverage and spatial access to healthcare services is essential to inform policies for development. These rates tend to reflect the urban-rural divide, typically with urban areas experiencing higher accessibility than rural ones. Especially in Sub-Saharan Africa (SSA), a region experiencing high disease burden amid fast urbanisation and population growth. However, such assessment has been hindered by a lack of updated and comparable geospatial data on urbanisation and health facilities. In this study, we apply the UN-endorsed Degree of Urbanisation (DoU or DEGURBA) method to investigate how geographic access to healthcare facilities varies across the urban-rural continuum in SSA as a whole and in each country, for circa 2020. Results show that geographic access is overall highest in cities and peri-urban areas, where more than 95% of inhabitants live within 30 min from the nearest HCF, with this share decreasing to 80-90% in towns. This share is lowest in villages and dispersed rural areas (65%), with about 10-15% of population more than 3 h away from any health post. Challenges in geographic access seem mostly determined by high travel impedance, since overall spatial densities of HCF are comparable to European levels.

The impact of financial development, health expenditure, CO2 emissions, institutional quality, and energy Mix on life expectancy in Eastern Europe: CS-ARDL and quantile regression Approaches

In recent years, the interrelationships between the environment, energy, and health have received a growing amount of attention due to their substantial impact on the health of humans. By examining what influences Eastern Europeans' longevity between 1990 and 2021, this study hopes to contribute to this field of study. Energy consumption, health expenditure, pollution, institutional quality index (IQI), financial development, and other attributes profoundly impact human health. Because of the extensive network of commerce, tourism, education, religion, and treaties connecting East European countries, tests for cross-sectional dependence (CSD) and slope heterogeneity (SH) are utilized. After verifying the CSD and SH issues, the study uses the second generation's unit root and cointegration tests. As the previous test indicates, a new panel method, the cross-sectional autoregressive distributive lag (CS-ARDL) model, is required, as conventional estimations are inappropriate. The Quantile Regression (QR) method is also applied to check robustness. This study indicated that increased health expenditure, renewable energy consumption, and IQI improves health outcomes in Eastern European nations. There was a good connection between renewable energy consumption and health benefits, the study concluded. Though financial development positively impacts life expectancy, the impact is insignificant. On the other hand, the study also shows that CO2 emissions and fossil fuel consumption decrease life expectancy. These results are consistent with those obtained using the QR method. To enhance health outcomes, it is necessary to take measures to raise health spending, increase the use of renewable energy, and foster financial development over the long term. On the other hand, Eastern European nations need to shift their attention from fossil fuels to renewable energy.

Effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in low resource setting of South Asia

BACKGROUND

Maternal and neonatal mortality is high in South Asia. Recent studies have identified factors such as adolescent female fertility, healthcare spending is reducing maternal and neonatal mortality. The objective of this study is to examine the effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in South Asian countries.

METHODS

A retrospective panel study design was used, a total of 8 South Asian countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) data from World development indicator 1990-2020 considered for analysis. Descriptive statistical method was used for summary. The effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality were analysed using fixed and random effect regression with multiple imputation.

FINDINGS

Adolescent female fertility, maternal, and neonatal mortality is very high in the aforementioned countries, and considerably varies among countries. A significant relationship between the maternal mortality and healthcare spending, neonatal mortality and adolescent female fertility was observed. We found neonatal and maternal mortality are more likely to decrease depends on healthcare spending. Healthcare spending has a significantly negative effect on neonatal mortality (- 0.182, 95% CI: [- 0.295 to -.069]; P-value < 0.01) and maternal mortality (- 0.169, 95% CI: [- 0.243 to - 0.028]; P-value < 0.05). A change in 1 % increases in healthcare spending should decrease by 0.182 neonatal mortality per 1000 live births and maternal mortality by 0.169 per 100,000 live births.

CONCLUSIONS

In south Asian countries, increasing healthcare spending and decreasing adolescent female fertility may contribute to reduce maternal and neonatal mortality. In addition, number of service providers such as physicians supplied contributed to the decline of neonatal mortality. These findings have important implications for future improvement of healthcare spending in maternal and neonatal health programs.

Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran's position?

OBJECTIVES

Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.

METHODS

This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.

RESULTS

Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.

CONCLUSIONS

Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.