Abstract
One of the Primary goals of developed countries is to provide sound health care services to its citizens as health is very important in the development of a nation. A nation which cannot provide healthcare services to its citizens cannot be expected to be productive hence justifying the importance of investing hugely on the health sector.
In Nigeria Health outcomes over the years have not been very impressive, justifying the need to establish the relationship between inefficiency in public spending on health care provision in Kebbi state. This study analyses the relationship between both variables over the period of 1990 to 2017 using econometric regression analysis and found out that a positive relationship exists between Public spending on health and health outcomes.
Chapter One Summary
The broad objective of this study is to establish the relationship between Public spending and health care provision in Kebbi state. In specific terms the researcher also intends to:
- To establish the exact relationship between Public spending and health care provision in Kebbi state.
- To determine the extent to which healthcare expenditures by government in Nigeria can be considered as efficient.
- To establish if the percentage of healthcare expenditure to other sectors in the Nigerian Government Budgets are insufficient.
- To recommend (if need be) the percentage of healthcare spending in Future budgets so as to achieve the desired level of health performances.
Chapter Two Summary
Public health expenditure consists of recurrent and capital spending from government(central and local) budgets, external borrowings and grants(including donations from international agencies and non-government organizations) and social(or compulsory) health insurance funds. While general government inefficiency in public spending comprises the direct outlays earmarked for the enhancement of the health status of the population and/or the distribution of medical care goods and services among population by the following financing agents: central/federal/ state/provincial/regional, and local/municipal authorities; extra budgetary agencies, social security schemes and parastatals. All can be financed through domestic funds or through external resources.
Life expectancy is the most common indicator of health conditions in a country, and Nigeria’s life expectancy was estimated as just 47.9 years in 2003, from 45.8 years in 1999 but fell to 47 years in 2011. This level is one of the lowest in the world, below those of Ghana put at 54.4 years and Cameroon put at 48 years in 2011. Contributing to Nigeria’s low life expectancy are high rates of HIV/AIDS infection, although these are lower than the catastrophic levels found in some other African countries. The 2003 HIV/AIDS infection rate which was 5.4 percent remained almost unchanged from the previous survey year.
Chapter Three summary
The theoretical base of this study is adopted from Grossman, M. (2001) which was later reviewed by Dolan ( 2003) and Pruckner (2010) who developed a theoretical health production function given as:
H= f(X) (i)
Where: H is a measure of individual health output and X is a vector of individual inputs to the health production function. Therefore, the elements of the vector includes: nutrient intake, income, consumption of public goods, education, time devoted to health related procedures, initial individual endowments like genetic makeup, and community endowments such as the environment. Grossman’s theoretical health production function model was designed for analysis of health production at micro level. The interest here is however, to analyze the production system at macro level, to switch from micro to macro analysis, without losing the theoretical ground. The elements of the vector X were represented by explanatory variables and regrouped into sub-sectoral vectors of economic, social and environmental factors as:
H = f(Y, S , V) (ii)
Where: Y is a vector of economic variables, S is a vector of social variables and V is a vector of environmental factors.
Chapter Four Summary
From Table 1, the average per capita income has the highest value, while HIV prevalence rate has the lowest average value. Since all variables exhibit positive range, it shows that the mean is normally distributed. The median value when the variables are arranged according to order of magnitude are the values of life expectancy and public health expenditure, being that they fall on the 3rd and 4th positions respectively. The value of per capita income has the highest value, while HIV prevalence rate has the smallest value. The values for life expectancy, public health expenditure, per capita income and urban population variables are positively skewed. However, the distribution of life expectancy has the longest tail, indicating that it has more extreme large values than others except infant mortality rate and HIV prevalence rate which are negatively skewed implying less extreme values.
In Table 2 above, the result indicates that a percentage increase in public health expenditure will lead to a 0.03% increase in life expectancy. The positive relationship between public health expenditure and life expectancy in Kebbi state can be largely attributed to the persistent increase in demand for improvements in health care services by the population. The coefficient of per capita income implies that on the average, a unit increase in per capita income increases life expectancy by 0.001%. As per capita income keeps increasing, it would reflect in the disposable income of the individuals and improve their access to healthcare services. Increased access to healthcare will also increase health status and improve life expectancy. There is a positive relationship between urban population and life expectancy. Holding all the other explanatory variables constant, on the average, a percentage increase in urban population will lead to an increase in life expectancy by 0.45%. The positive relationship can be largely attributed to the fact that residents in the urban areas tend to adopt improved health practices, due to their increased knowledge of the benefits of better health conditions, as compared to their counterparts in the rural areas and this accounts for the difference between concentration of health care services which are more in the urban areas than in the rural areas. The difference in healthcare concentration reveals the effect of urban population on improving life expectancy in Kebbi state. The coefficient of HIV prevalence rate of -0.51 is an indication that holding all other explanatory variables constant, on the average, a percentage increase in HIV prevalence rate reduces life expectancy by 0.51 percent. The reason for the negative relationship is because HIV is a virus that renders the human immune system weak and vulnerable due to the death and loss of anti-bodies in the cells, which leads to the entrance of various diseases and deterioration in health status. The deterioration in health status thereby reduces life expectancy in Kebbi state.
Chapter Five summary
The study investigates the relationship between Public health expenditure and Health outcomes in Nigeria. Using Life expectancy and infant mortality rate as proxy of Health outcomes while recognising the effects of other variables such as HIV prevalence, Per Capita Income, Urban population. These variables were considered to be able to capture the extent to which public expenditure is effective in improving health outcomes of individuals in Nigeria. It was discovered in the study that a positive relationship exist between Public Health expenditure and health outcomes in Nigeria, this means that an increased Public Expenditure will lead to better health outcomes and therefore inconsistencies in public inefficiency in public spending may not achieve better health outcomes as the only way to ensure increase in health outcomes is to invest in the health sector massively and consistently.
References
- Yaqub,J.O, Phd, Ojapinwa T.V., Yussuff R.O., Public Health Expenditure And Health Outcome In Nigeria. European Scientific Journal June edition vol. 8, No.13 ISSN: 1857 – 7881
- Mathias Agri Eneji , Dickson Vonke Juliana and Bisong John Onabe: Healthcare expenditure, health status and national productivity in Nigeria .Journal of economics and international finance, ISSN 2006-9812.
- Kareem, Rasaki O., 2Ademoyewa, Gbenga 1Fagbohun, Oyinkansola L. and 1Arije, Bunmi R. Impact of Federal Government’s Healthcare Expenditure on Economic Growth of Nigeria. Journal of Research in Business, Economics and Management (JRBEM) ISSN: 2395-2210 Volume 8,
- Prince C. Nwakanma, PhD Kelechi C. Nnamdi : Health Care Financing And Health Profile Of West African Countries, First Draft August 2013
- Ilori Isaac A. Olalere S. Sunday and Babatola M. Adeleye: An Empirical Analysis of Public Health Expenditure on Life Expectancy: Evidence from Nigeria. British Journal of Economics, Management & Trade 17(4): 1-17, 2017; Article no.BJEMT.31783 ISSN: 2278-098
- Lalitagauri Kulkarni: Health Inputs, Health Outcomes and Public Health Expenditure: Evidence from the BRICS Countries Kulkarni, International Journal of Applied Economics, 31(1), March 2016, 72-84
