A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations]
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 domestic sources and how much growth might be realist...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2021-08-01
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| Series: | Gates Open Research |
| Online Access: | https://gatesopenresearch.org/articles/3-5/v2 |
| _version_ | 1819067324861251584 |
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| author | Helen Saxenian Ipchita Bharali Osondu Ogbuoji Gavin Yamey |
| author_facet | Helen Saxenian Ipchita Bharali Osondu Ogbuoji Gavin Yamey |
| author_sort | Helen Saxenian |
| collection | DOAJ |
| description | 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 domestic 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 sources of growth in health expenditures from 2000-2015 across different income groups. We disaggregated how much growth in government expenditures on health from domestic sources was due to economic growth, growth in government spending as a share of GDP, and reallocations in government expenditures towards health. 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 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 increased government spending as a share of GDP was high in UMICs. For the high-income country group, where economic growth was relatively slower and government spending was already high with strong tax bases, the largest driver of growth in government expenditure on health from domestic sources was reallocation of the government budget towards health. Conclusions: Dialogue on domestic resource mobilization needs to emphasize overall economic growth and growth in the government spending as a share of GDP as well as the share of health in the government budget. |
| first_indexed | 2024-12-21T16:16:27Z |
| format | Article |
| id | doaj.art-4cdacac59aee458da902e660f204fd7b |
| institution | Directory Open Access Journal |
| issn | 2572-4754 |
| language | English |
| last_indexed | 2024-12-21T16:16:27Z |
| publishDate | 2021-08-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | Gates Open Research |
| spelling | doaj.art-4cdacac59aee458da902e660f204fd7b2022-12-21T18:57:41ZengF1000 Research LtdGates Open Research2572-47542021-08-01310.12688/gatesopenres.12900.214312A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations]Helen Saxenian0Ipchita Bharali1Osondu Ogbuoji2Gavin Yamey3The Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27708, USAThe Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27708, USAThe Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27708, USAThe Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, NC, 27708, USABackground: 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 domestic 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 sources of growth in health expenditures from 2000-2015 across different income groups. We disaggregated how much growth in government expenditures on health from domestic sources was due to economic growth, growth in government spending as a share of GDP, and reallocations in government expenditures towards health. 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 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 increased government spending as a share of GDP was high in UMICs. For the high-income country group, where economic growth was relatively slower and government spending was already high with strong tax bases, the largest driver of growth in government expenditure on health from domestic sources was reallocation of the government budget towards health. Conclusions: Dialogue on domestic resource mobilization needs to emphasize overall economic growth and growth in the government spending as a share of GDP as well as the share of health in the government budget.https://gatesopenresearch.org/articles/3-5/v2 |
| spellingShingle | Helen Saxenian Ipchita Bharali Osondu Ogbuoji Gavin Yamey A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations] Gates Open Research |
| title | A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full | A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_short | A quantitative analysis of sources of changes in government expenditures on health, 2000 to 2015: what can we learn from experience to date? [version 2; peer review: 1 approved, 2 approved with reservations] |
| title_sort | quantitative analysis of sources of changes in government expenditures on health 2000 to 2015 what can we learn from experience to date version 2 peer review 1 approved 2 approved with reservations |
| url | https://gatesopenresearch.org/articles/3-5/v2 |
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