PUBLIC HEALTH EXPENDITURES AND MATERNAL MORTALITY RATE: FURTHER EVIDENCE FROM NIGERIA
Keywords:
Health Expenditure; Mortality Rate; Poverty; Nigeria
Abstract
This study investigates the nexus between public health expenditure and health outcomes (using
maternal mortality as a proxy for the latter) for the period covering 1981-2014 in Nigeria. The
study employs Cointegration and error correction modeling procedure with its attendant
advantage of minimization spurious regression estimates, while providing long-run estimates at
the same time. The results from the analysis reveal that maternal mortality rate declines as both
public health expenditure and private health expenditure rise, suggesting that public health
expenditure does not crowd out private health financing within the Nigerian context. Poverty
rate was however found to contribute significantly to the rising rate of maternal mortality.
Finally, health-oriented official development assistance was found to have a negative but
insignificant impact on maternal mortality rate in Nigeria. Arising from the foregoing, we
recommend, among others, the need for policy makers to adopt a multi-pronged approach which
should include, but not limited to, the diversification of the productive base of the economy so as
to raise the revenue trajectory of the nation,economic status of women as well as guarantee the
provision of good quality facility-based delivery care system and ultimately reverse the rising
mortality rate in the country.
References
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Akinkugbe, O. and Afeikhena, J. (2006). Public health care spending as a determinant of health status: a panel data analysis for SSA and MENA. In Adenikinju, A, Olaniyan, O (eds.), Applied macroeconomics and economic development. Ibadan, University Press, Ibadan.
Akinkugbe, O. and Mohanoe, M (2009). Public Health expenditure as a determinant of health status in Lesotho. Social Work Public Health, 24: 131-147
Anyanwu, J.C. and Erhijakpor E.O. (2007): Health expenditure and Health Outcomes in Africa. Economic Research Working paper series. African Development Bank.
Anyanwu, J.C. and Erhijakpor, E.O.A. (2007). Health expenditures and health economics in Africa. African Development Bank Economic Research Working paper No 91. Available at: http://www.afdb.org/fileadmin/uploads/afdb.
Barenberg, J.A; Basu, D. and Soylu, C, (2015). The effect of public health expenditure on infant mortality: Evidence from a panel of Indian States, 1983-84 to 2011-12.University of Massachusetts Working Paper 2015-19.
Berger, M.C. and Messer, J. (2002). Public financing of health expenditure, insurance and health outcomes. Applied Economics 34(17), 2105-2114.
Brown, R. I., Durbin, J. and Evans, M. (1975). Techniques for testing the constancy of regression relationships overtime. Journal of the royal statistical society, 37, 149-163.
Burnside, C and Dollar, D (1998). Aid, the incentive regime and poverty reduction. The World Bank; Washington, D.C.
Carrin, G and Politi, C. (1995). Exploring the health impact of economic growth, poverty reduction, and public health expenditure. Tijdschrift voor Economic en Management, 40, 227-246.
Demery, L. and Walton, M (1998): Are poverty reduction and other 21st century social goals attainable? World Bank; Washington, D.C.
Enders, W. (1995). Applied Econometric Time series. New York: John Wiley.
14
Eneji, M.A, Dickson, V.J. and Onabe, J.B (2013). Health care expenditures, Health status and National productivity in Nigeria (1999-2012). Journal of Economics and International Finance, 5(7) : 258-272.
Engle, R.F. and Granger, C.W.J. (1987): Cointegration and error correction: Representation estimation and testing. Econometrica, 55:391-407
Farahani, M; Subramanian, S.V. and Canning, D (2010). Effect of State-level public spending on health on the mortality probability in India.Health Economics, 19(11): 1361-1376
Filmer, D. and Pritchett, L. (1999): Child mortality and public spending on health: how much does money matter?Social Science and Medicine, 49(10): 1309-1323
Granger, C.W.J. and Newbold, P. (1977). Time series approach to econometric model building, In: C.A. Sims, New Methods in Business Cycle Research: Proceedings from a conference, Federal Reserve Bank of Minneapolis.
Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80:223-255.
Igbinedion, S.O. (2010): The Challenges of poverty and reproductive health in Nigeria: meeting the millennium development goals, In: A Osuntokun, V. Ukaogo and A Odoemene (eds), Nigerian Studies: Readings in History. Society and Culture. New Jersey: Goldline and Jacobs Publishers.
Ilori, A.I.(2015) . Determinant of public health care expenditure in Nigeria: An error correction mechanism approach (1981-2014). Journal of Economics and Sustainable Development, 6(24) :7-17.
Johansen, S and Juselius, K. (1990). Maximum likelihood estimation and inference on cointegration -with applications to the demand for money. Oxford Bulletin of Economics and Statistics, 52: 169-210
Johansen, S. (1988): Statistical analysis of cointegrating vectors. Journal of Economic Dynamics and Control, 12:231-254
Khan, S.R. (1999). Do world bank and IMF policies work? Macmillan Press Ltd, Basingstoke and St. Martin‟s Press, Inc., New York.
Kim, T.K. and Lane, S.R. (2013). Government Health expenditure and public health outcomes: a comparative study among 17 countries and for US health care reform. America International Journal of Contemporary Research, 3(9): 8-13.
Nnabuihe, S.N, Etemike, L. and Odunze, N.T. (2015). Rural poor and rural health care in Nigeria: A consocial need for policy shift.European Scientific Journal,2 : 18-25
Obansa, S.A. J and Orimisan, A. (2013): Health care financing in Nigeria: Prospects and Challenges. Mediterranean Journal of Social Sciences, 4(1): 221-236
Pesaran, M.H. (1997). The role of economic theory in modeling the long-run. The Economic Journal, 10:178-191
Pickbourn, L. and Ndikumana, L (2016): The impact of the sectoral allocation of foreign aid on gender inequality. Journal of International Development, 28, 396-411
Rajkumar, A.S. and Swaroop, V. (2008). Public Spending and outcomes: does governance matter?Journal of Development Economics, 86:96-111
Sede, I.P. and Ohemeng, W.(2015). Social economic determinant of life expectancy in Nigeria (1980-2011).Health Economics Review, 5(2): Retrieved from: doi 10.1186/s13561-014-0037-z
15
Umoru, D. and Yaqub, J.O. (2013). Private and Public health capital expenditures in Nigeria: an empirical test of the relationship. American Academic and Scholarly Research Journal, 5 (1); 83-94.
Uzochukwu, B.S.C (2013): Health care financing: a review of the Nigerian situation. A paper presented at the Herfon Scientific Conference and General meeting, 24-26, March.
Wagner, A. (1883). Three extracts on public finance, in: R.A. Musgrave and A.T. Peacock (eds.) (1958), Classics in the theory of public finance, London: Macmillan
World Bank (2011): Nigeria Country Brief. Available at: www.worldbank.org
World Bank. Policy Research Working paper No 1864, Washington D.C.
World Health Organization (WHO) (2015): Trends in National Mortality: 1990 to 2015. Available at: http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/.
Zaidi, A.S.(2001). Structural adjustment and economic slowdown: Likely impact on health outcomes in Pakistan. In Imrana, Q.,Sen, K.and Nayar, K.R.(EDS.). Public Health and Poverty Reforms. Sage Publications, New Delhi.
Akinkugbe, O. and Afeikhena, J. (2006). Public health care spending as a determinant of health status: a panel data analysis for SSA and MENA. In Adenikinju, A, Olaniyan, O (eds.), Applied macroeconomics and economic development. Ibadan, University Press, Ibadan.
Akinkugbe, O. and Mohanoe, M (2009). Public Health expenditure as a determinant of health status in Lesotho. Social Work Public Health, 24: 131-147
Anyanwu, J.C. and Erhijakpor E.O. (2007): Health expenditure and Health Outcomes in Africa. Economic Research Working paper series. African Development Bank.
Anyanwu, J.C. and Erhijakpor, E.O.A. (2007). Health expenditures and health economics in Africa. African Development Bank Economic Research Working paper No 91. Available at: http://www.afdb.org/fileadmin/uploads/afdb.
Barenberg, J.A; Basu, D. and Soylu, C, (2015). The effect of public health expenditure on infant mortality: Evidence from a panel of Indian States, 1983-84 to 2011-12.University of Massachusetts Working Paper 2015-19.
Berger, M.C. and Messer, J. (2002). Public financing of health expenditure, insurance and health outcomes. Applied Economics 34(17), 2105-2114.
Brown, R. I., Durbin, J. and Evans, M. (1975). Techniques for testing the constancy of regression relationships overtime. Journal of the royal statistical society, 37, 149-163.
Burnside, C and Dollar, D (1998). Aid, the incentive regime and poverty reduction. The World Bank; Washington, D.C.
Carrin, G and Politi, C. (1995). Exploring the health impact of economic growth, poverty reduction, and public health expenditure. Tijdschrift voor Economic en Management, 40, 227-246.
Demery, L. and Walton, M (1998): Are poverty reduction and other 21st century social goals attainable? World Bank; Washington, D.C.
Enders, W. (1995). Applied Econometric Time series. New York: John Wiley.
14
Eneji, M.A, Dickson, V.J. and Onabe, J.B (2013). Health care expenditures, Health status and National productivity in Nigeria (1999-2012). Journal of Economics and International Finance, 5(7) : 258-272.
Engle, R.F. and Granger, C.W.J. (1987): Cointegration and error correction: Representation estimation and testing. Econometrica, 55:391-407
Farahani, M; Subramanian, S.V. and Canning, D (2010). Effect of State-level public spending on health on the mortality probability in India.Health Economics, 19(11): 1361-1376
Filmer, D. and Pritchett, L. (1999): Child mortality and public spending on health: how much does money matter?Social Science and Medicine, 49(10): 1309-1323
Granger, C.W.J. and Newbold, P. (1977). Time series approach to econometric model building, In: C.A. Sims, New Methods in Business Cycle Research: Proceedings from a conference, Federal Reserve Bank of Minneapolis.
Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80:223-255.
Igbinedion, S.O. (2010): The Challenges of poverty and reproductive health in Nigeria: meeting the millennium development goals, In: A Osuntokun, V. Ukaogo and A Odoemene (eds), Nigerian Studies: Readings in History. Society and Culture. New Jersey: Goldline and Jacobs Publishers.
Ilori, A.I.(2015) . Determinant of public health care expenditure in Nigeria: An error correction mechanism approach (1981-2014). Journal of Economics and Sustainable Development, 6(24) :7-17.
Johansen, S and Juselius, K. (1990). Maximum likelihood estimation and inference on cointegration -with applications to the demand for money. Oxford Bulletin of Economics and Statistics, 52: 169-210
Johansen, S. (1988): Statistical analysis of cointegrating vectors. Journal of Economic Dynamics and Control, 12:231-254
Khan, S.R. (1999). Do world bank and IMF policies work? Macmillan Press Ltd, Basingstoke and St. Martin‟s Press, Inc., New York.
Kim, T.K. and Lane, S.R. (2013). Government Health expenditure and public health outcomes: a comparative study among 17 countries and for US health care reform. America International Journal of Contemporary Research, 3(9): 8-13.
Nnabuihe, S.N, Etemike, L. and Odunze, N.T. (2015). Rural poor and rural health care in Nigeria: A consocial need for policy shift.European Scientific Journal,2 : 18-25
Obansa, S.A. J and Orimisan, A. (2013): Health care financing in Nigeria: Prospects and Challenges. Mediterranean Journal of Social Sciences, 4(1): 221-236
Pesaran, M.H. (1997). The role of economic theory in modeling the long-run. The Economic Journal, 10:178-191
Pickbourn, L. and Ndikumana, L (2016): The impact of the sectoral allocation of foreign aid on gender inequality. Journal of International Development, 28, 396-411
Rajkumar, A.S. and Swaroop, V. (2008). Public Spending and outcomes: does governance matter?Journal of Development Economics, 86:96-111
Sede, I.P. and Ohemeng, W.(2015). Social economic determinant of life expectancy in Nigeria (1980-2011).Health Economics Review, 5(2): Retrieved from: doi 10.1186/s13561-014-0037-z
15
Umoru, D. and Yaqub, J.O. (2013). Private and Public health capital expenditures in Nigeria: an empirical test of the relationship. American Academic and Scholarly Research Journal, 5 (1); 83-94.
Uzochukwu, B.S.C (2013): Health care financing: a review of the Nigerian situation. A paper presented at the Herfon Scientific Conference and General meeting, 24-26, March.
Wagner, A. (1883). Three extracts on public finance, in: R.A. Musgrave and A.T. Peacock (eds.) (1958), Classics in the theory of public finance, London: Macmillan
World Bank (2011): Nigeria Country Brief. Available at: www.worldbank.org
World Bank. Policy Research Working paper No 1864, Washington D.C.
World Health Organization (WHO) (2015): Trends in National Mortality: 1990 to 2015. Available at: http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/.
Zaidi, A.S.(2001). Structural adjustment and economic slowdown: Likely impact on health outcomes in Pakistan. In Imrana, Q.,Sen, K.and Nayar, K.R.(EDS.). Public Health and Poverty Reforms. Sage Publications, New Delhi.
Published
2019-06-27
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