Scholarly works in Economics
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Item Efficiency of health systems in Sub-Sahara Africa: a comparative analysis of time varying stochastic frontier models(2016-06) Lawanson, A. O.; Novignon, J.The purpose of the current study was to estimate efficiency of health systems in sub-Sahara Africa (SSA) and to compare efficiency estimates from various time-varying frontier models. The study used data for 45 countries in SSA from 2005 to 2011 sourced from the Word Bank World Development Indicators. Parametric time varying stochastic frontier models were used in the analysis. Infant survival rate was used as the outcome variable, while per-capita health expenditure was used as main controllable input. The results show some variations in efficiency estimates among the various models. Estimates from the ‘true’ random effect model were however preferable after controlling for unobserved heterogeneity which was captured in the inefficiency terms of the other frontier models. The results also suggest a wide variation in the efficiency of health systems in sub-Sahara Africa. On average health system efficiency was estimated to be approximately 0.80 which implies resource wastage of about 0.20. Cape Verde, Mauritius and Tanzania were estimated to be relatively efficient while Angola, Equatorial Guinea and Sierra Leone were among the least performers in terms of health system efficiency. The findings suggest that the omission of unobserved heterogeneity may lead to bias in estimated inefficiency. The ‘true’ random effect model was identified to address the problem of unobserved heterogeneity. The findings also suggest a generally poor performance of health systems in terms of efficiency in the use of resources. While resource commitment to the health sector is critical, it is important to also ensure the efficient use of these resources. Improving the performance of institutions in the health sector may go a long way in improving the general health status of the African population.Item Health care financing in Africa: what does NHA estimates do reveal about the distribution of financial burden?(College of Medicine, University of Ibadan, and University College Hospital, Ibadan, Nigeria, 2013-04) Lawanson, A. O.This paper, utilized National Health Accounts framework to profile the health financing situation in Sub- Saharan Africa countries. While Africa accounted for less than 0.9 percent of global health spending, the region carried over 43% of global burden of communicable diseases. Thus financing of healthcare remained a core issue to most African countries. The highest burden of healthcare financing is shouldered by households, which accounted for between 72% and 99% of private sources. The public and external sources accounted for around 33% and 30% of total health expenditure, respectively. With high poverty incidence in the continent, households are easily exposed to catastrophic spending risk. Health financing reforms that emphasis pooling mechanism, especially social health insurance is therefore required. Deviance to the Alma Alta Declaration, which laid precedence on preventive healthcare, curative healthcare generally, dominated the allocation of healthcare resources. This has implication on the efficiency and effectiveness of healthcare delivery in African countries. Public facilities played a dominant role in the provision of healthcare, which is arguably supported by the need to achieve greater equity in healthcare delivery. However, with the growing wave of public-private partnership initiatives, it may be intuitively wise and efficient to increase private participation in healthcare provision.