Search Results (14)

This study assesses the effects of the COVID-19 pandemic on catastrophic health expenditures and income inequality in Benin. A microsimulation was calibrated to estimate the impact of the pandemic under three different shock scenarios: low, moderate, and severe. The analysis relies on secondary data from household living condition surveys. The results indicate that the COVID-19 crisis would lead to a significant average income loss of up to 20% and income inequality, while the number of households with catastrophic health expenditures would increase by 4%. More importantly, the findings reveal heterogeneous impacts across households, with urban residents, younger individuals, more educated households, and male-headed households experiencing the greatest income decline. These findings underscore the need for targeted health coverage and employment policies to better protect vulnerable populations in Benin in the face of future shocks. Full article

This study analyses the conditions under which co-opetition improves the supply of healthcare services in Benin. Using non-centralised administrative data from a sample of public and private health centres, we apply network theory and negative binomial regression to assess the extent to which competition affects collaboration between public and private healthcare providers. We found that competition reduces the degree of collaboration between private and public health providers. However, the COVID-19 pandemic significantly mitigated this effect, highlighting the potential for competition within the healthcare system without compromising social welfare. Notwithstanding that, we show that these benefits are not sustained over time. These findings have policy implications for the sustainability of health system financing in Africa, particularly by promoting sustainable financial mechanisms for the private sector and more inclusive governance structures. Full article

The study examines changes in household food security and identifies their key determinants in Zambia by comparing the pre-pandemic period to the COVID-19 pandemic period. Using nationally representative surveys from 2015 and 2021 and the coarsened exact matching (CEM) approach, 8650 households were matched for comparison. Two complementary food security measures are analysed using multinomial logit regression models: household expenditure share, representing economic vulnerability, and household dietary diversity score (HDDS), representing diet quality. The results show that household food expenditure share significantly increased from 53.8% to 61.4%, indicating increased economic vulnerability. Notably, household dietary diversity improved from 7.1 to 8.2 out of 12, indicating better dietary quality. Consistent determinants of food security—such as household size, education level, marital status, region, and employment—remained significant, but their protective effects weakened during the pandemic. Specifically, the protective effect of education declined, urban households became relatively more vulnerable, and wealthier households experienced minimal changes. The study recommends targeted interventions, including expanding social protection programmes for economically vulnerable households, supporting informal food markets, enhancing rural–urban food supply linkages, and promoting nutrition education to ensure diverse, affordable food access during crises. Full article

The COVID-19 pandemic intensified existing structural challenges in Africa, including poverty, weak healthcare systems, and fragile agricultural supply chains. Consequently, examining its effects remains a critical area of study. This research investigates the effect of food prices on the prevalence of malnutrition in the context of the COVID-19 pandemic in sub-Saharan Africa. The findings indicate a significant long-term relationship between the number of COVID-19 cases, food prices, and the prevalence of undernourishment. Specifically, increases in food prices are associated with a rise in undernourishment rates over the long term. These results are corroborated by estimations using Fully Modified Ordinary Least Squares (FMOLS). To mitigate malnutrition in the face of potential future health shocks, governments could create and operationalize food price stabilization funds to cushion against sharp increases in food prices. These funds can be used to subsidize key staples during periods of price volatility, ensuring affordability for vulnerable populations. Full article

This study seeks to identify the factors driving household food insecurity in Cameroon during the COVID-19 pandemic, examine the effects of coping strategies on household resilience, and explore complementarities among these strategies. We used data from the COVID-19 panel surveys conducted by the National Institute of Statistics of Cameroon. Three models are estimated: an ordered logit model for food insecurity factors, a logit model for the impact of coping strategies, and a multivariate probit model for complementarities. The findings reveal that food insecurity is exacerbated by conflict, socio economic shocks (e.g., loss of employment, crop theft), and price hikes. About 28.59% of households are resilient, mainly due to past savings, cash transfers, free food, and in-kind transfers. The study emphasizes the importance of social and governmental support to mitigate food insecurity during crises, and underscores the need for monitoring socio-economic conditions during pandemics and other crises. Full article

This paper investigates the implication of the COVID-19 pandemic on household food insecurity in Burkina Faso. We used data from the High-Frequency Phone Survey collected from the period June 2020 to June 2021 by the World Bank in collaboration with the National Institute of Statistics. To assess the persistence of food inadequacy, we estimated a dynamic linear probability model. Our results revealed that female and elderly household members were more likely to skip meals during the pandemic than their respective counterparts. For households that skipped a meal due to the pandemic, the likelihood of facing food insecurity in the subsequent month increased by 37 percent. Similarly, individuals who ran out of food in consecutive months were 0.28 times more likely to experience the same situation in the following month. While other shocks can cause food insecurity, the global health-related, economic, social, and information dimensions of COVID-19 created a distinctive and multifaceted form of food shortage that sets it apart from many other types of shock. These findings suggest the implementation of effective programs to respond to shocks and the mitigation effects experienced by most disadvantaged groups. Full article

In this paper, we utilize the 2019/20 Uganda National Household Survey data to answer three related questions: (i) To what extent did out-of-pocket payments (OOPs) for health care services exceed the threshold for household financial catastrophe amidst COVID-19? (ii) What is the impoverishing effect of OOPs for health care services on household welfare? (iii) What are the socioeconomic and demographic determinants of OOPs for health care services in Uganda? Leveraging three health expenditure thresholds (10%, 25%, and 40%), we run a Tobit model for “left-censored” health expenditures and quantile regressions, and we find that among households which incur any form of health care expense, 37.7%, 33.6%, and 28.7% spend more than 10%, 25%, and 40% of their non-food expenditures on health care, respectively. Their average OOP budget share exceeds the respective thresholds by 82.9, 78.0, and 75.8 percentage points. While, on average, household expenditures on medicine increased amidst the COVID-19 pandemic, expenditures on consultations, transport, traditional doctors’ medicines, and other unbroken hospital charges were reduced during the same period. We find that the comparatively low incidence and intensity of catastrophic health expenditures (CHEs) in the pandemic period was not necessarily due to low household health spending, but due to foregone and substituted care. Precisely, considering the entire weighted sample, about 22% of Ugandans did not seek medical care during the pandemic due to a lack of funds, compared to 18.6% in the pre-pandemic period. More Ugandans substituted medical care from health facilities with herbs and home remedies. We further find that a 10% increase in OOPs reduces household food consumption expenditures by 2.6%. This modality of health care financing, where households incur CHEs, keeps people in chronic poverty. Full article

The modern world is confronting interconnected challenges, such as achieving sustainable health system financing for poverty reduction, amid limited guidance for stakeholders. Adhering to SDG-3 guidelines for good health and well-being could aid in accomplishing SDG-1 for eradicating poverty. This roadmap requires scientific validation. Therefore, this study aims to investigate the effect of out-of-pocket health expenditure (OOPHE) and government health expenditure (GHE) on poverty in sub-Saharan Africa (SSA) using Fully Modified Ordinary Least Squares (FMOLS) from 1990 to 2022. The results reveal that OOPHE increases poverty in the long run. In addition, the results also show that GHE augments poverty in the long run. Moreover, it is observed that GHE reinforces the positive impact of OOPHE on poverty in the long run. Additionally, the study’s empirical results support the conclusion that policymakers should advocate for the effective management of government health expenditure. Full article

The empirical findings of this study suggest a significant long-term relationship between the probability of mortality due to non-communicable diseases (NCDs) among individuals aged 30–70 in Azerbaijan and key economic and social indicators, including Gross Domestic Product per Capita, Waged Employment, Human Development Index, and out-of-pocket health expenditures. The Error Correction Model coefficient (−0.724701) implies that the system adjusts back to equilibrium at a rate of 72.47% per period, highlighting a strong corrective mechanism. Additionally, in the short run, GDP, HDI, wage employment, and out-of-pocket health expenditures significantly influence mortality rates. The model’s statistical diagnostics confirm its robustness, and the results align with economic theory, reinforcing their validity and policy relevance. According to the conclusion of this research, we suggest the enhancement of the HDI and Employment, control out-of-pocket expenditures, and increase Government Healthcare Spending to significantly reduce mortality rates. This study emphasizes that enhancing social determinants like the HDI, Waged Employment, and accessible healthcare services is crucial for reducing mortality rates of NCDs. While Azerbaijan’s economic growth has improved living standards, further efforts are necessary to improve healthcare investments and reduce inequalities in health outcomes. Full article

The European Commission’s 2015 aging report forecasts a substantial increase in public spending on Long-Term Care (LTC) for OECD countries by 2060, posing significant fiscal challenges. This study aims to assess the efficiency and productivity of the LTC sector from 2010 to 2019 and explore whether efficiency gains can alleviate these fiscal pressures. Using a non-parametric Data Envelopment Analysis (DEA) model, combined with Tobit regression, we estimate the efficiency of OECD countries and examine the role of decentralization in shaping performance outcomes. The findings reveal that, on average, countries operate at 94% efficiency, with modest productivity growth. However, technical inefficiencies persist, especially in unitary countries, while federal countries, though initially less efficient, show greater improvements over time. Despite these gains, the current efficiency levels are insufficient to counterbalance the projected increase in LTC demand. Policymakers should prioritize reforms that enhance efficiency through decentralization, promoting accountability and competition as mechanisms to sustain the LTC system in the face of demographic shifts. Full article

Background: The objective was to analyze the budgets invested in prisons by the member states of the Council of Europe (CoE) and the relationships between the global cost, the cost incurred per single inmate, the number of inmates per 100,000 inhabitants (PPR), the gross domestic product (GDP) and per capita GDP. Methods: The data relating to the variables considered for the year 2020 were obtained from the SPACE-I 2021 of the CoE, the World Bank/OECD, and Eurostat. Regression models were used to evaluate the relationships between the PPR and the GDP, the daily cost per prisoner and per capita GDP, and between the PPR and the per capita GDP. A multiple correspondence analysis was performed to evaluate associations between the PPR, EU membership, cost per day, cost rate, geographical area, and inmate gender. Results: The daily expenditure per inmate in northern European countries reaches very high values, respectively: EUR 330.6 (Norway) and EUR 303 (Sweden), while, in the eastern countries, the values drop sharply (EUR 6.50 in Bulgaria and EUR 8.08 in Azerbaijani). The lowest PPR values are found in northern European countries, and the highest in the following countries: Russia, Turkey, Georgia, and Azerbaijan. Conclusions: Countries with a higher GDP per capita tend to have lower prison population rates and to invest larger amounts of funds for prison systems. Full article

One of the worst natural, economic, and social catastrophes caused by human activity is the Aral Sea crisis in Central Asia. The Aral Sea’s desiccation, which has an impact on the region’s overall sustainable development, human welfare, security, and survival, is what led to the problem. This study assesses the effects of economic expansion, population ageing, life expectancy, internet usage, and greenhouse gas emissions on the fertility rate in the countries that made up the Aral Sea basin between 1990 and 2021. Several econometric techniques were used in this study, including Pooled OLS (Ordinary Least Squares) with the Driscoll–Kraay estimating method, FMOLS (Fully Modified Ordinary Least Square), and DOLS (Dynamic Ordinary Least Square). Additionally, we used the Hurlin and Dumitrescu non-cause tests to verify the causal links between the variables. The empirical findings verify that a decrease in the fertility rate among women in the nations surrounding the Aral Sea occurs when the population of a certain age (women aged 15–64 as a percentage of the total population) grows and life expectancy rises. Greenhouse gas emissions (GHGs) also have an adverse effect on reproductive rates. Conversely, the region’s fertility rate may rise as a result of increased internet usage and economic growth. Furthermore, this study indicates that certain variables—aside from greenhouse gas emissions (GHGs)—have a causal relationship with the fertility rate. Full article

In this paper, we focus on the sustainability of hospital care in The Netherlands from a labour market perspective. The continued increase in the demand for hospital care and the subsequent growth in the demand for hospital labour can cause permanent shortages of medical and nursing personnel, but can also affect labour conditions in other sectors of the economy. We analyse how the hospital sector put pressure on the labour market between 2000 and 2021 by applying a regression analysis to the share of hospital labour costs in the total economy on hospital production, wages and technical change. From the raw data, we observe a modest growth in hospital production over the whole research period. Strikingly, hospital wages underwent explosive growth compared to wages in other sectors of the economy in the same timeframe, seemingly disproving the hypothesis that hospital wages follow wages in other sectors. A worrisome result comes from the estimated Baumol parameter, which indicates that productivity growth in the hospital sector lagged significantly behind other sectors. This implies that the hospital sector, aside from developments in hospital care demand and hospital wages, is also causing a serious problem because of a low or negative productivity change. At this rate, we will stumble into the situation that the pressure of hospitals on the Dutch labour force will be doubled in the next decades. To avoid this situation, severe measures need to be taken, such as implementing incentives and sanctions to improve productivity. Full article

This paper employs the microdata of the Russia Longitudinal Monitoring Survey (RLMS-HSE) to discuss the impact of economic factors, such as household income and female wages, and subjective well-being, such as life satisfaction and health condition, on childbirth probability in Russia, which, following a continuous decline in birth rate throughout the 1990s, began to increase in the 2000s, and rose thereafter almost continuously. The following results were obtained: higher household incomes serve to encourage childbirth, while female wages are seen to act by curtailing childbirth, and when indicators such as life satisfaction and health condition are high, the likelihood of childbirth is increased significantly. Most previous research concerning the determinants of the birth rate in Russia has shown that household income has no effect at all, but the findings in this paper suggest that this may have been due to the special circumstances that existed at the beginning of the economic transformation period in the 1990s. Full article