Showing papers by "Osondu Ogbuoji published in 2019"

Trends in global health financing

Abstract: Low income countries are still unable to fund a basic package of health services

Middle-income countries graduating from health aid: Transforming daunting challenges into smooth transitions

Abstract: Gavin Yamey and co-authors discuss approaches to providing support for middle-income countries transitioning away from health aid.

How many child deaths can be averted in Nigeria? Assessing state-level prospects of achieving 2030 sustainable development goals for neonatal and under-five mortality.

Abstract: Background: Nigeria’s neonatal mortality rate (NMR) and under-five mortality rate (U5MR) are 39 per 1,000 and 120 per 1,000 live births, respectively. On average, 0.23 million neonates and 0.7 million under-five children die every year, but some states contribute more to this burden than others. If the country is to meet its sustainable development goal (SDG) targets for NMR and U5MR, it needs to make progress at both the national and subnational levels. Methods: Using the 2016-2017 Nigeria Multiple Indicator Cluster Survey (MICS), we estimated state-level neonatal and under-five mortality rates. Next, we estimated how long it would take for each state to reach the SDG targets for NMR and U5MR. Finally, we estimated the average number of neonatal and under-five deaths that could be averted between 2018 and 2030 in each state under different scenarios. Results: At current average annual rates of decline, Nigeria is unlikely to meet both sustainable development goals targets for NMR and U5MR. At the subnational level, some states are close to or have met both NMR and U5MR targets, while others are projected to meet the targets as late as 2088 (58 years delayed). Between 850,000 and 1.89 million neonatal deaths could be averted between 2018 and 2030, while 3.1 million to 5.96 million under-five deaths could be averted over the same period. Conclusions: Nigeria has the potential to achieve its SDG targets for NMR and U5MR, and in the process avert millions of preventable child deaths. But this will not happen under a business-as-usual approach. The NMR and U5MR trajectories achieved by high-performing states is evidence that achieving these SDG targets is possible. For the country to achieve positive results nationally, systems that encourage peer learning and transfer of technical expertise between states are needed.

Which delivery model innovations can support sustainable HIV treatment

Abstract: The rapid scale-up of antiretroviral treatment (ART) for HIV since the mid-2000s, mostly through disease-specific or “vertical” programmes, has been a highly successful undertaking, which averted m...

A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date?

Abstract: Background: Achieving universal health coverage (UHC) requires increased domestic financing of health by low-income countries (LICs) and middle-income countries (MICs). It is critical to understand how much governments have devoted to health from their own sources and how much growth might be realistic over time. Methods: Using data from WHO’s Global Health Expenditure Database, we examined how the composition of current health expenditure changed by financing source and the main sources of growth in health expenditures from 2000-2015. We also disaggregated how much growth in government expenditures on health from domestic sources was due to economic growth, growth in the tax base, reallocations in government expenditures towards health, and the interactions of these factors. Results: Lower MICs (LMICs) and upper MICs (UMICs), as a group, saw a significant reduction in out-of-pocket expenditures and a significant growth in government expenditures on health from domestic sources as a share of current health expenditures over the period. This trend indicates likely progress in the pathway to UHC. For LICs, these trends were much more muted. Growth in government expenditure on health from domestic sources was driven primarily by economic growth in LICs, LMICs, and UMICs. Growth in government expenditure on health due to a strengthened tax base was most important in UMICs. For high-income countries, where economic growth was relatively slower and tax bases were already strong, the largest driver of growth in government expenditure on health from domestic sources was reallocation of the government budget towards health. Conclusions: Given these findings from 2000-2015, discussions about a government’s ability to reallocate to health from its overall budget need to be evidence based and pragmatic. Dialogue on domestic resource mobilization needs to emphasize overall economic growth and growth in the tax base as well as the share of health in the government budget.