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[afro-nets] Public financing of health in developing countries: a cross-national systematic analysis
- From: "Claudio Schuftan" <email@example.com>
- Date: Sat, 10 Apr 2010 11:32:00 +0700
Public financing of health in developing countries: a cross-national systematic analysis
Chunling Lu PhD a, Matthew T Schneider BA b, Paul Gubbins BA b, Katherine Leach-Kemon MPH b, Dean Jamison PhD b, Prof Christopher JL Murray MD b a Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
b Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
Lancet 2010; published online April 8. 2010 -
“…….Government spending on health from domestic sources is an important indicator of a government's commitment to the health of its people, and is essential for the sustainability of health programmes. We aimed to systematically analyse all data sources available for government spending on health in developing countries; describe trends in public financing of health; and test the extent to which they were related to changes in gross domestic product (GDP), government size, HIV prevalence, debt relief, and development assistance for health (DAH) to governmental and non-governmental sectors.
In all developing countries, public financing of health in constant US$ from domestic sources increased by nearly 100% (IMF 120%; WHO 88%) from 1995 to 2006. Overall, this increase was the product of rising GDP, slight decreases n the share of GDP spent by government, and increases in the share of government spending on health. At the country level, while shares of government expenditures to health increased in many regions, they decreased in many sub-Saharan African countries. The statistical analysis showed that debt relief, and development assistance for health DAH to government had a negative and significant effect on domestic government spending on health uch that for every US$1 of DAH to government, government health xpenditures from domestic resources were reduced by $0•43 (p=0) to $1•14
However, debt relief, and development assistance for health DAH to the on-governmental sector had a positive and significant effect on domestic overnment health spending. Both results were robust to multiple pecifications and subset analyses. Other factors, such as debt relief, had o detectable effect on domestic government health spending.
To address the negative effect of debt relief, and development assistance or health DAH on domestic government health spending, we recommend strong standardised monitoring of government health expenditures and government spending in other health-related sectors; establishment of collaborative targets to maintain or increase the share of government expenditures going to health; investment in the capacity of developing countries to effectively receive and use DAH; careful assessment of the risks and benefits of expanded DAH to non-governmental sectors; and investigation of the use of global price subsidies or product transfers as mechanisms for debt relief, and development assistance for health DAH
Ruggiero, Mrs. Ana Lucia (WDC)