This study examines the effect of cigarette prices on the likelihood of experimental smoking among adolescents in Sierra Leone. The study links data from the 2017 Global Youth Tobacco Survey (GYTS) ...to price data covering 2008–2017 obtained from the World Health Organization (WHO). After employing duration analysis techniques, we find that increases in cigarette prices are associated with a lower probability of smoking experimentation, with an estimated price elasticity of −1.63 (CI: −.24 to −3.02). Other factors affecting an adolescent’s decision to experiment with smoking are parental and friends’ smoking status, gender, exposure to tobacco advertising, and income. We conclude that higher prices, through excise taxation, are important tools for controlling smoking uptake among the youth of Sierra Leone.
ObjectiveMany smokers initiate smoking during adolescence. Making tobacco products less affordable is one of the best ways to control tobacco use. Studies on the effect of relative income price (RIP ...(ie, affordability)) of cigarettes on smoking initiation are scarce in low-income and middle-income countries, especially in Sub-Saharan Africa where data are limited. The goal of this study is to examine the effect of cigarette RIP on adolescent smoking initiation in Ghana.SettingThe study uses a pseudo-longitudinal data set constructed from the Global Youth Tobacco Surveys (GYTS (2000–2009 and 2017)) and RIP for the most sold cigarette brand in Ghana.ParticipantsThe GYTS is a national survey on adolescents.Primary and secondary outcomeEffect of RIP on adolescent smoking initiation in Ghana.ResultsUsing the GYTS 2000–2009 data, we find that the probability of smoking initiation falls significantly in response to a higher RIP, with an elasticity of −0.372 (95% CI −0.701 to −0.042) for the unmatched sample and −0.490 (95% CI −0.818 to −0.161) for the matched sample. The RIP elasticity for women ((−0.888) (95% CI −1.384 to −0.392) and (−0.928) (95% CI −1.434 to −0.422)) is statistically significant at 1% in both the unmatched and the matched samples, respectively, while the RIP elasticity for men is statistically insignificant in the 2000–2009 surveys. Analysis of the 2017 GYTS shows a similar outcome: a negative relationship between RIP and smoking initiation, and the results are statistically significant for both men and women, and for both matched and unmatched samples.ConclusionThe affordability (RIP) of cigarettes is negatively related to the probability of smoking initiation among adolescents in Ghana. Raising tobacco taxes in line with income growth would make cigarettes less affordable and dissuade adolescents from initiating smoking.
In Ghana, about 76% of households are at risk of drinking water polluted with faecal matter, hence, poor sanitation and unsafe water are responsible for 80% of all diseases in the country. Given ...this, some studies have been carried out concerning the factors that determine access and use of improved water among households in Ghana. However, although financial inclusion can make it easy for households to afford and hence, use improved water, it has received very little attention. This study, thus, examines the effect of financial inclusion on the use of improved water among households in Ghana.
The Ghana Living Standards Survey round 7 (GLSS7) is used as the data source while the binary logit regression is employed as the main empirical estimation technique.
The results show that households with financial inclusion (employing an indicator which has not been disaggregated into formal and informal financial inclusion) have a higher likelihood of using improved water sources relative to those without financial inclusion. The results are robust using formal financial inclusion as well as a combined index of financial inclusion.
Enhancing financial inclusion, especially formal financial inclusion can be utilised as a major policy instrument towards increasing access and use of improved water sources among households in Ghana.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This paper examines the factors influencing government health spending in Ghana with a particular focus on IMF conditionalities.
We estimate four simultaneous equations using three-stage least ...squares (3SLS) estimator. The data used cover the period 1980–2014.
After controlling for some other factors affecting government health spending, the results show that democracy and foreign aid significantly increase public sector health funding. IMF programs with its associated conditionalities insignificantly reduce public health spending Ghana.
This study provides important evidence on the impact of IMF conditionalities on health sector funding in Ghana. The results will serve as guide to policymakers when negotiating for IMF credit so that such arrangements do not obstruct health sector funding.
Overweight and obesity are major risk factors for noncommunicable diseases. This presents a major burden to health systems and to society in South Africa. Collectively, these conditions are ...overwhelming public healthcare. This is happening when the country has embarked on a journey to universal health coverage, hence the need to estimate the cost of overweight and obesity.
Our objective was to estimate the healthcare cost associated with treatment of weight-related conditions from the perspective of the South African public sector payer.
Using a bottom-up gross costing approach, this study draws data from multiple sources to estimate the direct healthcare cost of overweight and obesity in South Africa. Population Attributable Fractions (PAF) were calculated and multiplied by each disease's total treatment cost to apportion costs to overweight and obesity. Annual costs were estimated for 2020.
The total cost of overweight and obesity is estimated to be ZAR33,194 million in 2020. This represents 15.38% of government health expenditure and is equivalent to 0.67% of GDP. Annual per person cost of overweight and obesity is ZAR2,769. The overweight and obesity cost is disaggregated as follows: cancers (ZAR352 million), cardiovascular diseases (ZAR8,874 million), diabetes (ZAR19,861 million), musculoskeletal disorders (ZAR3,353 million), respiratory diseases (ZAR360 million) and digestive diseases (ZAR395 million). Sensitivity analyses show that the total overweight and obesity cost is between ZAR30,369 million and ZAR36,207 million.
This analysis has demonstrated that overweight and obesity impose a huge financial burden on the public health care system in South Africa. It suggests an urgent need for preventive, population-level interventions to reduce overweight and obesity rates. The reduction will lower the incidence, prevalence, and healthcare spending on noncommunicable diseases.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Out-of-pocket payment (OOPP) is reported to be a major barrier to seeking maternal health care especially among the poor and can expose households to a risk of catastrophic ...expenditure and impoverishment.This study examined the OOPPs women made during childbirth in the Upper West region of Ghana.
Methods
We carried out a cross-sectional study and interviewed women who gave birth between January 2013 and December 2017. Data on socio-demographic characteristics, place of childbirth, as well as direct cost (medical and non-medical) were collected from respondents. The costs of childbirth were estimated from the patient perspective. Logistics regression was used to assess the factors associated with catastrophic payments cost. All analyses were done using STATA 16.0.
Results
Out of the 574 women interviewed, about 71% (406/574) reported OOPPs on their childbirth. The overall average direct medical and non-medical expenditure women made on childbirth was USD 7.5. Cost of drugs (USD 8.0) and informal payments (UDD 5.7) were the main cost drivers for medical and non-medical costs respectively. Women who were enrolled into the National Health Insurance Scheme (NHIS) spent a little less (USD 7.5) than the uninsured women (USD 7.9). Also, household childbirth expenditure increased from primary health facilities level (community-based health planning and services compound = USD7.2; health centre = USD 6.0) to secondary health facilities level (hospital = USD11.0); while home childbirth was USD 4.8. Overall, at a 10% threshold, 21% of the respondents incurred catastrophic health expenditure. Regression analysis showed that place of childbirth and household wealth were statistically significant factors associated with catastrophic payment.
Conclusions
The costs of childbirth were considerably high with a fifth of households spending more than one-tenth of their monthly income on childbirth and therefore faced the risk of catastrophic payments and impoverishment. Given the positive effect of NHIS on cost of childbirth, there is a need to intensify efforts to improve enrolment to reduce direct medical costs as well as sensitization and monitoring to reduce informal payment. Also, the identified factors that influence cost of childbirth should be considered in strategies to reduce cost of childbirth.
Africa is estimated to lose a very significant number of high‐skilled individuals through emigration. This has resulted in a number of studies investigating the effect of high‐skilled emigration on ...socio‐economic indicators in Africa. Notwithstanding, the majority of these studies have examined the effect of high‐skilled emigration on economic growth, with less attention paid to health outcomes. Meanwhile, health outcomes, especially child health outcomes, have major implications for future human capital and overall economic development. With sub‐Saharan Africa (SSA) having the highest child mortality rate in the world, this study, therefore, investigates the effect of the emigration of high‐skilled individuals on child health in 48 African countries for the period, 1985–2010. Neonatal mortality and infant mortality rates are used to proxy child health. The panel fixed effects and the dynamic panel system Generalised Methods of Moments (GMM) regressions are employed as estimation techniques. Using the panel fixed effects, we find that, while the emigration of high‐skilled individuals is detrimental to neonatal mortality, in the case of infant mortality, it is insignificant. However, after controlling for endogeneity using the dynamic panel system GMM, the emigration of high‐skilled individuals is found to be detrimental to both neonatal mortality and infant mortality. The results suggest that, in order to enhance child mortality in Africa, attention should be paid towards decreasing high‐skilled emigration on the continent.
While most developing countries are devising strategies to attract more Foreign Direct Investment (FDI) inflows, the effect of FDI on sustainable economic development remains debatable, with very ...little known on its health effects. Using data from 1980 to 2018 on 43 African countries, this study therefore, investigates the effect of FDI on health outcomes (life expectancy and the death rate) by employing the panel fixed effects estimator. The study finds that, FDI improves health outcomes even after robustness checks using different estimator and specification. The implication is that, efforts toward attracting more FDI into Africa as well as making optimum use of the advantages that accompany FDI, should be deepened given its health enhancing effects.
Foreign direct investment (FDI) is generally viewed as a major supplement to domestic resources in economies all over the world. Given this, most countries including Ghana continue to devise ...strategies aimed at attracting more FDI inflows as well as reducing FDI outflows (positive net FDI inflows). This has led to several empirical studies examining the effects of FDI on development indicators. However, while FDI can affect population health, it has received very little attention especially in the case of Ghana. This study, therefore, uses annual time series data from 1975 to 2019 to examine the effect of net FDI inflows on population health (life expectancy and death rate) in Ghana. The ordinary least square (OLS) and the instrumental variable two‐stage least square (IV2SLS) estimators are employed as the empirical estimation techniques. The study finds that, net FDI inflows improve population health even after controlling for endogeneity. Thus, enhancing net FDI inflows can be used as an effective tool towards improving population health in Ghana.
This article examines the role of financial development and trade openness in promoting private investment in India. We use data (1960– 2013) from the World Development Indicators database. After ...checking the time series properties of the data, we employ auto-regressive distributed lag (ARDL) estimation technique to investigate the impact of the concurrent existence of financial development and trade openness on private investment and whether the effect of financial development is dependent on the level of openness. The results show that, independently, financial development and trade openness have significant positive effects on India’s private sector investment, in both the long run and the short run. However, the effect of the interaction between financial development and trade openness on private investment is significantly negative, suggesting that the effect of financial development on private investment depends on the level of openness. Therefore, we conclude that care should be taken in the design of policies that allow for the coexistence of financial development and trade openness if India aims at promoting private sector capital formation for job creation.
JEL Classification: E22, E44, F10, F60
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