Conceptualizing monetary benchmarks for health investments toward poverty reduction in low- and lower middle-income countries.

Abstract

Public spending can improve population well-being, for example, by averting or reducing poverty. We aim to conceptualize monetary benchmarks for health sector investments oriented towards poverty alleviation in low- and lower middle-income countries. These benchmarks are meant to indicate the approximate range of health sector costs incurred to avert a single case of poverty across countries. Such conceptualizations could help identify the health interventions that are worthwhile investing in from financial risk protection and social welfare standpoints. We sourced secondary data from the World Bank for low-income and lower-middle-income countries over 2002-2019, including: per capita government expenditures on health, the proportion of a country's population living under the international poverty line ($1.90 per day, 2011 Purchasing Power Parity), and the features of national social protection programs whose primary intent is poverty reduction. We then examined the associations between poverty headcount and per capita government health spending to gauge the potential relationship between this spending and poverty reduction. Subsequently, we derived a range of plausible poverty reduction benchmarks (PRBs). We also computed the per capita costs of national poverty reduction programs so as to contrast these with the estimated range of PRBs. Priority setting in low- and lower-middle-income countries could be informed by health-sector PRBs, in addition to burden of disease and cost-effectiveness considerations. The computed PRBs, expressed in dollars per poverty case averted, can possibly be viewed in a manner akin to economic evaluation thresholds which are usually expressed in dollars per disability-adjusted life year averted.