Can sugar taxes be used for financing surgical systems in Nigeria? A mixed-methods political economy analysis.

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Health policy and planning Pub Date : 2024-05-15 DOI:10.1093/heapol/czae021
Martilord Ifeanyichi, Cyril Dim, Maeve Bognini, Meskerem Kebede, Darshita Singh, Obinna Onwujekwe, Rachel Hargest, Rocco Friebel
{"title":"Can sugar taxes be used for financing surgical systems in Nigeria? A mixed-methods political economy analysis.","authors":"Martilord Ifeanyichi, Cyril Dim, Maeve Bognini, Meskerem Kebede, Darshita Singh, Obinna Onwujekwe, Rachel Hargest, Rocco Friebel","doi":"10.1093/heapol/czae021","DOIUrl":null,"url":null,"abstract":"<p><p>This study determined the feasibility of investing revenues raised through Nigeria's sugar-sweetened beverage (SSB) tax of 10 Naira/l to support the implementation of the National, Surgical, Obstetrics, Anaesthesia and Nursing Plan, which aims to strengthen access to surgical care in the country. We conducted a mixed-methods political economy analysis. This included a modelling exercise to predict the revenues from Nigeria's SSB tax based on its current tax rate over a period of 5 years, and for several scenarios such as a 20% ad valorem tax recommended by the World Health Organization. We performed a gap analysis to explore the differences between fiscal space provided by the tax and the implementation cost of the surgical plan. We conducted qualitative interviews with key stakeholders and performed thematic analyses to identify opportunities and barriers for financing surgery through tax revenues. At its current rate, the SSB tax policy has the potential to generate 35 914 111 USD in year 1, and 189 992 739 USD over 5 years. Compared with the 5-year adjusted surgical plan cost of 20 billion USD, the tax accounts for ∼1% of the investment required. There is a substantial scope for further increases in the tax rate in Nigeria, yielding potential revenues of up to 107 663 315 USD, annually. Despite an existing momentum to improve surgical care, there is no impetus to earmark sugar tax revenues for surgery. Primary healthcare and the prevention and treatment of non-communicable diseases present as the most favoured investment areas. Consensus within the medical community on importance of primary healthcare, along the recent government transition in Nigeria, offers a policy window for promoting a higher SSB tax rate and an adoption of other sin taxes to generate earmarked funds for the healthcare system. Evidence-based advocacy is necessary to promote the benefits from investing into surgery.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"509-518"},"PeriodicalIF":2.9000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095260/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health policy and planning","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/heapol/czae021","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

This study determined the feasibility of investing revenues raised through Nigeria's sugar-sweetened beverage (SSB) tax of 10 Naira/l to support the implementation of the National, Surgical, Obstetrics, Anaesthesia and Nursing Plan, which aims to strengthen access to surgical care in the country. We conducted a mixed-methods political economy analysis. This included a modelling exercise to predict the revenues from Nigeria's SSB tax based on its current tax rate over a period of 5 years, and for several scenarios such as a 20% ad valorem tax recommended by the World Health Organization. We performed a gap analysis to explore the differences between fiscal space provided by the tax and the implementation cost of the surgical plan. We conducted qualitative interviews with key stakeholders and performed thematic analyses to identify opportunities and barriers for financing surgery through tax revenues. At its current rate, the SSB tax policy has the potential to generate 35 914 111 USD in year 1, and 189 992 739 USD over 5 years. Compared with the 5-year adjusted surgical plan cost of 20 billion USD, the tax accounts for ∼1% of the investment required. There is a substantial scope for further increases in the tax rate in Nigeria, yielding potential revenues of up to 107 663 315 USD, annually. Despite an existing momentum to improve surgical care, there is no impetus to earmark sugar tax revenues for surgery. Primary healthcare and the prevention and treatment of non-communicable diseases present as the most favoured investment areas. Consensus within the medical community on importance of primary healthcare, along the recent government transition in Nigeria, offers a policy window for promoting a higher SSB tax rate and an adoption of other sin taxes to generate earmarked funds for the healthcare system. Evidence-based advocacy is necessary to promote the benefits from investing into surgery.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
尼日利亚能否利用糖税为外科手术系统提供资金?混合方法政治经济学分析。
本研究确定了将通过尼日利亚每升 10 奈拉的含糖饮料(SSB)税筹集到的收入用于支持国家外科、产科、麻醉和护理计划实施的可行性,该计划旨在加强该国外科护理的可及性。我们采用混合方法进行了政治经济学分析。其中包括一项建模工作,根据尼日利亚目前的税率预测其 SSB 税在 5 年内的收入情况,以及几种情况下的收入情况,如世界卫生组织建议的 20% 从价税。我们进行了差距分析,以探讨税收提供的财政空间与手术计划实施成本之间的差异。我们对主要利益相关者进行了定性访谈,并进行了专题分析,以确定通过税收为手术提供资金的机会和障碍。按照目前的税率,SSB 税收政策在第一年有可能产生 35 914 111 美元的收入,5 年内有可能产生 189 992 739 美元的收入。与 5 年调整后的手术计划成本 200 亿美元相比,该税收占所需投资的 1%。尼日利亚进一步提高税率的空间很大,每年可产生高达 107 663 315 美元的潜在收入。尽管改善外科护理的势头已经存在,但却没有将糖税收入专门用于外科手术的动力。初级医疗保健以及非传染性疾病的预防和治疗是最受欢迎的投资领域。医学界对初级医疗保健重要性的共识,以及尼日利亚最近的政府转型,为促进提高 SSB 税率和采用其他罪恶税为医疗保健系统创造专项资金提供了政策窗口。有必要开展以证据为基础的宣传,以推广投资外科手术的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
期刊最新文献
Conceptualising maternal mental health in rural Ghana: A realist qualitative analysis. Learning Analysis of Health System Resilience. Managing medicines in decentralisation: discrepancies between national policies and local practices in primary healthcare settings in Indonesia. What is the relationship between hospital management practices and quality of care? A systematic review of the global evidence. Development partner influence on domestic health financing contributions in Senegal: a mixed methods case study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1