This document discusses the relationship between health outcomes and economic growth in African countries. It estimates regression equations showing relationships between per capita GNI and factors like life expectancy, mortality rates, and literacy. The results show significant correlations between higher GNI and greater life expectancy, lower child and adult mortality, and higher literacy. The document concludes that improving health systems and increasing access to proven interventions could significantly reduce mortality in Africa and thereby boost economic prospects.
Attaining sustainable agricultural development in any economy indubitably points towards ensuring improved quality of life and enough food for both present and future generations. The need to understand the links between agricultural output and health outcomes necessitates an inquiry to ascertain the extent the changes in health outcomes can influence agricultural output. This study using the dynamic error correction built an econometric model such that mortality rate and life expectancy are proxies for health outcomes while agricultural output is the dependent variable; HIV/AIDS is the dummy. Results showed that HIV/AIDS has lethal effects on health outcomes and aggregate output. It revealed that health outcomes also have significant impact on agricultural output potentials; and there is a causal relationship between health outcomes and agricultural output in Nigeria. This implies that if the healthcare system in Nigeria can be taken as a policy priority, a tremendous increase in the agricultural sector is unarguably expected. A simultaneous front involving both the public and private sectors in extending the healthcare services is necessary to enable workers and prospective workers access to healthcare delivery; this will invariably boost the agricultural output.
Population growth poses a significant challenge to countries' efforts to improve access to health workers. Many countries with critical shortages of health workers have high annual population growth rates of 2-3%. Small changes in growth rates can greatly impact future health worker requirements. For example, a country with 100 million people in 2000 needing 230,000 health workers could need over 500,000 additional workers by 2050 with a 2.4% annual growth rate compared to under 400,000 with a 2% rate. Careful attention to both increasing health worker numbers and slowing population growth will be needed to adequately address the global health workforce crisis.
Predictive analysis WHO's life expectancy dataset using Tableau data visualis...Tarun Swarup
This document discusses a statistical analysis of factors influencing life expectancy using data from the World Health Organization and United Nations. It describes the dataset, variables considered, and objectives of analyzing relationships between life expectancy and factors like immunization rates, mortality rates, economics, and demographics. Four dashboards are proposed to analyze trends in adult mortality rates, compare life expectancy and infant death rates in populated countries, forecast adult mortality and hepatitis rates in Brazil, and compare GDP in developed and developing countries.
Unemployment has a statistically significant negative impact on Ethiopia's economic growth. The study used annual time series data from 1974-2014 and empirical analysis methods like Johansen cointegration and Vector Error Correction to examine the relationship. The results indicate that a 1% increase in unemployment leads to about a 0.82% decline in real GDP growth. To reduce this impact, the study recommends adopting more employment generation policies, improving labor productivity and agricultural productivity, and increasing linkages between sectors.
The economic impact of agricultural development on poverty reduction and welf...Caroline Chenqi Zhou
This study employs quantitative and qualitative methods to identify the relationship between agricultural development, poverty reduction, and income inequality. Building upon the World Bank’s Enabling the Business of Agriculture study (2016) and data from the World Development Indicators (2015) for the years 2000 to 2014, we test two hypotheses. The first pertains to agricultural development and poverty reduction to assess to what extent agricultural development reduces poverty. The second, in a similar fashion, addresses the relationship between agricultural development and income inequality. To supplement our quantitative analysis of these questions, we include a case study of agricultural development, agricultural policy reforms, and their impact in Vietnam and Tanzania. We find evidence that agricultural development reduces poverty.
This document analyzes dietary patterns, diabetes rates, and overweight/obesity prevalence across regions in Italy from 1961-2013. It finds that mortality rates for diabetes and rates of overweight/obesity increased continuously across Italy and varied between regions, with the highest rates in southern Italy and the islands. Consumption of wheat and legumes decreased while consumption of animal products, vegetable oils, sugar, and packaged/processed foods increased. Food prices for sweets and sugary drinks decreased. Changes in dietary patterns towards more animal products and processed foods correlated with rising rates of diabetes and obesity in Italy.
2013 12 b azais at pan hellenic health-finalBoris Azaïs
This document summarizes a presentation on sustainability of healthcare systems and elements of a roadmap to address rising costs. It notes that populations are living longer but healthcare costs are rising due to increased chronic diseases. To control costs, the presentation advocates focusing on patients, improving quality and efficiency, embracing innovation, promoting the health economy, and adopting a "Health in All Policies" approach across government. The roadmap principles are proposed as focusing on patients and outcomes, rewarding value, promoting efficiency, and being open to innovation.
Attaining sustainable agricultural development in any economy indubitably points towards ensuring improved quality of life and enough food for both present and future generations. The need to understand the links between agricultural output and health outcomes necessitates an inquiry to ascertain the extent the changes in health outcomes can influence agricultural output. This study using the dynamic error correction built an econometric model such that mortality rate and life expectancy are proxies for health outcomes while agricultural output is the dependent variable; HIV/AIDS is the dummy. Results showed that HIV/AIDS has lethal effects on health outcomes and aggregate output. It revealed that health outcomes also have significant impact on agricultural output potentials; and there is a causal relationship between health outcomes and agricultural output in Nigeria. This implies that if the healthcare system in Nigeria can be taken as a policy priority, a tremendous increase in the agricultural sector is unarguably expected. A simultaneous front involving both the public and private sectors in extending the healthcare services is necessary to enable workers and prospective workers access to healthcare delivery; this will invariably boost the agricultural output.
Population growth poses a significant challenge to countries' efforts to improve access to health workers. Many countries with critical shortages of health workers have high annual population growth rates of 2-3%. Small changes in growth rates can greatly impact future health worker requirements. For example, a country with 100 million people in 2000 needing 230,000 health workers could need over 500,000 additional workers by 2050 with a 2.4% annual growth rate compared to under 400,000 with a 2% rate. Careful attention to both increasing health worker numbers and slowing population growth will be needed to adequately address the global health workforce crisis.
Predictive analysis WHO's life expectancy dataset using Tableau data visualis...Tarun Swarup
This document discusses a statistical analysis of factors influencing life expectancy using data from the World Health Organization and United Nations. It describes the dataset, variables considered, and objectives of analyzing relationships between life expectancy and factors like immunization rates, mortality rates, economics, and demographics. Four dashboards are proposed to analyze trends in adult mortality rates, compare life expectancy and infant death rates in populated countries, forecast adult mortality and hepatitis rates in Brazil, and compare GDP in developed and developing countries.
Unemployment has a statistically significant negative impact on Ethiopia's economic growth. The study used annual time series data from 1974-2014 and empirical analysis methods like Johansen cointegration and Vector Error Correction to examine the relationship. The results indicate that a 1% increase in unemployment leads to about a 0.82% decline in real GDP growth. To reduce this impact, the study recommends adopting more employment generation policies, improving labor productivity and agricultural productivity, and increasing linkages between sectors.
The economic impact of agricultural development on poverty reduction and welf...Caroline Chenqi Zhou
This study employs quantitative and qualitative methods to identify the relationship between agricultural development, poverty reduction, and income inequality. Building upon the World Bank’s Enabling the Business of Agriculture study (2016) and data from the World Development Indicators (2015) for the years 2000 to 2014, we test two hypotheses. The first pertains to agricultural development and poverty reduction to assess to what extent agricultural development reduces poverty. The second, in a similar fashion, addresses the relationship between agricultural development and income inequality. To supplement our quantitative analysis of these questions, we include a case study of agricultural development, agricultural policy reforms, and their impact in Vietnam and Tanzania. We find evidence that agricultural development reduces poverty.
This document analyzes dietary patterns, diabetes rates, and overweight/obesity prevalence across regions in Italy from 1961-2013. It finds that mortality rates for diabetes and rates of overweight/obesity increased continuously across Italy and varied between regions, with the highest rates in southern Italy and the islands. Consumption of wheat and legumes decreased while consumption of animal products, vegetable oils, sugar, and packaged/processed foods increased. Food prices for sweets and sugary drinks decreased. Changes in dietary patterns towards more animal products and processed foods correlated with rising rates of diabetes and obesity in Italy.
2013 12 b azais at pan hellenic health-finalBoris Azaïs
This document summarizes a presentation on sustainability of healthcare systems and elements of a roadmap to address rising costs. It notes that populations are living longer but healthcare costs are rising due to increased chronic diseases. To control costs, the presentation advocates focusing on patients, improving quality and efficiency, embracing innovation, promoting the health economy, and adopting a "Health in All Policies" approach across government. The roadmap principles are proposed as focusing on patients and outcomes, rewarding value, promoting efficiency, and being open to innovation.
Impact of Low Social Spending on Human Development: Regional Disparity in Utt...inventionjournals
he objective of the paper is to describe the low status of human development and increasing intrastate
disparity regarding all the development indicators across the districts and regions in the state. The low
income levels keep the expenditure on social sector at a low level which results in low status of human
development. On the other hand, the low status of human development acts as a major economic constraint on
economic development of the state. The state presents a dismal scenario with regard to both economic growth
and human development. It is characterized by low levels of per capita income, high incidence of poverty,
sluggish economic growth, high population pressure along with high rates of population growth, high birth and
fertility rates, widespread illiteracy, high infant mortality and death rates and low life expectancy. Social sector
expenditure in U.P. is lower even as compared to other backward states. This was true for the different
components of social sector as well. These figures are reflective of the low priority to social sector given by the
policy makers in the state and underscore the need of substantial improvement in levels of social sector
expenditure in U.P.
What strategy for optimal health in poorest developing countriesAlexander Decker
This article analyzes strategies for achieving optimal health in developing countries with high rates of HIV/AIDS. It uses an economic model to study how international goals of zero new HIV infections, zero deaths from AIDS, and zero discrimination in healthcare access can be achieved. The model finds that HIV vaccines may be effective before individuals reach the "seropositivity" threshold, and medical care may slow death rates after individuals pass the HIV threshold but before reaching the AIDS threshold. However, once the AIDS threshold is passed, existing tools are no longer effective at fighting the virus. Overall eradication requires public education to change behaviors and cooperation between governments, international organizations, and low-cost drug companies on prevention and treatment.
Factors Affecting Consumption Expenditure in Ethiopia: The Case of Amhara Nat...Dr. Amarjeet Singh
The document analyzes factors affecting household consumption expenditure in the Amhara National Regional State of Ethiopia using data from the 2015/16 Ethiopian Household Consumption Expenditure and Welfare Monitoring Surveys. A quantile regression model was used to examine the relationship between per capita consumption expenditure and various demographic and socioeconomic variables. The results show that households headed by educated persons, those that own their home, and those with income-generating household heads had higher consumption expenditures across quantiles. Rural households also had higher expenditures than urban households.
Growth Redistribution and Inequality Effects on Poverty in NigeriaUNDP Policy Centre
Jude Chukwu (Department of Economics, University of Nigeria and Visiting Research Fellow, IPC-IG) introduced his research, presenting its empirical findings during a presentation on the IPC-IG’s Seminar Series. He delved into the patterns of growth and inequality in Nigeria, as well as on the extent of pro-poorness and inclusiveness of growth in the country.
This document discusses food security in Egypt, focusing on the 2008 global food price crisis. It provides background on Egypt's reliance on food imports and subsidies. It then summarizes the causes and effects of the 2008 price spike, including political, social, and nutritional implications. The document also outlines Egypt's policy responses, such as expanding food subsidies, reducing import tariffs, and banning rice exports, and discusses criticisms of targeting and effectiveness.
Dr Dev Kambhampati | FAO- World Agriculture Towards 2030/2050 Dr Dev Kambhampati
This document provides projections for global agriculture and food security to 2030/2050. It summarizes that world population is projected to increase from 7 billion in 2010 to over 9 billion in 2050, which will raise global food demand substantially. Food consumption per person is also projected to continue increasing in most developing countries, driven by economic and income growth. However, undernourishment is still projected to persist in some developing country regions with slow income growth and high population growth. Meeting rising global food demand will require increasing agricultural production significantly, likely through a combination of expanding crop yields and cultivated land area. Key uncertainties include future economic and population trends, as well as constraints on expanding agricultural land and intensifying production due to land, water
How Land Laws Are Currently Affecting Food Security for Smallholder Farmers i...Emilene Sivagnanam
My policy term paper for Transformation through Sustained Agricultural and Rural Development: Policies and Institutions, which focused on Cambodia, smallholder farmers, rice, climate change, aid dependence, governance, and land laws
This document summarizes a study that examines the relationship between top income shares and mortality rates in 9 advanced countries from 1952-1998. The study uses 3 measures of top income shares (shares going to the richest 0.1%, 1%, and 10% of the population) and examines their relationship with crude death rates and infant mortality rates. The key finding is that there is no overall relationship found between top income shares and mortality rates. When examining mortality rates by gender separately, there is some evidence that higher income inequality is associated with lower crude death rates for males, but no relationship is found for females. Several robustness checks are also performed to test the stability of the results.
This document discusses the relationship between health expenditure and development. It notes that public health expenditure is important for both fighting diseases and promoting economic development. Health is considered a form of human capital. The document then examines several indicators of development in India, such as life expectancy, infant mortality rate, and maternal mortality rate, finding that they have generally improved but some targets have not yet been met. It analyzes trends in these health outcomes over time and relationships to factors like health expenditure. The conclusion is that greater investment in efficient, equitable health services can lead to better health status, human capital, reduced poverty, and improved economic development.
The document summarizes immunization financing efforts in Armenia. It discusses how the government spending on immunization has increased substantially over time, rising from $2 per child in 2006 to $84 in 2014. Armenia also scores highly among peer countries in terms of government spending per child. The document outlines legislation supporting immunization and notes the country is drafting a new public health law. It also describes how a financing program has helped analyze Armenia's immunization budget flows and expenditures.
The document summarizes the findings of a Lives Saved Tool (LiST) analysis conducted in Ethiopia. It describes:
1) An overview of LiST, how it models the impact of scaling up interventions on child mortality.
2) The modeling of 3 scenarios - if interventions remained at 2000 levels, were scaled up from 2000-2005, and from 2000-2011.
3) The major findings - over 100,000 additional child deaths were averted by scaling up interventions from 2000-2011, with over 50% of lives saved due to reducing undernutrition and 23% from immunizations.
This document summarizes the HIV/AIDS situation and trends in Zimbabwe. It begins with background on Zimbabwe's geography, population, and socioeconomic conditions. HIV was first reported in Zimbabwe in 1985, and surveillance of blood donors from 1985 onward showed increasing prevalence over time, peaking at 8.8% in 1995. National surveys in the 1990s found high and increasing prevalence among the general population as well, especially among certain groups. While prevalence has declined significantly in recent years, HIV disproportionately impacts women due to cultural and economic factors. Overall the document provides a concise overview of the progression of the HIV epidemic in Zimbabwe and key demographic factors that have influenced trends over time.
The document is a term project analyzing the health of U.S. household consumer finances using data from the 2007 Survey of Consumer Finances. It examines household income, net worth, assets, and debt. The analysis finds that median income increased while mean income decreased, indicating a wider income distribution. Income is influenced by factors like age, education, and race. Those with college degrees earn much more than those with only high school diplomas. White households earn almost double what non-white or Hispanic households earn. The analysis also looks at different types of household debt like housing debt, education debt, and credit card balances.
This document summarizes a presentation given by Willem Adema on gender equality trends in Asia and the Pacific. It finds that while educational attainment for women has increased and gender gaps in areas like wages have declined, disparities still persist in areas like leadership positions, unpaid work, and entrepreneurship. Encouraging greater female labor force participation and addressing issues like work-life balance and stereotypes are seen as important to mitigate challenges from trends like population aging facing some countries in the region.
This document discusses a study that aimed to assess the determinants of poverty in Mkinga District, Tanzania. The study found that nearly 93% of respondents in the area were poor. Using an ordinal regression model and data from 210 households, the study identified several factors associated with poverty in the area, including gender (with women more affected), smaller land size, smaller farm size, larger household size, and higher dependency ratio. The study recommends empowering people, especially women, to participate in economic activities using local resources to alleviate poverty in the district.
This document presents key indicators on household consumer expenditure in India based on data from the 66th round of the National Sample Survey (NSS) conducted from July 2009 to June 2010. It provides estimates of monthly per capita expenditure on food, non-food and total expenditure at the state level for rural and urban areas separately, as well as for all-India across income deciles. It also includes the breakdown of average monthly per capita expenditure by broad item groups of food and non-food items, and estimates of monthly per capita quantity and value of consumption for food and non-food items at the all-India level. The survey utilized detailed household schedules to collect information on the quantity and value of consumption of over 300 consumer goods and
The attempt of local government in achieving food self sufficiencyAlexander Decker
This document summarizes a study on the local government's attempts to achieve food self-sufficiency in the district of Malinau, East Kalimantan. It discusses the agricultural potential and policies in Malinau, how the policies have implications for establishing food self-sufficiency, and proposes a developmental model to better support this goal. Key points analyzed include decentralization of agricultural development, empowering local farmers, diversifying food crops beyond just rice, and increasing households' ability to purchase sufficient nutritious food. The study concludes that changes are needed to agricultural policies and programs to better achieve social goals, improve target systems and outputs, and increase farmer productivity through technology.
The document summarizes findings from 4 rounds of National Health Accounts conducted in Ethiopia between 1995-2008. Key findings include:
- Total health expenditure increased from Birr 1.4 billion (1995/96) to Birr 11.1 billion (2007/08), with per capita expenditure more than doubling from Birr 25 (1995/96) to Birr 150 (2007/08).
- In 2007/08, HIV/AIDS accounted for 20% of health spending, reproductive health 13%, child health 10%, malaria 5%, and tuberculosis 4%.
- Spending on priority areas like HIV/AIDS, reproductive health and child health all increased between rounds, however still fell short of international benchmarks.
The document is a report from the OECD and European Commission titled "Health at a Glance: Europe 2014" that was released in December 2014. It provides data and analysis on health status, risk factors, health care resources, quality of care, access to care, and health expenditure in European countries. The report finds that while life expectancy has increased across Europe, gaps remain between countries and education levels. It also examines trends in diseases, health risks, health workforce and capacity, treatment outcomes, financial barriers to care, and spending on health systems.
This document discusses strategies for wealth preservation and estate planning, including the risks of taxes reducing the value of an estate and solutions like life insurance. It also covers the risks of critical illnesses and long term care needs, and how insurance can help cover costs to protect finances during illness or care needs. Estate equalization strategies using life insurance are presented as a way to fairly distribute assets among heirs.
O documento descreve os serviços oferecidos pela empresa Microcis, incluindo manutenção de equipamentos de TI, assistência técnica, contact center, impressões digitais, websites, sistemas, e soluções de TI como segurança, redes e automação. A Microcis tem 14 anos de experiência e certificações de qualidade ISO.
This document discusses a study on customer acceptance of Islamic versus conventional financial institutions. It begins with background on the development of financial institutions since the 1940s. The objectives are to investigate customer acceptance and differences between Islamic and conventional institutions. Key findings are that customer acceptance is related to interest rates, risk/returns, and service quality. Islamic finance prohibits interest and uncertainty while allowing profit-sharing. Conventional finance offers more familiar instruments like mutual funds and mortgages. Overall, the study found a positive relationship between customer acceptance and financial institution products, and that Islamic institutions differ from conventional ones in their ethical foundations.
Impact of Low Social Spending on Human Development: Regional Disparity in Utt...inventionjournals
he objective of the paper is to describe the low status of human development and increasing intrastate
disparity regarding all the development indicators across the districts and regions in the state. The low
income levels keep the expenditure on social sector at a low level which results in low status of human
development. On the other hand, the low status of human development acts as a major economic constraint on
economic development of the state. The state presents a dismal scenario with regard to both economic growth
and human development. It is characterized by low levels of per capita income, high incidence of poverty,
sluggish economic growth, high population pressure along with high rates of population growth, high birth and
fertility rates, widespread illiteracy, high infant mortality and death rates and low life expectancy. Social sector
expenditure in U.P. is lower even as compared to other backward states. This was true for the different
components of social sector as well. These figures are reflective of the low priority to social sector given by the
policy makers in the state and underscore the need of substantial improvement in levels of social sector
expenditure in U.P.
What strategy for optimal health in poorest developing countriesAlexander Decker
This article analyzes strategies for achieving optimal health in developing countries with high rates of HIV/AIDS. It uses an economic model to study how international goals of zero new HIV infections, zero deaths from AIDS, and zero discrimination in healthcare access can be achieved. The model finds that HIV vaccines may be effective before individuals reach the "seropositivity" threshold, and medical care may slow death rates after individuals pass the HIV threshold but before reaching the AIDS threshold. However, once the AIDS threshold is passed, existing tools are no longer effective at fighting the virus. Overall eradication requires public education to change behaviors and cooperation between governments, international organizations, and low-cost drug companies on prevention and treatment.
Factors Affecting Consumption Expenditure in Ethiopia: The Case of Amhara Nat...Dr. Amarjeet Singh
The document analyzes factors affecting household consumption expenditure in the Amhara National Regional State of Ethiopia using data from the 2015/16 Ethiopian Household Consumption Expenditure and Welfare Monitoring Surveys. A quantile regression model was used to examine the relationship between per capita consumption expenditure and various demographic and socioeconomic variables. The results show that households headed by educated persons, those that own their home, and those with income-generating household heads had higher consumption expenditures across quantiles. Rural households also had higher expenditures than urban households.
Growth Redistribution and Inequality Effects on Poverty in NigeriaUNDP Policy Centre
Jude Chukwu (Department of Economics, University of Nigeria and Visiting Research Fellow, IPC-IG) introduced his research, presenting its empirical findings during a presentation on the IPC-IG’s Seminar Series. He delved into the patterns of growth and inequality in Nigeria, as well as on the extent of pro-poorness and inclusiveness of growth in the country.
This document discusses food security in Egypt, focusing on the 2008 global food price crisis. It provides background on Egypt's reliance on food imports and subsidies. It then summarizes the causes and effects of the 2008 price spike, including political, social, and nutritional implications. The document also outlines Egypt's policy responses, such as expanding food subsidies, reducing import tariffs, and banning rice exports, and discusses criticisms of targeting and effectiveness.
Dr Dev Kambhampati | FAO- World Agriculture Towards 2030/2050 Dr Dev Kambhampati
This document provides projections for global agriculture and food security to 2030/2050. It summarizes that world population is projected to increase from 7 billion in 2010 to over 9 billion in 2050, which will raise global food demand substantially. Food consumption per person is also projected to continue increasing in most developing countries, driven by economic and income growth. However, undernourishment is still projected to persist in some developing country regions with slow income growth and high population growth. Meeting rising global food demand will require increasing agricultural production significantly, likely through a combination of expanding crop yields and cultivated land area. Key uncertainties include future economic and population trends, as well as constraints on expanding agricultural land and intensifying production due to land, water
How Land Laws Are Currently Affecting Food Security for Smallholder Farmers i...Emilene Sivagnanam
My policy term paper for Transformation through Sustained Agricultural and Rural Development: Policies and Institutions, which focused on Cambodia, smallholder farmers, rice, climate change, aid dependence, governance, and land laws
This document summarizes a study that examines the relationship between top income shares and mortality rates in 9 advanced countries from 1952-1998. The study uses 3 measures of top income shares (shares going to the richest 0.1%, 1%, and 10% of the population) and examines their relationship with crude death rates and infant mortality rates. The key finding is that there is no overall relationship found between top income shares and mortality rates. When examining mortality rates by gender separately, there is some evidence that higher income inequality is associated with lower crude death rates for males, but no relationship is found for females. Several robustness checks are also performed to test the stability of the results.
This document discusses the relationship between health expenditure and development. It notes that public health expenditure is important for both fighting diseases and promoting economic development. Health is considered a form of human capital. The document then examines several indicators of development in India, such as life expectancy, infant mortality rate, and maternal mortality rate, finding that they have generally improved but some targets have not yet been met. It analyzes trends in these health outcomes over time and relationships to factors like health expenditure. The conclusion is that greater investment in efficient, equitable health services can lead to better health status, human capital, reduced poverty, and improved economic development.
The document summarizes immunization financing efforts in Armenia. It discusses how the government spending on immunization has increased substantially over time, rising from $2 per child in 2006 to $84 in 2014. Armenia also scores highly among peer countries in terms of government spending per child. The document outlines legislation supporting immunization and notes the country is drafting a new public health law. It also describes how a financing program has helped analyze Armenia's immunization budget flows and expenditures.
The document summarizes the findings of a Lives Saved Tool (LiST) analysis conducted in Ethiopia. It describes:
1) An overview of LiST, how it models the impact of scaling up interventions on child mortality.
2) The modeling of 3 scenarios - if interventions remained at 2000 levels, were scaled up from 2000-2005, and from 2000-2011.
3) The major findings - over 100,000 additional child deaths were averted by scaling up interventions from 2000-2011, with over 50% of lives saved due to reducing undernutrition and 23% from immunizations.
This document summarizes the HIV/AIDS situation and trends in Zimbabwe. It begins with background on Zimbabwe's geography, population, and socioeconomic conditions. HIV was first reported in Zimbabwe in 1985, and surveillance of blood donors from 1985 onward showed increasing prevalence over time, peaking at 8.8% in 1995. National surveys in the 1990s found high and increasing prevalence among the general population as well, especially among certain groups. While prevalence has declined significantly in recent years, HIV disproportionately impacts women due to cultural and economic factors. Overall the document provides a concise overview of the progression of the HIV epidemic in Zimbabwe and key demographic factors that have influenced trends over time.
The document is a term project analyzing the health of U.S. household consumer finances using data from the 2007 Survey of Consumer Finances. It examines household income, net worth, assets, and debt. The analysis finds that median income increased while mean income decreased, indicating a wider income distribution. Income is influenced by factors like age, education, and race. Those with college degrees earn much more than those with only high school diplomas. White households earn almost double what non-white or Hispanic households earn. The analysis also looks at different types of household debt like housing debt, education debt, and credit card balances.
This document summarizes a presentation given by Willem Adema on gender equality trends in Asia and the Pacific. It finds that while educational attainment for women has increased and gender gaps in areas like wages have declined, disparities still persist in areas like leadership positions, unpaid work, and entrepreneurship. Encouraging greater female labor force participation and addressing issues like work-life balance and stereotypes are seen as important to mitigate challenges from trends like population aging facing some countries in the region.
This document discusses a study that aimed to assess the determinants of poverty in Mkinga District, Tanzania. The study found that nearly 93% of respondents in the area were poor. Using an ordinal regression model and data from 210 households, the study identified several factors associated with poverty in the area, including gender (with women more affected), smaller land size, smaller farm size, larger household size, and higher dependency ratio. The study recommends empowering people, especially women, to participate in economic activities using local resources to alleviate poverty in the district.
This document presents key indicators on household consumer expenditure in India based on data from the 66th round of the National Sample Survey (NSS) conducted from July 2009 to June 2010. It provides estimates of monthly per capita expenditure on food, non-food and total expenditure at the state level for rural and urban areas separately, as well as for all-India across income deciles. It also includes the breakdown of average monthly per capita expenditure by broad item groups of food and non-food items, and estimates of monthly per capita quantity and value of consumption for food and non-food items at the all-India level. The survey utilized detailed household schedules to collect information on the quantity and value of consumption of over 300 consumer goods and
The attempt of local government in achieving food self sufficiencyAlexander Decker
This document summarizes a study on the local government's attempts to achieve food self-sufficiency in the district of Malinau, East Kalimantan. It discusses the agricultural potential and policies in Malinau, how the policies have implications for establishing food self-sufficiency, and proposes a developmental model to better support this goal. Key points analyzed include decentralization of agricultural development, empowering local farmers, diversifying food crops beyond just rice, and increasing households' ability to purchase sufficient nutritious food. The study concludes that changes are needed to agricultural policies and programs to better achieve social goals, improve target systems and outputs, and increase farmer productivity through technology.
The document summarizes findings from 4 rounds of National Health Accounts conducted in Ethiopia between 1995-2008. Key findings include:
- Total health expenditure increased from Birr 1.4 billion (1995/96) to Birr 11.1 billion (2007/08), with per capita expenditure more than doubling from Birr 25 (1995/96) to Birr 150 (2007/08).
- In 2007/08, HIV/AIDS accounted for 20% of health spending, reproductive health 13%, child health 10%, malaria 5%, and tuberculosis 4%.
- Spending on priority areas like HIV/AIDS, reproductive health and child health all increased between rounds, however still fell short of international benchmarks.
The document is a report from the OECD and European Commission titled "Health at a Glance: Europe 2014" that was released in December 2014. It provides data and analysis on health status, risk factors, health care resources, quality of care, access to care, and health expenditure in European countries. The report finds that while life expectancy has increased across Europe, gaps remain between countries and education levels. It also examines trends in diseases, health risks, health workforce and capacity, treatment outcomes, financial barriers to care, and spending on health systems.
This document discusses strategies for wealth preservation and estate planning, including the risks of taxes reducing the value of an estate and solutions like life insurance. It also covers the risks of critical illnesses and long term care needs, and how insurance can help cover costs to protect finances during illness or care needs. Estate equalization strategies using life insurance are presented as a way to fairly distribute assets among heirs.
O documento descreve os serviços oferecidos pela empresa Microcis, incluindo manutenção de equipamentos de TI, assistência técnica, contact center, impressões digitais, websites, sistemas, e soluções de TI como segurança, redes e automação. A Microcis tem 14 anos de experiência e certificações de qualidade ISO.
This document discusses a study on customer acceptance of Islamic versus conventional financial institutions. It begins with background on the development of financial institutions since the 1940s. The objectives are to investigate customer acceptance and differences between Islamic and conventional institutions. Key findings are that customer acceptance is related to interest rates, risk/returns, and service quality. Islamic finance prohibits interest and uncertainty while allowing profit-sharing. Conventional finance offers more familiar instruments like mutual funds and mortgages. Overall, the study found a positive relationship between customer acceptance and financial institution products, and that Islamic institutions differ from conventional ones in their ethical foundations.
This document discusses the importance of website security and protecting online customers' personal information. It notes that 92% of websites lack adequate security protections. While SSL encryption is widely used, over half of implementations have issues. The document recommends practices like using SSL on all pages, secure cookies, and valid certificates to better safeguard data. Adopting an "always-on SSL" approach can boost customer confidence and online sales.
El documento contrasta las actitudes y comportamientos de una persona ganadora versus una persona perdedora. Señala que una persona ganadora asume la responsabilidad de sus errores, aprende de la adversidad, cree que puede controlar los resultados a través de su esfuerzo, y busca mejorar continuamente. En contraste, una persona perdedora culpa a otros por sus errores, se siente víctima de la adversidad, cree en la mala suerte, y está satisfecha con el statu quo.
APPBACS: AN APPLICATION BEHAVIOR ANALYSIS AND CLASSIFICATION SYSTEMijcsit
Number and complicacy of malware attack has increased multiple folds in recent times. Informed Internet
users generally keep their computer protected but get confused when it comes to execute the untrusted
applications. In such cases users may fall prey to malicious applications. There are malware behavior
analyzers available but leave report analysis to the user. Common users are not trained to understand and
analyze these reports, and generally expect direct recommendation whether to execute this application on
their computer. This research paper tries to analyze behavior and help the common users and analysts to
quickly classify an application as safe or malicious.
O documento discute o que é software livre, comparando-o com software proprietário e privativo. Ele explica que software livre pode ser usado, copiado, modificado e redistribuído sem restrições, diferentemente do software proprietário. Também discute como projetos como o GNU, Linux e a licença GPL ajudaram a promover o software livre e como desenvolvedores podem ganhar dinheiro e reconhecimento mantendo seu código aberto.
Informe de gestión del ministerio de haciendamasipspyacuiba2
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Required Resources week 6Required TextLovett-Scott, M., & Pra.docxsodhi3
Required Resources week 6
Required Text
Lovett-Scott, M., & Prather, F. (2014). Global health systems: Comparing strategies for delivering health services. Burlington, MA: Jones & Bartlett Learning.
· Chapter 15: Prevalence and Management of Behavioral Health Care
· Chapter 16: Comparative Health Systems
· Chapter 17: Conclusions and Future Leadership
Articles
Baumol, W., & Blinder, A. (1999). Economics: Principles and policy (8th ed.). Fort Worth, TX: Dryden Press.
Collins, T. (2003). Globalization, global health, and access to healthcare. International Journal of Health Planning and Management, 18, 97–104.
Flesner, M. K. (2004). Care of the elderly as a global nursing issue. Nursing Administration Quarterly, 28(1), 67-72.
Getzen, T. E. (2004). Health care economics: Fundamentals and flow of funds (2nd ed.). New York, NY: Wiley.
Lee, R. (2003). The demographic transition: Three centuries of fundamental change. Journal of Economic Perspectives, 17(4), 167-190.
Medicare Rights Center. (2011). The history of Medicare and the current debate (Links to an external site.)Links to an external site.. Retrieved from http://www.medicarerights.org/
Strunk, B., Ginsburg, P., & Banker, M. (2006). The effect of population aging on future hospital demand. Health Affairs, 25(3), 141-149. doi: 10.1377/hlthaff.25.w141
World Health Organization. (2011). Globalization (Links to an external site.)Links to an external site.. Retrieved from http://www.who.int/trade/glossary/story043/en/index.html
Recommended Resources
Textbook PowerPoint Presentations
Lovett-Scott, M., & Prather, F. (2014). Chapter 15: Prevalence and Management of Behavioral Health Care. Burlington, MA: Jones & Bartlett Learning.
Lovett-Scott, M., & Prather, F. (2014). Chapter 16: Comparative Health Systems. Burlington, MA: Jones & Bartlett Learning.
Lovett-Scott, M., & Prather, F. (2014). Chapter 17: Conclusions and Future Leadership. Burlington, MA: Jones & Bartlett Learning.
Week Six Standard Guidance
The globalization of health services has moved to the forefront of national political discussions. According to the World Health Organization (2011):
Increased interconnectedness and interdependence of people and countries, is generally understood to include two interrelated elements: the opening of borders to increasingly fast flows of goods, services, finance, people, and ideas across the international borders and the changes in institutional and policy regimes at the international and national levels that facilitate or promote such flows (para. 1).
Balancing the increasing cost of quality health care and access for a country’s population has given rise to economic measurement of inputs and outputs to determine actual cost of health delivery. An aging population in countries around the globe adds to the growing list of health trends that have taxed health systems around the world.
Global healthcare systems today are growing at an unsustainable rate, while consumers on a worldw ...
Prompted by the 20th anniversary of the 1993 World Development Report, a Lancet Commission revisited the case for investment in health and developed a new investment frame work to achieve dramatic health gains by 2035. Our report has four key messages, each accompanied by opportunities for action by national governments of low-income and middle-income countries and by the international community.
European Journal of Internal Medicine 32 (2016) e13–e14ConBetseyCalderon89
European Journal of Internal Medicine 32 (2016) e13–e14
Contents lists available at ScienceDirect
European Journal of Internal Medicine
journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor
No correlation between health care expenditure
and mortality in the European Union
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Fig. 1. Trends of aggregate health care expenditures and mortality in the European Union
from the year 2000 to the year 2013 (Fig. 1a), and correlation between variation of health
care expenditures and mortality over the same period normalized for data of the year 2000
(Fig. 1b).
Keywords:
Health care expenditure
Health care costs
Mortality
Deaths
There is ongoing debate about the impact of aggregate health care
expenditure on health outcomes, and it also remains quite uncertain
whether increasing health spending may be a significant factor for
decreasing death rates. In 1991, Mackenbach published an interesting
analysis to establish whether a higher national level of health care
expenditure could be associated with a larger degree of success in
decreasing mortality within the European Community [1], concluding
that no association existed between deaths and health care funding.
Interestingly, no other comprehensive evidence has been published
so far in Europe. Therefore, in order to establish whether or not any
relationship exists between aggregate health care expenditure and
mortality in the European Union in recent years, we analyzed data of
overall mortality in the 28 European countries from the year 2000 to
the year 2013, combined with those of the concomitant expenditure
for health care (all functions). Health care costs were reported as per
capita expenditure, including all financing agencies and all health care
providers (i.e., both private and public). Mortality data were extracted
from the official website of the European Union [2], whereas health
care costs were retrieved from the Organization for Economic Co-
operation and Development (OECD) [3]. For each year after the 2000,
a ratio was calculated for both mortality and health care expenditure
to normalize the data.
The results of our analysis are shown in Fig. 1. From the year 2000
to the year 2013, health care costs have constantly increased in the
countries of the European Union, nearly doubling at the end of the
observational period (Fig. 1a). At variance, the mortality trend did not
follow a consistent trend from the year 2000 to the year 2013, exhibiting
peaks (e.g., in the year 2003) and troughs (e.g., in the year 2004)
(Fig. 1a). When the ratio of health care expenditures and mortality of
each single y ...
The document discusses achieving global health convergence by 2035 through increased investment in health. Three key points:
1) A "grand convergence" is achievable with targeted investments that could reduce under-5 mortality, AIDS deaths, and TB deaths to rates seen in developed countries by 2035.
2) Investing $70 billion annually could avert over 10 million deaths between 2016-2035 and yield high economic returns through gains in productivity.
3) Achieving universal health coverage through "progressive universalism" - initially focusing on essential services for infectious diseases and maternal/child health, and gradually expanding coverage of non-communicable diseases - is an efficient path to both improved health and financial risk protection.
Economic development injury mortality suic homic acidDaniel Bando
1) The study examined longitudinal data on injury mortality rates and GDP per capita for OECD countries from 1960-1999 to determine if cross-sectional findings showing an inverted U-shaped relationship held true over time for individual countries.
2) The results showed that for higher-income countries, injury mortality rates increased until 1972 and then declined, while for middle-income countries rates increased until 1977 and then declined.
3) Intentional injury mortality rates, such as suicide and homicide, generally increased until countries reached around $13,000-$14,000 GDP per capita, after which rates leveled off or declined.
There are numerous changes taking place in South Africa, in the economy, politics and health. All these are interdependent and embedded in a social milieu which brings a number of pressures on health services and systems. The major event in the medium to long term is the impact of the National Health Insurance. Other contextual factors of importance include the range of social determinants of health and disease, with the provision of water, sanitation, electricity and housing being the key services. South Africa will also be influenced in the future by the major diseases it harbours at present. This seminar provided some insight into how these factors will impact on the South African Health Services.
Analysis for the global burden of disease study 2016 lancet 2017Luis Sales
This document summarizes the findings of the Global Burden of Disease Study 2016, which assessed prevalence, incidence, and years lived with disability for 328 diseases and injuries from 1990 to 2016 for 195 countries. Some key findings were:
1) Low back pain, migraine, hearing loss, iron-deficiency anemia, and major depressive disorder were the top five causes of years lived with disability globally in 2016.
2) Age-standardized rates of years lived with disability decreased by 2.7% between 1990 and 2016, but the number of years lived with disability from non-communicable diseases has risen due to population growth and aging.
3) Years lived with disability rates were 10.4% higher
Dr Yousef Elshrek is One co-authors in this study >>>> Global, regional, and...Univ. of Tripoli
Global, regional, and national age–sex specifi c all-cause and cause-specifi c mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
GBD 2013 Mortality and Causes of Death Collaborators*
Dr. Yousef Elshrek is Coauthors in this study
This document provides an introduction and objectives for India's National Population Policy 2000. Some key points:
- India launched its first family planning program in 1952 but birth rates did not decline as quickly as death rates, leading to rapid population growth. The 2000 policy aims to lower fertility rates to replacement levels by 2010.
- India's population is projected to reach 1 billion in 2000 and may overtake China's population by 2045. The large reproductive-age population and high fertility rates due to unmet contraceptive needs contribute to continued high population growth.
- The policy outlines national socio-demographic goals like increasing education, lowering infant/maternal mortality, and achieving replacement fertility levels by 2010. It identifies strategic
The research of Warwick McKibbin (Australian National University, The Brookings Institution, Centre of Excellence in Population Ageing Research) and Roshen Fernando (Australian National University, Centre of Excellence in Population Ageing Research (CEPAR))
This National Health Policy addresses the urgent need to improve the performance of health systems. India today possesses as never before, a sophisticated arsenal of interventions, technologies and knowledge required for providing health care to her people. It is being formulated at the last year of the Millennium Declaration and its Goals, in the global context of all nations committed to moving towards universal health coverage.
This document outlines India's National Health Policy for 2015. It begins with an introduction noting the changes in context since the previous 2002 policy, including progress on health indicators but persisting inequities, a growing private healthcare industry, and rising costs of care.
Section 2 provides a situation analysis, noting achievements in reducing maternal and child mortality but the need to address quality of care issues. It also discusses mixed progress in disease control programs, developments under the National Rural Health Mission including expanded infrastructure and services but uneven implementation, and the growing burden of non-communicable diseases.
Section 3 will outline the goal, principles and objectives of the new policy.
CAMA: The global macroeconomic impacts of COVID-19: Seven scenarios (results)TatianaApostolovich
The research of Warwick McKibbin (Australian National University, The Brookings Institution, Centre of Excellence in Population Ageing Research) and Roshen Fernando (Australian National University, Centre of Excellence in Population Ageing Research (CEPAR))
Harvard global economic burden non communicable diseases 2011paulovseabra
This document provides an overview and analysis of the global economic burden of non-communicable diseases (NCDs). It finds that NCDs already pose a substantial economic burden, expected to grow tremendously over the next two decades to $47 trillion in lost global output. This represents 75% of global GDP in 2010. Cardiovascular diseases and mental health conditions are the leading contributors. While high-income countries currently bear most of the burden, the developing world will see a rising share due to population and economic growth. Business leaders also express significant concern about the economic impacts of NCDs. The findings suggest a pressing need for increased prevention and control efforts to curb this mounting threat.
This presentation by Ankit KUMAR was made at the 3rd Joint DELSA/GOV Health Meeting, Paris 24-25 April 2014. Find out more at www.oecd.org/gov/budgeting/3rdmeetingdelsagovnetworkfiscalsustainabilityofhealthsystems2014.htm
Health spending is likely to continue growing faster than economic growth, putting pressure on public budgets. While accommodating greater health spending may be acceptable, opportunities exist to increase productivity in health systems. In the long run, the correlation between health spending and GDP may need to be weakened to ensure fiscal sustainability, through policies like improving efficiency, shifting focus to prevention, and better defining public coverage.
This document summarizes key findings from the OECD report "Health at a Glance 2015: How Japan Compares?". It finds that:
1) Quality of care in Japan is generally good, though there is room to improve diabetes care and reduce unnecessary hospital admissions. Mortality for heart attacks after admission is also high.
2) Japan has fewer doctors per capita than most OECD countries, though nurse supply is high. There are opportunities to better utilize nurses and improve efficiency.
3) Healthcare spending in Japan has risen faster than most OECD countries in recent years and is now higher than the OECD average as a share of GDP. Achieving greater value for money through efficiency gains is a priority
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11.macroeconomics and health the way forward in the who african region
1. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol 1, No.3, 2011
Macroeconomics and Health: The Way Forward in the WHO
African Region
Joses Muthuri Kirigia
World Health Organization, Regional Office for Africa, B.P. 06, Brazzaville, Congo
* E-mail of the corresponding author: kirigiaj@afro.who.int
Abstract
The specific objectives of this paper were: (i) to estimate the effects of life expectancy and mortality rates
on the per capita gross national income; and (ii) to propose to countries in the African region a set of
generic steps for implementing the action agenda recommended by WHO Commission for
Macroeconomics and Health (CMH), within the context of national development plans and poverty
reduction strategies. Four simple double-log (log-linear or constant elasticity) regression equations were
estimated with data from the World Health Statistics 2011. The dependent variable in all equations was the
logarithm of per capita gross national income.
The key findings were as follows: in equation 1 the coefficients for life expectancy and adult literacy had a
positive sign and were statistically significant at 95% confidence level; in equation 2 the coefficient for
under 5 mortality rate took a negative sign and was statistically significant; in equation 3 the coefficients
for adult mortality rate and adult literacy were statistically significant and had expected signs; and in
equation 4 the coefficient for maternal mortality was not statistically significant at 95% level of confidence
but had a negative sign as expected. These results clearly show a significant correlation between per capita
gross national income and life expectancy, under 5 mortality rate, and adult mortality rate. This implies that
by working closely with health development partners, countries in the African region can better their
economic prospects through greater investments in close-to-client health systems and increased use of
proven cost-effective prevention and treatment interventions to curb mortality and increase life expectancy.
Keywords: Macroeconomics, Health, African Region, Way Forward
1. Introduction
Improved health is not just an end in itself but also an essential means of reducing poverty and achieving
sustained economic growth. In the WHO African Region, health outcomes must be significantly improved
because the current huge burden of disease largely undermines socioeconomic development.
In recognition of the above, the WHO Director-General established the Commission on Macroeconomics
and Health (CMH) in January 2000 to study the links between increased investments in health, economic
development and poverty reduction. The findings of the Commission, published in December 2001 (WHO
2001), demonstrated that judicious investments in health can help increase economic growth in developing
countries.
The Commission’s analysis revealed that:
• ill-health contributes significantly to poverty and low economic growth;
• a few health conditions account for the high proportion of ill-health and premature deaths;
• a substantial increase in the use of cost-effective interventions in addressing priority health
problems can potentially save millions of lives per year;
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• a close-to-client (CTC) system is required to increase cost-effective interventions targeting the
poor;
• the current level of health spending in Member States is not sufficient to help implement
cost-effective interventions.
The Fifty-fifth World Health Assembly, held in May 2002, commended the CMH action agenda as a useful
approach to the achievement of the Millennium Development Goals (MDGs) (WHO 2002, UN 2000) and
the targets of the New Partnership for Africa’s Development (NEPAD) (NEPAD 2001).
The purpose of this paper is to put the key CMH findings in the WHO African Region perspective. The
specific objectives are: (i) to estimate the effects of life expectancy and mortality rates on the per capita
gross national income (GNI); and (ii) to propose to countries in the African region a set of generic steps for
implementing the action agenda recommended by WHO Commission for Macroeconomics and Health
(CMH), within the context of national development plans and poverty reduction strategies.
2. Methods
2.1 Analytical framework
According to the CMH, per capita gross national income is hypothesized to be a function of health
outcomes (e.g. life expectancy and mortality rates) and education (e.g. adult literacy) (WHO 2001). We
would expect a positive relationship between per capita GNI and life expectancy and educational
attainment. As life expectancy and adult literacy increase, we would expect per capita GNI to also increase
(and vice versa). On the contrary, we would expect an inverse relationship between per capita GNI and
mortality rates. This is because while increases in life expectancy and adult literacy enhance stocks of
human capital, and hence productive capabilities, premature mortality erodes them.
Formally, the effect of life expectancy and mortality rates on the per capita GNI can be expressed as
follows:
PER_CAPITA_GNI = f (LE, U5MR,1560MR, MMR, Literacy)...........(1)
where: f = function of; PER_CAPITA_GNI = per capita GNI in purchasing power parity, i.e. total
gross national income divided by population; LE = average life expectancy at birth (years); U5MR =
under-five mortality rate (probability of dying by age 5 per 1000 live births); 1560MR = adult
mortality rate (probability of dying between 15 and 60 years per 1000 population); MMR = maternal
mortality ratio (per 100 000 live births); Literacy = adult literacy rate (%).
We estimated four simple double-log equations specified below:
logPER_CAPITA_GNI = log α + β1 log LE + β 2 log Literacy + ε .........................(2)
logPER_CAPITA_GNI = log α + β1 log U 5MR + β 2 log Literacy + ε ...................(3)
logPER_CAPITA_GNI = log α + β1 log 1560MR + β 2 log Literacy + ε .............( 4)
logPER_CAPITA_GNI = log α + β1 log MMR + β 2 log Literacy + ε .......... ...(5)
where: log is the natural log (i.e., log to the base e, where is e equals 2.718); a is the intercept term; β’s
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are the coefficients of elasticity (CoE), i.e. the percentage change in per capita GNI for a given small
percentage change in a specific explanatory variable; and ε is a random (stochastic) error term
capturing all factors that affect per capita GNI but are not taken into account explicitly (Gujarati 1988,
Kirigia et al 2004).
CoE is the ratio of the percentage change in per capita GNI (PER_CAPITA_GNI) to the percentage
change in a specific independent (explanatory) variable, such as LE. Mathematically, the absolute
value of the CoE ranges from zero (perfectly inelastic PER_CAPITA_GNI) to infinity (perfectly
elastic PER_CAPITA_GNI). Unitary elastic PER_CAPITA_GNI depicts a scenario in which the
percentage change in PER_CAPITA_GNI is exactly equal to the percentage change in an independent
variable, i.e. CoE=1. Inelastic PER_CAPITA_GNI refers to a situation where PER_CAPITA_GNI is
relatively unresponsive to a change in an independent variable, i.e. CoE > 0 < 1. Similarly, elastic
PER_CAPITA_GNI implies that GNI is relatively responsive to a change in an independent variable,
i.e. CoE > 1. Thus, in simple terms, elasticity is a measure of the degree of responsiveness of a
dependent variable (PER_CAPITA_GNI in our case) to changes in an independent variable, such as
LE.
2.2 Data Sources and Analysis
The per capita GNI, average life expectancy, under-five mortality rate, adult mortality rate, maternal
mortality rate, and adult literacy rate data on the 46 countries in the WHO African Region, which was used
to estimate equations 2 to 5, were obtained from the World Health Statistics 2011 (WHO 2011). The raw
data were collated in EXCEL spreadsheet, and subsequently, exported to STATA (Statacorp 2010) for
analysis. Prior to estimation of the regression equation 2 to 5, both the dependent and independent
(explanatory) variables were transformed into their logarithms using standard STATA commands.
3. Results and Discussion
3.1 Analysis
Table 1 provides a summary of descriptive Statistics (mean, median, standard deviation, minimum,
maximum). There is remarkable variation in per capita GNI between countries, e.g. the minimum is Int$163
while the maximum is Int$19,330 (in PPP). Also there is significant variation in the life expectancies and
mortality rates between countries – minimum is 47 years and maximum is 73 years.
Table 2 presents the results of regression of logarithm of per capita GNI against various health outcomes
(explanatory variables). In equation 1, the coefficients for the logarithms of average life expectancy at birth
and adult literacy were positive and statistically significant at 95% level of confidence. The per capita GNI
was elastic with respect to both explanatory variables since their coefficients were greater than one. As
shown in Table 2, the life expectancy elasticity coefficient is 2.732, implying that for a one percent increase
in the life expectancy, the per capita gross national income on the average increases by about 2.732 percent.
The adjusted R-squared was 0.268, meaning that the two independent variables explained about 27% of the
total variations in the per capita GNI.
In equation 2, the coefficient for under-five mortality rate was statistically significant and had as expected a
negative sign. The coefficient for adult literacy rate had as expected a positive sign but was not significant
at 95% confidence level. Both coefficients were less than one, signifying that in this equation, the per capita
GNI was inelastic in relation to under-five mortality and adult literacy. The adjusted R-squared was 0.298,
implying that under-five mortality rate and adult literacy rate accounted for about 30% of variations in per
capita GNI.
In equation 3, the coefficients for adult mortality rate and adult literacy were both statistically significant at
95% level of confidence. The coefficient for adult mortality had a negative sign and that of adult literacy
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rate was positive as expected. Whilst the coefficient for adult mortality was less than one, the one for adult
literacy was greater than one. The adult mortality rate elasticity coefficient was -0.793, denoting that for a
one percent increase in adult mortality rate, the per capita gross national income on average decreases by
about 0.793%. Since the adult mortality rate elasticity value of 0.793 is less than one in absolute terms, one
can say that the per capita GNI is adult mortality rate-inelastic. On the contrary, since the adult education
rate elasticity value of 1.383 is greater than one in absolute terms, we can say that per capita GNI is adult
literacy-elastic. The adjusted R-squared was 0.257, indicating the two variables explained almost 26% of
variations in the dependent variable.
In equation 4, the coefficient for maternal mortality ratio was not statistically significant at 95% confidence.
However, it had a negative sign as expected. The maternal mortality elasticity coefficient of -0.062 indicate
that for a one percent increase in MMR, the per capita GNI on average decreases by about 0.062%. Because
the MMR elasticity value of 0.062 is less than one in absolute terms, one can conclude that the per capita
GNI is maternal mortality-inelastic. On the other hand, the coefficient for adult literacy rate was statistically
significant and had a positive sign, and was greater than one meaning that per capita GNI is adult
literacy-elastic in equation 4. In view of the fact that the adult literacy elasticity coefficient is 1.20, the per
capita GNI on average increases by about 1.2% for a one percent increase in the adult literacy rate. The
adjusted R-squared was 0.213, which suggests that the two variables accounted for 21% of variations in the
per capita GNI.
Figures 1 and 5 show that as the life expectancy and adult literacy rate increase, the per capita GNI also
increases. Figure 2 and 3 and 4 portray that per capita GNI decreases with increase in under-five mortality
rate, adult mortality rate, and maternal mortality ratio. These results clearly show that there is a strong
correlation between capita GNI and life expectancy, under-five mortality rate and adult mortality rate. The
findings are consistent with those of the CMH (WHO 2001), Gallup and Sachs (2001) and Bloom and
Sachs (1998) among others.
The WHO African Region population suffers a heavy burden of communicable and non-communicable
diseases. In the year 2002, 66% of the 10.7 million deaths that occurred in the Region resulted from the ten
causes shown in Figure 7 (WHO 2005a). HIV/AIDS, lower respiratory tract infection, malaria, diarrhoeal
diseases and maternal and perinatal conditions alone accounted for 55% of the deaths and 54% of
disability-adjusted life years. This heavy burden of disease and its multiple effects on productivity,
demography and education have contributed significantly to Africa’s chronically poor economic
performance (Bloom and Sachs 1998).
Substantial increase in the use of available cost-effective interventions to address priority health problems
can potentially save millions of lives each year in the Region. About 47% of the population in the Region
have no access to health services and more than 70% of the people have no access to essential drugs (WHO
2000); and about 59% of pregnant women deliver babies without the assistance of skilled health personnel;
out-of-pocket expenditures constitute 51% to 90% of the private health expenditure in 14 countries and
91% to 100% in 24 countries (in a region where 38.2% of people live below the international income
poverty lines of US$1 per day) (WHO 2005a). Many cost-effective interventions (e.g. use of
insecticide-treated materials, directly-observed treatment - short-course (DOTS), condoms, vaccines against
childhood killer diseases) are available and yet they are not reaching the poor (WHO 2001). There is,
therefore, need to substantially increase the use of such interventions.
A close-to-client (CTC) system (a health system that provides affordable promotive, preventive and basic
curative care in localities inhabited mainly by the poor) is required to scale up cost-effective public health
interventions targeting the poor (WHO 2001). CTC systems consisting of health centres, health posts and
outreach points are capable of delivering the key cost-effective interventions (cost-effective interventions
are public health interventions with the least cost per unit of effectiveness) required to reduce the burden of
disease and improve health conditions in the Region. Developing an effective CTC system requires
increased investments in infrastructure and health personnel capacity building.
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Opportunities exist to improve current resource allocation within health systems by increasing the
proportion of resources allocated to CTC systems. By undertaking significant health sector reforms, more
resources can be reallocated from over-resourced, less cost-effective systems of care to more cost-effective
CTC systems. There is also growing evidence in the Region that national health systems (Kirigia et al
2007), hospitals (Mbeeli et al 2004; Osei et al 2005; Kirigia, Emrouznejad and Sambo 2002; Masiye et al
2002; Zere, McIntyre and Addison 2001; Kirigia, Lambo and Sambo 2000) and health centers (Kirigia et al
2008; Masiye et al 2006; Renner et al 2005; Kirigia et al 2004; Kirigia, Sambo and Scheel 2001) can attend
to more patients if the resources available to them are better managed.
Despite efforts to improve efficiency in the use of available resources, the level of health spending in
Member States is not sufficient to scale up cost-effective interventions. The CMH estimated that a
minimum of US$ 34 per capita per year would be required to provide an essential package of public health
interventions (WHO 2001). Between 2000 and 2008 the number of countries achieving the CMH
recommendation increased from 11 to 27, out of 46 African Regional countries (WHO 2011). Thus, the 19
(41%) countries currently spending less than US$ 34 on health per capita per year will need to increase
their budgetary allocations to reach the recommended minimum health spending.
Member States can increase their domestic resource allocations to health. Heads of State of African
countries made a commitment in Abuja to allocate at least 15% of their annual budgets to the health sector
(OAU 2000). Yet, in 2008, six countries spent less than 5% of their total annual national budget on health;
14 countries spent between 5% and 9%; 18 countries spent between 10% and 14%; and seven countries
spent 15% and above of their budget on health. Only seven countries spent 15% or above of their budgets
on health (WHO 2011). This means that 39 countries spent less than 15% of their national budgets on
health and will need to take appropriate steps to fulfill the commitment given by their respective Heads of
State (See Figure 8).
In spite of the increased allocation of domestic resources to health, a financing gap will still need to be
filled from external sources. CMH estimated that, globally, US$ 27 billion per year (as measured against
the current US$ 6 billion) will need to be mobilized from international donors to complement domestic
resources (WHO 2001). Therefore, Member States need to advocate, individually and collectively, at the
international level, for a fair share of such funds. In addition, there will be need to significantly improve the
management of resources and the capacity to use the additional resources in a manner that especially
benefits the poor.
Investment in health-related sectors ought to be increased to tackle social determinants of health (WHO
2008). Almost 66% of the population in the Region lack sustainable access to improved sanitation facilities;
39% lack sustainable access to an improved water source; and 37% of adults in the Region are illiterate
(WHO 2011). This underscores the need for increased investments in sectors such as water, sanitation,
education and agriculture, all of which have an impact on health in order to achieve the relevant MDGs.
3.2 Regional Response to the Report of the Commission on Macroeconomics and Health
In June 2002, a Regional Health Economics Capacity Strengthening Workshop took place in Windhoek,
Namibia. A total of 103 senior economists, planners and public health specialists from 43 countries
participated in the workshop which critically examined the CMH findings and recommendations; the health
component of Poverty Reduction Strategy Papers (PRSPs); health care financing; national health accounts;
and health systems performance assessment.
The participants generally felt that the CMH report presented compelling evidence that health was a
prerequisite for economic development, and that the recommended action agenda was pertinent for the
African Region. However, they envisaged that countries planning to implement that agenda might face the
following challenges:
a) limited capacity of ministries of health to undertake advocacy and negotiate with other sectors and
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partners;
b) weak national health management information systems;
c) need to revise the health component of PRSPs to include strategies for scaling up the essential
package of interventions;
d) proliferation of committees at the national level;
e) attrition of human resources resulting from brain drain;
f) lack of sustainable health care financing mechanisms;
g) making health systems responsive to the needs and expectations of the poor;
h) coordination of donor support to enhance contributions to the attainment of national health
developmental goals.
At the recommendation of the Windhoek workshop, an agenda item entitled “Macroeconomics and health:
The way forward in the African Region”, was included in the Fifty-third session of the WHO Regional
Committee for Africa. The Committee adopted a resolution (WHO Regional Office for Africa 2003) urging
Member States of the African Region:
a) to widely disseminate among all stakeholders the findings and recommendations of the CMH and
build consensus for action;
b) to establish or strengthen institutional mechanisms for implementing the recommendations of the
CMH;
c) to develop multi-year strategic plans for scaling up health investment into pro-poor health
interventions;
d) to revise health sector and health-related development plans, the relevant components of Poverty
Reduction Strategy Papers (PRSPs) and Medium-Term Expenditure Frameworks (MTEFs) to
incorporate strategic plans for scaling up pro-poor health investments;
e) to fulfill the pledge made by Heads of State in Abuja to allocate at least 15% of their annual
budgets to the improvement of the health sector;
f) to utilize the multi-year strategic plans to mobilize resources from domestic and external sources
in a sustainable manner;
g) to closely involve relevant ministries and agencies with responsibility for specific components of
the strategic plan (e.g. health services, water, sanitation, nutrition, education, finance, planning)
during planning, implementation and monitoring;
h) to strengthen health economics and public health capacity within the ministries of health and other
relevant sectors in order to enhance health investments, and pre-empt and mitigate negative effects
of development projects on public health.
3.3 The Way Forward
The CMH report recommends enhanced political commitment, at both national and international levels, to
increased investments for scaling up the delivery of essential health interventions using close-to-client
health systems (WHO 2001). Given that different Member States face different challenges, and considering
the lessons learnt from the Ghana (Government of Ghana 2005) experience, this paper suggests steps that
can be taken to implement the CMH recommendations. The steps suggested below should be implemented
within the framework of:
a) existing national policies, development plans and poverty reduction strategies;
b) administrative, planning, implementation and monitoring structures and processes existing in
individual countries.
The suggested steps to be taken at the country level are as follows:
Step 1: Dissemination, at country level, of the findings and recommendations of the Commission on
Macroeconomics and Health and consensus building on their relevance
Ministries of health, with support from relevant United Nations (UN) Agencies and the World Bank, may
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organize a meeting of key stakeholders to disseminate the CMH findings and recommendations and build
consensus on their relevance to the national health situation. This would potentially set in motion a process
that would build greater political and financial commitment to the health sector.
Step 2: Making institutional arrangements to facilitate implementation of the recommendations of the
Commission on Macroeconomics and Health in the countries
Individual countries may set up an inter-ministerial national steering committee on macroeconomics and
health or, where appropriate, expand the terms of reference and composition of existing committees
performing similar functions to take action on the CMH recommendations. This committee may spearhead
the scaling up of priority health and health-related interventions and, at national and international levels,
undertake advocacy for increased investments in health. Its membership may consist of ministers
responsible for health, economic planning and regional cooperation, finance, local government and rural
development, works and housing as well as parliamentarians, representatives of civil society, the private
sector, UN agencies, and bilateral and multilateral donors.
A technical committee, acting as the secretariat of the national steering committee on macroeconomics and
health, may be established to undertake a health situation analysis and an economic analysis of alternative
health interventions and financing options. This committee may comprise a health economist,
representatives of ministries of health (including public health specialists and planners); education; water
supply and sanitation; finance; economic planning and regional cooperation; local government and rural
development; as well as representatives of the donor community and relevant UN Agencies.
Step 3: Analysis and strategy development
Drawing on the recommendations of CMH and national strategic plans such as the Poverty Reduction
Strategy Papers, the technical committee will carry out analyses of: the national health situation; national
health policies, including human resource policies and plans; health system performance (goals and
functions); national health accounts (or national health expenditure) to quantify the financial contribution to
health from the activities undertaken by all the sectors; and macroeconomic (including poverty) indicators
to facilitate the development of a sound strategy for scaling up health interventions. The emerging gaps in
information and health systems performance can be addressed in a multi-year strategic plan. The main
purpose of this plan is to extend the coverage of essential health and health-related services after taking into
account synergy with other health-related sectors. It should ensure consistency with sound macroeconomic
policy framework and provide the basis for filling information gaps through adequate investment in
operations research.
The plan would contain:
(a) an analysis of health and health-related sectors;
(b) a set of priority national health problems;
(c) a package of cost-effective essential public health interventions for addressing problems;
(d) current levels of coverage of various essential interventions;
(e) the target coverage of individual essential health interventions;
(f) the cost of scaling up the use of essential interventions to the desired levels including the cost of
strengthening close-to-client health services;
(g) an estimate of the current level of spending (broken down by source) on essential interventions;
(h) an estimate of the expenditure gap (i.e. item “f” minus item “g” above);
(i) an indication of how the expenditure gap would be financed (from domestic and international
sources);
(j) a monitoring and evaluation section.
The relevant ministries and agencies primarily responsible for specific components of the defined essential
public health interventions will need to devise proposals for scaling up such interventions.
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Step 4: Filling expenditure gaps
The technical committee will, on the recommendation of the national steering committee, develop scenarios
of how expenditure gaps can be bridged. The advantages and disadvantages of each scenario should be
carefully examined and considered. The scenarios may include: reduction of the technical and allocative
inefficiencies within and between health-related sectors and subsectors; termination of least cost-effective
diagnostic procedures and health interventions; national social health insurance (Carrin, Desmet and Basaza
2001; WHO 2005b; African Union 2006) funded from “sin” taxes (e.g. on tobacco and alcohol); a
dedicated tax for health; reallocation of budgetary resources from other sectors such as defence; reduction
of subsidies for the export-oriented manufacturing industry; funds expected from the highly-indebted poor
countries (HIPC) initiative; soft loans and grants from multilateral and bilateral donor agencies;
development of project proposals for submission to the Global Alliance for Vaccines and Immunizations
(GAVI), the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and the Multicountry AIDS
Programme of the World Bank.
Step 5: Using the multi-year strategic plan (step 3) to revise the health and health-related sector
development plans and the relevant components of PRSPs
The multi-year strategic plan should be incorporated into the relevant health and health-related sector
development plans (e.g. health, water supply and sanitation, education) and the relevant components of
poverty reduction strategy papers (PRSPs) and the Medium Term Expenditure Frameworks (MTEF).
Step 6: Implementation of the multi-year strategic plan
The ministries and agencies with primary responsibility for specific components of the strategic plan (e.g.
health services, water, sanitation, nutrition) will scale up their respective interventions.
Step 7: Monitoring, evaluation and reporting
The national steering committee on macroeconomics and health will monitor the implementation of the
strategic plan as well as the proposals developed by each lead ministry or agency. To that end, the national
steering committee will develop key indicators and decide on a frequency of reporting consistent with the
national reporting mechanisms. As a guide, the national steering committee may consider meeting
half-yearly to review progress in the implementation of the strategic plan and its relevant proposals. The
lessons emerging from these reviews will then be used to revise the plans.
Partner alliances ought to be built and maintained at all levels, to ensure that countries receive appropriate
support when developing, implementing, monitoring and evaluating multi-year plans for scaling up
pro-poor health investments. Such alliances would involve stakeholders such as the relevant UN and
bilateral development agencies, the World Bank, the African Development Bank, the African Union, the
NEPAD Secretariat, civil society, international and national NGOs, private organizations, academics and
global initiatives, e.g. GFATM, GAVI, Stop TB, Roll Back Malaria Partnership.
Those partners ought to:
(a) disseminate the key CMH findings and recommendations to governments, members of parliament,
civil servants, civil society, local leaders and other relevant development partners;
(b) support countries to develop or strengthen existing national institutional mechanisms for planning,
implementing and monitoring the CMH recommendations;
(c) provide technical support to the national steering committee and lead ministries or agencies to
enable them to develop plans and proposals for scaling up relevant national interventions;
(d) strengthen Member States’ capacity to collect, analyze, document, disseminate and utilize relevant
health and economic evidence;
(e) monitor and document lessons emerging from the implementation of the CMH recommendations
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in different countries and facilitate shared learning among countries.
5. Conclusion
This paper has attempted to put the key findings of the CMH within the context of the African Region. It
has proposed to countries in the African Region a set of generic steps for implementing the action agenda
recommended by CMH, within the context of national development plans and poverty reduction strategies.
By working closely with health development partners, countries can better their economic prospects
through greater investments in close-to-client health systems and increased use of cost-effective
interventions in addressing priority national health problems.
Acknowledgement
We are grateful to Ministers of Health from the 46 countries of the WHO African Region and delegates for
their comments on an earlier version of this paper during the 53rd session of the WHO Regional Committee
for Africa. I also do appreciate the comments and suggestions made by the WHO/AFRO technical staff who
peer reviewed an earlier version of this paper. Mrs Eva Ndavu provided excellent editorial support. I owe
profound gratitude to Jehovah Jireh for the inspiration and for assuring sustenance in the process of
preparing the paper.
This paper contains the views of the author only and does not represent the decisions or stated policies of
the World Health Organization.
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4.5
Logarithm of per capita gross national income
2.5 3 3.5
2 4
1.65 1.7 1.75 1.8 1.85
Logarithm of life expectancy in years
Figure 1: Per capita gross national income versus life expectancy for males
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4.5
Logarithm of per capita gross national income
2.5 3 3.5
2 4
1 1.5 2 2.5
Under-five mortality rate
Figure 2: Per capita gross national income versus under-five mortality rate
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4.5
Logarithm of per capita gross national income
2.5 3 3.5
2 4
2 2.2 2.4 2.6 2.8
Logarithm of adult mortality rate
Figure 3: Per capita income versus adult mortality rate
20
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4.5
Logarithm of per capita gross national income
2.5 3 3.5
2 4
-6 -4 -2 0 2 4
logarithm of maternal mortality ratio
Figure 4: Per capita income versus maternal mortality ratio
21
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Vol 1, No.3, 2011
4.5
Logarithm of per capita gross national income
2.5 3 3.5
2 4
1.4 1.6 1.8 2
Logarithm of adult literacy rate
Figure 5: Per capita income versus adult literacy rate
22
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Figure 6: Leading causes of death in the WHO African Region, 2002
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Zambia
Tanzania
Uganda
Togo
Swaziland
South Africa
Sierra Leone
Seychelles
Senegal
Sao Tome and Principe
Rwanda
Nigeria
Niger
Namibia
Mozambique
Mauritius
Mauritania
Mali
Malawi
Madagascar
Liberia
Lesotho
Kenya
Guinea-Bissau
Guinea
Ghana
Gambia
Gabon
Ethiopia
Eritrea
Equatorial Guinea
DRC
Côte d'Ivoire
Congo
Comoros
Chad
Central African Republic
Cape Verde
Cameroon
Burundi
Burkina Faso
Botswana
Benin
Angola
Algeria
0 2 4 6 8 10 12 14 16 18 20
Percent
Year 2000 Year 2008
Figure 7: General government expenditure on health as % of total government expenditure
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Table 1: Descriptive Statistics (mean, median, standard deviation, minimum, maximum)
Variable Mean Median Standard Minimum Maximum
deviation
Per capita 2,632 1,510 4,640 163 19,330
gross national
income
life expectancy 54 55 7 47 73
Under-five 127 111 51 10 209
mortality rate
Adult (15-60 383 364 125 120 613
years)
mortality rate
Maternal 620 490 284 36 1,200
mortality ratio
Logarithm of 63 70 20 26 93
adult literacy
rate
25
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Table 2: Regression of logarithm of per capita gross national income against various health outcome
indicators
Equation Variable Coefficient ‘t’ statistic P > |t| 95% confidence interval
1 Logarithm of life 2.732117 2.40 0.021 .4331116 5.031122
expectancy at birth
Logarithm of adult 1.136843 2.80 0.008 .3183335 1.955352
literacy rate
Constant -3.551565 -1.84 0.073 -7.444182 .3410521
Number of 46
observations
F( 2, 43) 9.24
Adjusted R-squared 0.2680
2 Logarithm of -.6861078 -2.80 0.008 -1.180436 -.1917794
under-five
mortality rate
Logarithm of adult .7308112 1.62 0.112 -.178284 1.639906
literacy rate
Constant 3.308904 2.89 0.006 1.001472 5.61633
Number of 46
observations
F( 2, 43) 10.56
Adjusted R-squared 0.2981
3 Logarithm of adult -.7934807 -2.24 0.030 -1.507957 -.0790047
(15-60 years)
mortality rate
Logarithm of adult 1.38352 3.51 0.001 .5885413 2.178499
literacy rate
Constant 2.782053 2.42 0.020 .4617483 5.102358
Number of 46
observations
F( 2, 43) 8.78
Adjusted R-squared 0.2569
4 Logarithm of -.0618062 -1.53 0.132 -.1430848 .0194724
maternal mortality
ratio
Logarithm of adult 1.201144 2.83 0.007 .3440617
literacy rate 2.058226
Constant 1.248408 1.56 0.125 -.3620744 2.8588
Number of 46
observations
F( 2, 43) 7.10
Adjusted R-squared 0.2133
26
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