Effectiveness of public health spending: Investigating the moderating role of governance using partial least squares structural equation modelling (PLS-SEM).

IF 3.6 2区医学 Q1 HEALTH POLICY & SERVICES Health Research Policy and Systems Pub Date : 2024-07-08 DOI:10.1186/s12961-024-01159-x

Wa Ntita Serge Kabongo, Josue Mbonigaba

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Abstract

Background: The link between public health spending (PHS) and population health outcomes (PHO) has been extensively studied. However, in sub-Saharan Africa (SSA), the moderating effects of governance in this relationship are little known. Furthermore, studies have focused on mortality as the main health outcome. This study contributes to this literature by investigating the moderating role of governance in the relationship by simultaneously assessing three dimensions of governance (corruption control, government effectiveness and voice accountability) using disability-adjusted life years (DALYs) as a measure of outcomes.

Methods: The study applies the two-stage moderation approach using partial least squares structural equation modelling (PLS-SEM) to panel data from 43 SSA nations from 2013 to 2019. The study also uses domestic general government health expenditure (DGGHE) as an independent variable and disability-adjusted life years (DALY) as the dependent variable in this relationship.

Results: The analysis reveals that DGGHE affects DALY negatively and that governance improves the effect of DGGHE on DALY, with bigger improvements among countries with worse governance.

Conclusion: These findings provide evidence that good governance is crucial to the effectiveness of PHS in SSA nations. Sub-Saharan Africa (SSA) countries should improve governance to improve population health.

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公共卫生支出的有效性：利用偏最小二乘结构方程模型（PLS-SEM）研究治理的调节作用。

背景：公共卫生支出（PHS）与人口健康结果（PHO）之间的关系已得到广泛研究。然而，在撒哈拉以南非洲（SSA），人们对治理在这种关系中的调节作用知之甚少。此外，研究主要集中在作为主要健康结果的死亡率上。本研究采用残疾调整寿命年数（DALYs）作为衡量结果的指标，通过同时评估治理的三个方面（腐败控制、政府效率和发言权问责）来调查治理在这一关系中的调节作用，从而为这一文献做出贡献：本研究使用偏最小二乘结构方程模型（PLS-SEM）对 43 个撒哈拉以南非洲国家 2013 年至 2019 年的面板数据进行两阶段调节。研究还将国内一般政府卫生支出（DGGHE）作为自变量，将残疾调整生命年（DALY）作为这一关系中的因变量：结果：分析表明，DGGHE 对残疾调整寿命年数有负面影响，而治理可以改善 DGGHE 对残疾调整寿命年数的影响，治理较差的国家改善幅度更大：这些研究结果证明，良好的治理对撒哈拉以南非洲国家公共卫生服务的有效性至关重要。撒哈拉以南非洲（SSA）国家应改善治理，以提高人口健康水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Research Policy and Systems HEALTH POLICY & SERVICES-

CiteScore

7.50

自引率

7.50%

发文量

124

审稿时长

27 weeks

期刊介绍： Health Research Policy and Systems is an Open Access, peer-reviewed, online journal that aims to provide a platform for the global research community to share their views, findings, insights and successes. Health Research Policy and Systems considers manuscripts that investigate the role of evidence-based health policy and health research systems in ensuring the efficient utilization and application of knowledge to improve health and health equity, especially in developing countries. Research is the foundation for improvements in public health. The problem is that people involved in different areas of research, together with managers and administrators in charge of research entities, do not communicate sufficiently with each other.