Determinants of health insurance ownership among South African women

BACKGROUND: Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women. METHODS: The analysis was based on data from a cross-sectional national household sample derived from the South African Health Inequalities Survey (SANHIS). The study subjects consisted of 3,489 women, aged between 16 and 64 years. It was a non-interventional, qualitative response econometric study. The outcome measure was the probability of a respondent's ownership of a health insurance policy. RESULTS: The χ(2 )test for goodness of fit indicated satisfactory prediction of the estimated logit model. The coefficients of the covariates for area of residence, income, education, environment rating, age, smoking and marital status were positive, and all statistically significant at p ≤ 0.05. Women who had standard 10 education and above (secondary), high incomes and lived in affluent provinces and permanent accommodations, had a higher likelihood of being insured. CONCLUSION: Poverty reduction programmes aimed at increasing women's incomes in poor provinces; improving living environment (e.g. potable water supplies, sanitation, electricity and housing) for women in urban informal settlements; enhancing women's access to education; reducing unemployment among women; and increasing effective coverage of family planning services, will empower South African women to reach a higher standard of living and in doing so increase their economic access to health insurance policies and the associated health services

Health Economics: Potential Applications in HIV/AIDS Control in Africa

There is growing evidence that HIV/AIDS has enormous negative impact on health status and economic development of individuals, households, communities and nations in the African region [33]. Thus, there is urgent need for various disciplines to demonstrate how they can contribute in curbing the spread of this deadly disease in the African region. This paper, using an extended version of Professor Alan Williams [32] schema as the conceptual framework, attempts to demonstrate how health economics can be used to inform policy and managerial choices related to HIV/AIDS advocacy, prevention, treatment and management. It argues that the discipline of health economics (and economics generally) is extremely valuable in: measuring health impacts of the disease and interventions; evaluating the relationships between health care-seeking behaviour of individuals and health system specific attributes; the estimation of determinants of compliance of HIV/AIDS patients with treatment regimen; establishing of health institutions efficiency in combating AIDS; guiding choices of HIV/AIDS interventions; assessing the relationships between HIV/AIDS, development, poverty, and trade; programme planning, monitoring and evaluation; and assessing health system's overall performance. The paper is a modest attempt to show how the discipline of health economics can elucidate, and help in resolving practical and conceptual issues in HIV/AIDS control in Africa

Impact of disaster-related mortality on gross domestic product in the WHO African Region

BACKGROUND: Disaster-related mortality is a growing public health concern in the African Region. These deaths are hypothesized to have a significantly negative effect on per capita gross domestic product (GDP). The objective of this study was to estimate the loss in GDP attributable to natural and technological disaster-related mortality in the WHO African Region. METHODS: The impact of disaster-related mortality on GDP was estimated using double-log econometric model and cross-sectional data on various Member States in the WHO African Region. The analysis was based on 45 of the 46 countries in the Region. The data was obtained from various UNDP and World Bank publications. RESULTS: The coefficients for capital (K), educational enrolment (EN), life expectancy (LE) and exports (X) had a positive sign; while imports (M) and disaster mortality (DS) were found to impact negatively on GDP. The above-mentioned explanatory variables were found to have a statistically significant effect on GDP at 5% level in a t-distribution test. Disaster mortality of a single person was found to reduce GDP by US$0.01828. CONCLUSIONS: We have demonstrated that disaster-related mortality has a significant negative effect on GDP. Thus, as policy-makers strive to increase GDP through capital investment, export promotion and increased educational enrolment, they should always keep in mind that investments made in the strengthening of national capacity to mitigate the effects of national disasters expeditiously and effectively will yield significant economic returns

Impact of HIV/AIDS on Gross Domestic Product (GGP) in the WHO Africa Region

HIV/AIDS is hypothesized to have substantive negative impact on health status and economic development of individuals, households, communities and nations. The objective of this study was to estimate the burden of HIV/AIDS on GDP in the WHO African Region using a production function approach. The economic burden analysis was done using a double-log econometric model and a cross-sectional data on 45 to 46 countries in the WHO African Region. The data were obtained from WHO, UNAIDS, ECA, UNDP and the World Bank publications. The coefficient for Capital (K), Education (EN), Export (X) and Imports (M) were found to be statistically significant determinants of per capita Gross Domestic Product (GDP) at 5% level of significance (using a one-sided t-distribution test). Unfortunately, HIV/AIDS morbidity (V) and HIV/AIDS deaths (VD), at the same level of significance, were found to have statistically insignificant impact on GDP. However, the coefficients of these variables had negative signs as expected. In all African countries, there is need for more detailed research on the total economic cost of HIV/AIDS (probably estimated using micro-level costing and willingness-to-pay methods) and for economic evaluations of treatment, prevention and promotion programmes. [Afr. J. Health Sci. 2002; 9: 27-39

The burden of natural and technological disaster-related mortality on gross domestic product (GDP) in the WHO Africa Region

No abstract available [Afr. J. Health Sci. 2002; 9: 169-180

Health economics: potential applications in HIV/AIDS control in Africa

There is growing evidence that HIV/AIDS has enormous negative impact on health status and economic development of individuals, households, communities and nations in the African region [33]. Thus, there is urgent need for various disciplines to demonstrate how they can contribute in curbing the spread of this deadly disease in the African region. This paper, using an extended version of Professor Alan Williams [32] schema as the conceptual framework, attempts to demonstrate how health economics can be used to inform policy and managerial choices related to HIV/AIDS advocacy, prevention, treatment and management. It argues that the discipline of health economics (and economics generally) is extremely valuable in: measuring health impacts of the disease and interventions; evaluating the relationships between health care-seeking behaviour of individuals and health system specific attributes; the estimation of determinants of compliance of HIV/AIDS patients with treatment regimen; establishing of health institutions efficiency in combating AIDS; guiding choices of HIV/AIDS interventions; assessing the relationships between HIV/AIDS, development, poverty, and trade; programme planning, monitoring and evaluation; and assessing health system's overall performance. The paper is a modest attempt to show how the discipline of health economics can elucidate, and help in resolving practical and conceptual issues in HIV/AIDS control in Africa.African Journal of Health Sciences Vol. 12(1-2) 2005: 1-1

User charges and utilisation of health services in Kenya

This paper uses data from Kenya to examine the role played by user charges and the quality of health services in determining the choice of health care providers. We find that an increase in the price of using public facilities diverts demand from public to private facilities. The reduction in demand for modern healthcare, captured by an increase in the use of self-treatment, is minimal. In contrast, a decline in the quality of services may be expected to lead to a sharp reduction in the use of public facilities and additional reliance on the self-care alternative. These patterns suggest that a programme of increasing the quality of services and enhancing drug availability through cost-sharing may be more effective at meeting the healthcare needs of the population than a programme of fully subsiding health services at low standards of care. However, since improved health services entail higher costs of provision and use, targeted subsidies are required to ensure that the poor are not denied access to basic care. Difficulties in enforcing statutory fee exemptions at public health facilities have created interest among Kenyan policy makers in social health insurance as a dominant mechanism for financing health care. Demand effects of this potential shift in policy are briefly discussed