The association between medical spending and health status: A study of selected African countries

BackgroundThe report from the World Health Organization (WHO) reveals that health spending worldwide remains highly unequal as more than 80% of the world’s population live in low and middle-income countries but only account for about 20% of global health expenditure. Another report by the WHO on the state of health financing in Africa published in 2013 intimates that countries that are part of their member states are still on the average level in meeting set goals in financing key health projects. ObjectiveThe study set out to investigate the association between public and private spending and health status for eight selected African countries, namely Burundi, Eritrea, Ethiopia, Kenya, Rwanda, Sudan, Tanzania and Uganda. Health status indicators include the incidence of tuberculosis, mortality rates, maternal deaths and prevalence of HIV. MethodsDescriptive statistics and pairwise correlation are used to assess the relationship between healthcare spending and health status. Random and fixed effect models are further employed to provide insights into the association between descriptive statistics and pairwise correlation. We used annual data from the year 2000 to 2014 obtained from world development indicators.ResultsThe relationship between healthcare spending (public and private) and health status is statistically significant. Public healthcare expenditure has a higher association than private expenditure in reducing the mortality rate, tuberculosis and HIV for the average country in our sample. For example, an increase in public healthcare spending is negatively associated and statistically significant at 5% or better in reducing female mortality, male mortality, tuberculosis and HIV. Private healthcare spending is more impactful in the area of maternal deaths, where it is associated negatively and statistically significant at 1%. An increase in private healthcare spending is linked to a reduction in maternal deaths. We also compared the association between an increase in healthcare spending on males versus females and observed that public health expenditure impacts the health status of both sexes equally, however, private health expenditure provides a greater positive benefit to males. It is worth remembering that two goals of the United Nations agenda on sustainable development are gender equality and ensuring healthcare for all. ConclusionThe findings of this research call for the selected African countries to pay more attention to public healthcare expenditure in order to improve health status, especially since private healthcare which provides access to healthcare facilities for some poor people leads to costs that are a burden. So, future research should focus on analyzing components of private healthcare spending such as direct household out-of-pocket spending, private insurance and direct service payments by private corporations as dependent variables to understand what form of private investment should be encouraged

Meet the Moment: A Call for Progressive Philanthropic Response to the Anti-Gender Movement

In early 2020, Global Philanthropy Project worked with our member organizations and philanthropic partners to develop two related pieces of private research: 1) a report mapping the funding of the global "anti-gender ideology" or "anti-gender" movement, and 2) a report mapping the progressive philanthropic response. We offer the following public document in order to share key learning and to offer additional analysis gained in the comparison of the two reports. Additionally, we share insights based on comparing global and regional LGBTI funding data as documented in the 2017-2018 Global Resources Report: Government and Philanthropic Support for Lesbian, Gay, Bisexual, Transgender, and Intersex Communities.These findings offer a clear call to action: progressive movements and their philanthropic partners are being outspent by hundreds of millions of dollars each year, and the institutions providing that opposition funding have developed sophisticated and coordinated systems to learn, co-fund, and expand their influence. The philanthropic community is called to recognize the scale of the fight and to be both rigorous and creative in our response. Let us seize this remarkable opportunity to work together and engage our collective learning, spending power, and institutional knowledge to help transform the conditions of our communities. Together we can leverage the collective power that this generational crisis demands.

Healthcare: rejection of privatisation and patient fees in Central Europe

Since 2006, there have been successful campaigns against commercialisation of public health services in the four central European countries – Czech Republic, Hungary, Poland and Slovakia

The Economic Impact of the Iraq War and Higher Military Spending

In order to get an approximation of the economic impact of the increase in U.S. military spending associated with the wars in Iraq and Afghanistan, CEPR commissioned the economic forecasting company Global Insight to run a simulation with its macroeconomic model. It produced a simulation of the impact of an increase in annual U.S. military spending equal to 1 percent of GDP, approximately the actual increase in spending compared with the pre-war budget. Global Insight's simulation shows higher military spending raises interest rates, which reduces net exports, housing construction and car sales, thereby slowing the economy and job creation

Harnessing Health Care Markets for the Public Interest: Insights for U.S. Health Reform From the German and Dutch Multipayer Systems

Outlines how the German and Dutch systems offer universal coverage via competing insurance plans and promote effective and efficient care. Highlights insurance exchanges, multipayer policies and group purchasing, information systems, and public reporting

European studies: Taking stock and looking ahead

This essay is an attempt to generalize experiences of Central and Eastern European universities in the field of European Studies over the past 20 years. The paper follows the logic of business analysis in order to come up with proposals for future action

Chronicle of a Pandemic Foretold. CEPS Policy Insights No 2020-05 / March 2020

In just a few weeks, COVID-19 appeared in China and quickly spread to the rest of the world, including Europe and the United States. Many have rushed to describe the outbreak as a ‘black swan’ – an unpredictable event with extremely severe consequences. However, COVID-19 was not only predictable ex post: it was amply predicted ex ante. This allows us to draw some preliminary lessons: • First, economic policy will need to shift from its current focus on efficiency, towards a greater emphasis on resilience and sustainability. • Second, a more centralised governance to address health emergencies is needed. • Third, Europe should create a centre for the prevention of large-scale risks. • Fourth, digital technologies, if handled with care, can be an important part of both a mitigation and a response strategy. • Fifth, Europe should improve its science advice and communication functions. Finally, there are many ways to pursue enhanced resilience and responsiveness, but not all of them are compatible with sustainability and democratic values. The challenge is to find an adequate policy mix, which safeguards individual rights and liberties, protects the economy, and at the same time strengthens government preparedness for cases of epidemics and pandemics

Electronic Reverse Auctions: Spawning Procurement Innovation in the Context of Arab Culture

Government e-procurement initiatives have the potential to transform local institutions, but few studies have been published of strategies for implementing specific e-procurement tools, particularly involving procurement by a foreign government adapting to local culture in the Middle East/North Africa (MENA). This case describes procurement at a forward operating base (FOB) in Kuwait in support of operations in Iraq. The government procurers had to deal with a phenomenon unique to the MENA region: wasta. Wasta is a form of social capital that bestows power, influence, and connection to those who possess it, similar to guanxi in China. This study explores the value proposition and limitations of electronic reverse auctions (eRA) with the purpose of sharing best practices and lessons learned for government procurement in a MENA country. The public value framework provides valuable theoretical insights for the implementation of a new government e-procurement tool in a foreign country. In a culture dominated by wasta, the suppliers enjoyed the transparency and merit-based virtues of eRA’s that transferred successfully into the new cultural milieu: potential to increase transparency, competition, efficiency, and taxpayer savings. The practices provided herein are designed specifically to help buyers overcome structural barriers including training, organizational inertia, and a lack of eRA policy and guidance while implementing a new e-procurement tool in a foreign country

Some alternative perspectives on macroeconomic theory and some policy implications

The macroeconomic theories and models favoured by academics, as well as those used more commonly by policymakers, effectively rule out by assumption economic and financial crises of the sort we are living through. In particular, the longer run dangers posed by the rapid expansion of credit and resulting private sector balance sheet developments were inadequately appreciated. As a result, the current crisis was neither anticipated nor prepared for, and the crisis was also less well managed than it might have been. At the level of macroeconomic theory and modelling, this experience suggests that basic Keynesian insights need to be complemented by some insights from the Austrian school as well as those of Minsky. Demand factors are important, but so too are supply side and financial considerations. Such a synthesis provides a reasonable explanation of the crisis and points to some of the difficulties likely to be faced in emerging from it. As for the policy implications in current circumstances, it needs to be better recognized that policies with positive short run effects can have negative effects over a longer time period. If, as a result, fiscal and monetary expansion have now reached their limits in some countries, supply side policies must be given greater emphasis. These would include measures to encourage investment, both private and public, as well as other structural measures to raise the potential growth rate of the economy. Such measures, along with more decisive efforts to reduce the "headwinds" of over indebtedness, should with time provide the foundations for a sustainable economic recovery.Global financial crisis ; Business cycles - Econometric models ; Financial markets ; Macroeconomics - Econometric models ; Supply-side economics ; Monetary policy ; Fiscal policy