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Countdown to 2015 country case studies: what can analysis of national health financing contribute to understanding MDG 4 and 5 progress?
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- Author(s): Mann, Carlyn1 ; Ng, Courtney1; Akseer, Nadia2; Bhutta, Zulfiqar A.3,4,5; Borghi, Josephine6; Colbourn, Tim7; Hernández-Peña, Patricia8; Huicho, Luis9,10,11; Malik, Muhammad Ashar3; Martinez-Alvarez, Melisa6; Munthali, Spy12; Salehi, Ahmad Shah6; Mekonnen Tadesse, Mekonnen13; Yassin, Mohammed13; Berman, Peter1; Tadesse, Mekonnen13 (AUTHOR); On behalf of the Countdown to 2015 Health Finance Working Group (CORPORATE AUTHOR); Countdown to 2015 Health Finance Working Group (CORPORATE AUTHOR)
- Source:
BMC Public Health. 9/12/2016, Vol. 16 Issue 1, p67-81. 15p. 3 Charts, 8 Graphs.- Subject Terms:
- Source:
- Additional Information
- Subject Terms:
- Subject Terms:
- 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. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of BMC Public Health is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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