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An Assessment of Domestic Financing for Reproductive, Maternal, Neonatal and Child Health in Sub-Saharan Africa: Potential Gains and Fiscal Space

Author

Listed:
  • Chris Atim

    (African Health Economics and Policy Association (AfHEA))

  • Eric Arthur

    (Kwame Nkrumah University of Science and Technology)

  • Daniel Malik Achala

    (African Health Economics and Policy Association (AfHEA))

  • Jacob Novignon

    (Kwame Nkrumah University of Science and Technology)

Abstract

Background Reproductive, maternal, neonatal and child health (RMNCH) remains an important public health objective. In sub-Saharan Africa (SSA), inadequate financial commitment continues to pose a major challenge to improving RMNCH outcomes. Understanding financing gains and potential fiscal space for RMNCH can therefore not be overemphasized. Objective This study sought to analyse the potential gains from increased domestic financing as a source for improving RMNCH outcomes in SSA. We also assessed, in addition to the potential gains, the potential fiscal space available for financing RMNCH in SSA. Methods Our study used panel econometric techniques to estimate gains from increased health financing in terms of RMNCH. We also reviewed tax system performance as well as debt sustainability to identify fiscal space potentials across countries. Results We found significant gains from both domestic and external financing. The estimated elasticities suggest that the gains from domestic public financing were much stronger. The fiscal space options identified include tax revenue performance improvements, improved public financial management, and borrowing, at least in the short to medium term. The results show that fiscal space from improved tax systems ranged from US$34.6 per capita in Uganda to US$310.6 per capita in Nigeria. Conclusion This result reinforces calls for increased domestic financing for health through innovations in domestic resource mobilization. Improving the performance of tax systems will be a step in the right direction, with possible long-term gains to the health sector.

Suggested Citation

  • Chris Atim & Eric Arthur & Daniel Malik Achala & Jacob Novignon, 2020. "An Assessment of Domestic Financing for Reproductive, Maternal, Neonatal and Child Health in Sub-Saharan Africa: Potential Gains and Fiscal Space," Applied Health Economics and Health Policy, Springer, vol. 18(6), pages 789-799, December.
    • Handle: RePEc:spr:aphecp:v:18:y:2020:i:6:d:10.1007_s40258-019-00508-0
    DOI: 10.1007/s40258-019-00508-0
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    References listed on IDEAS

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    1. Jacob Novignon & Solomon Olakojo & Justice Nonvignon, 2012. "The effects of public and private health care expenditure on health status in sub-Saharan Africa: new evidence from panel data analysis," Health Economics Review, Springer, vol. 2(1), pages 1-8, December.
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    3. Debasri Mukherjee & Elsy Thomas Kizhakethalackal, 2013. "Empirics of health-aid, education and infant mortality: a semiparametric study," Applied Economics, Taylor & Francis Journals, vol. 45(22), pages 3137-3150, August.
    4. World Bank, 2017. "World Development Indicators 2017," World Bank Publications - Books, The World Bank Group, number 26447, December.
    5. Mishra, Prachi & Newhouse, David, 2009. "Does health aid matter?," Journal of Health Economics, Elsevier, vol. 28(4), pages 855-872, July.
    6. Ensor, Tim & Ronoh, Jeptepkeny, 2005. "Effective financing of maternal health services: A review of the literature," Health Policy, Elsevier, vol. 75(1), pages 49-58, December.
    7. Jowett, Matthew, 2000. "Safe motherhood interventions in low-income countries: an economic justification and evidence of cost effectiveness," Health Policy, Elsevier, vol. 53(3), pages 201-228, October.
    8. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7222, eSocialSciences.
    9. Peter Okwero & Ajay Tandon & Susan Sparkes & Julie McLaughlin & Johannes G. Hoogeveen, 2010. "Fiscal Space for Health in Uganda," World Bank Publications - Books, The World Bank Group, number 5949, December.
    10. Mr. Peter S. Heller, 2005. "Understanding Fiscal Space," IMF Policy Discussion Papers 2005/004, International Monetary Fund.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 28th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-28 12:00:00

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