Addressing malaria incidence in Africa through health care expenditure and access to basic sanitation services

Alfred Eboh, Aderonke Omotayo Adebayo
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Abstract

Abstract Background Malaria is a significant public health concern, particularly in sub-Saharan Africa. This study examined the impact of health care expenditure and access to basic sanitation services on malaria incidence in 28 selected African countries from 2000 to 2019. Methods The study was anchored on Health Production Function [HPF] model while General Panel Linear Model was adopted to examine the relationships between the variables. The retrospective research design was utilised. The statistical diagnostics tests were performed to check for multicollinearity, hereroskedasticity, normality and model specification using correlation matrix, Breusch Pagan/Cook Weisberg, Shapiro–Wilk and the Hausman specification. The hypotheses were tested at the 5% significance level and the analysis of the data was aided by the use of the STATA 13.0. Results Domestic Government General Health Expenditure [DGGHE] had a positive relationship with Malaria Incidence [MI], although it was not statistically significant [coefficient = 0.0454708, p -value = 0.604]. Out-Of-Pocket Health Expenditure [OOPHE] demonstrated a statistically significant positive association with MI [coefficient = 0.2839394, p -value = 0.009]. External Health Expenditure [EHE] showed a statistically significant negative relationship with MI [coefficient = − 0.1452344, p -value = 0.012]. Moreover, People using at least Basic Sanitation Services [PBSS] exhibited a statistically significant negative relationship with MI [coefficient = − 0.3854207, p -value = 0.000]. Conclusions The results suggested that while government health expenditure alone may not significantly impact malaria incidence, increased out-of-pocket expenditure and external health expenditure, as well as improved access to basic sanitation services, are associated with a higher likelihood of reducing malaria incidence in the selected African countries. Addressing malaria incidence in Africa requires a comprehensive approach that includes adequate government health care expenditure, reduction of out-of-pocket costs, increased external funding, and improved access to basic sanitation services. By implementing these recommendations, policymakers can make significant progress in reducing the burden of malaria and improving public health outcomes in affected African countries.
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通过保健支出和获得基本卫生服务,解决非洲疟疾发病率问题
疟疾是一个重要的公共卫生问题,特别是在撒哈拉以南非洲地区。本研究调查了2000年至2019年选定的28个非洲国家的医疗保健支出和获得基本卫生服务对疟疾发病率的影响。方法采用健康生产函数(HPF)模型,采用一般面板线性模型检验各变量之间的关系。采用回顾性研究设计。采用相关矩阵、Breusch Pagan/Cook Weisberg、Shapiro-Wilk和Hausman规范进行统计诊断检验,以检查多重共线性、方差、正态性和模型规范。假设在5%显著性水平下进行检验,数据分析使用STATA 13.0辅助。结果国内政府一般卫生支出(DGGHE)与疟疾发病率(MI)呈正相关,但无统计学意义[系数= 0.0454708,p值= 0.604]。自费医疗支出(OOPHE)与心肌梗死呈显著正相关[系数= 0.2839394,p值= 0.009]。外部卫生支出(EHE)与心肌梗死呈显著负相关[系数= - 0.1452344,p值= 0.012]。此外,至少使用基本卫生服务(PBSS)的人口与MI呈统计学显著负相关[系数= - 0.3854207,p值= 0.000]。结果表明,虽然政府卫生支出本身可能不会显著影响疟疾发病率,但在选定的非洲国家,自费支出和外部卫生支出的增加以及基本卫生服务可及性的改善与降低疟疾发病率的可能性较高有关。解决非洲疟疾发病率问题需要采取综合办法,其中包括充足的政府保健支出、减少自付费用、增加外部资金和改善获得基本卫生服务的机会。通过实施这些建议,决策者可以在受影响非洲国家减轻疟疾负担和改善公共卫生成果方面取得重大进展。
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