Title
Countdown to 2015 country case studies: What can analysis of national health financing contribute to understanding MDG 4 and 5 progress?
Date Issued
12 September 2016
Access level
open access
Resource Type
journal article
Author(s)
Mann C.
Ng C.
Akseer N.
Bhutta Z.A.
Borghi J.
Colbourn T.
Hernández-Peña P.
Malik M.A.
Martinez-Alvarez M.
Munthali S.
Salehi A.S.
Tadesse M.
Yassin M.
Berman P.
Rannan-Eliya R.
Brearley L.
Friedman H.
Ravishankar N.
Cortes R.
Mtei G.
Publisher(s)
BioMed Central Ltd.
Abstract
Background: Countdown to 2015 (Countdown) supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs) 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies. Methods: This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania), supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed. It also examines the effect of other contextual factors presented in the case studies to help interpret health-financing data. Results: Dramatic increases in health funding occurred since 2000, where the MDG agenda encouraged countries and donors to invest more resources on health. Most low-income countries relied on external support to increase health spending, with an average 20-64 % of total health spending from 2000 onwards. Middle-income countries relied more on government and household spending. RMNCH funding also increased since 2000, with an average increase of 119 % (2005-2010) for RMNH expenditures (2005-2010) and 165 % for CH expenditures (2005-2011). Progress was made, especially achieving MDG 4, even with low per capita spending; ranging from US$16 to US$44 per child under 5 years among low-income countries. Improvements in distal factors were noted during the time frame of the analysis, including rapid economic growth in Ethiopia, Peru, and Tanzania and improvements in female literacy as documented in Malawi, which are also likely to have contributed to MDG progress and achievements. Conclusions: Increases in health and RMNCH funding accompanied improvements in outcomes, though low-income countries are still very reliant on external financing, and out-of-pocket comprising a growing share of funds in middle-income settings. Enhancements in tracking RMNCH expenditures across countries are still needed to better understand whether domestic and global health financing initiatives lead to improved outcomes as RMNCH continues to be a priority under the Sustainable Development Goals.
Volume
16
Language
English
OCDE Knowledge area
Ciencias médicas, Ciencias de la salud Políticas de salud, Servicios de salud
Scopus EID
2-s2.0-84986877634
PubMed ID
Source
BMC Public Health
ISSN of the container
14712458
Sponsor(s)
All costs for the writing and publication of this paper were provided through a sub-grant from the U.S. Fund for UNICEF under the Countdown to 2015 for Maternal, Newborn and Child Survival grant from the Bill & Melinda Gates Foundation, and from the Government of Canada, Foreign Affairs, Trade and Development. This article has been published as part of BMC Public Health Volume 16 Supplement 2, 2016: Countdown to 2015 country case studies: analysing progress towards maternal and child survival in the Millennium Development Goal era. The full contents of the supplement are available online at http://bmcpublichealth.biomedcentral.com/articles/supplements/ volume-16-supplement-2.
Sources of information: Directorio de Producción Científica Scopus