Per capita income and public health expenditure: what makes good child health outcomes in Tanzania? a comparison of Frequentist and Bayesian approach (1995-2013)

Mwoya Byaro,Patrick Musonda

doi:10.14419/ijh.v5i1.7372

Abstract

Using data for World Bank Development Indicators (2015) database from 1995 to 2013, this paper explores the impact of public health expenditure on national health outcomes in Tanzania while GDP per capita and improved sanitation facilities as explanatory variables were controlled for. Two national health outcomes indicators namely, infant and under-five mortality were used as dependent variables. With separate modeling approach, Frequentist and Bayesian based on time series and Markov Chain Monte Carlo (MCMC) respectively, empirical evidence shows that income, represented by real GDP per capita lower infant and under-five mortality in Tanzania. Under both methodological approach regardless of the sample size, we failed to support evidence that, public health expenditure and improved sanitation facilities had an impact on child health outcomes. Our results imply that, public health spending in Tanzania is poorly targeted to bring good child health outcomes. The paper draws attention to policy makers in Tanzania to focus either within public health spending composition or beyond to other close determinants of infant and under-five mortality.

Highlights

The performance of a country health system lies with government (World Health Report, 2000)
Using data for World Bank Development Indicators (2015) in Tanzania for the years 1995-2013, first we present frequentist approach unit root tests for government health expenditure, real Gross Domestic Product (GDP) per capita, infant mortality, under-five mortality and improved sanitation facility's variables based on the Augmented Dickey-Fuller (ADF) test of non-stationarity
Previous studies that found no association between public health expenditure, infant and under-five mortality include, (Ssozi & Amlani, 2015,Deluna & Peralta, 2014, Musgrove, 1996, Filmer & Pritchett, 1999, Filmer & Pritchett, 1997, Burnside & Dollar, 1998, McGuire, 2006, Barlow & Vissandjee, 1999), among others has been attributed to misallocations of overall public health expenditure due to corruption, poor policy, low institutional quality, poor incentive environment and weak administration capacity (Filmer et al, 2000, Burnside & Dollar 1998)

Summary

Introduction

The performance of a country health system lies with government (World Health Report, 2000). Health system performance in many countries differs, as some countries perform well while others perform poorly (World Health Report, 2000). This implies that the primary goal of government financial resource (that is public health expenditure categories), and health care system is to improve the health of the population they serve (Kim & Lane, 2013; World Bank Report, 2000). Countries with similar level of development, public health spending differs greatly in health outcomes measures (World Health Report, 2000). Our primary question is what makes good health outcomes (infant and under-five mortality) between per capita income and public health expenditures in Tanzania? Our paper explores the relationship between health outcomes, per capita income and public health expenditures in Tanzania

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Discussion

Conclusion