Development assistance to achieve universal health care

This paper, utilizing National Health Accounts framework attempts a profile of the health financing situation Sub-Saharan Africa countries. While Africa accounts for less than 0.9 percent of global health spending, the region carries over 43% of global burden of communicable diseases. The households bear the highest burden of healthcare financing, accounting for between 72% and 99% of private sources. The public and external sources account for around 33% and 30% of total health expenditure, respectively. With high poverty incidence in the continent, households are easily exposed to catastrophic spending risk. This calls for health financing reforms that emphasis pooling mechanism, especially social health insurance. Deviance to the Alma Alta Declaration, which laid precedence on preventive healthcare, curative healthcare generally, dominates in the allocation of healthcare funds. This has implication on the efficiency and effectiveness of healthcare delivery in African countries. Public facilities play a dominant role in provision of healthcare, which is arguably supported by the need to achieve greater equity in healthcare delivery. However, with the growing wave of public-private-partnership initiatives, it may be intuitively wise and efficient to increase private participation in the provision of healthcare.

In the past decade, accelerated, yet insufficient progress in child mortality reduction to reach MDG 4 and a rapid increase in development assistance for health (DAH) to resource-poor settings for financing child health-related activities have been observed. Given the increase in DAH to child medical care from 1.67 billion in 2003 to 4.44 billion in 2010 (in constant 2010 US$), tracking of donor funding to child health is crucial for assessing aid effectiveness in improving child health.

This study provides new time-series cross-country estimates for global development assistance to child health with a new definition based on a demographic model of determinants of child survival over an extended time series from 1995 to 2010. Data comes from several sources, including the OECD's Creditor Reporting System. Unlike previous studies, we estimate aid from non-medical sectors, such as sanitation, food, and nutrition, which directly influence child health. Our study uses a multi-disciplinary approach to estimate DAH and improves the estimates in terms of their comparability and completeness. We conduct a descriptive study on the portion of assistance allocated to countries with the highest child mortality rates and expect to see an increase of DAH to child health both at the global level and in countries with high mortality rates.

Money, or the lack of it, is likely to be the deciding factor in meeting global health targets. Using panel data for 22 OECD/DAC countries over the period 1996-2007, this paper analyzes the determinants of donor funding for reproductive health activities. Much of the previous research on this subject found a strong positive correlation between donor funding and GDP of donor countries. I use disaggregated data on donor funding to account for the fact that relative importance of aid determinants is likely to vary across specific funding categories. The results strongly support the notion that it is important to differentiate between restricted (earmarked) and unrestricted (non-earmarked) funding. There is undoubtedly some discretion over both types of funding. Nevertheless, unrestricted funding seems to be more responsive to economic developments in donor countries as demonstrated by the strong positive correlation of this type of funding with GDP. Unrestricted funds are thus easier to increase or cut according to discretionary criteria. Restricted funding, on the other hand, can be viewed as more undeliberate or non-discretionary. This finding has an interesting implication with regard to items in donor aid budgets that could be particularly affected in times of economic crisis.