Publication: Health Expenditures, Services and Outcomes in Africa
Loading...
Published
2010-04
ISSN
Date
2012-08-13
Editor(s)
Abstract
In the past thirty years, Sub-Saharan African countries have made remarkable improvements in health conditions and status. However, they still suffer from some of the worst health problems in the world, and AIDS is making conditions much worse than they will be otherwise. This study, health expenditures, services, and outcomes in Africa considers 48 countries of Sub-Saharan Africa and outlines broad patterns of health spending, service delivery, mortality, fertility and nutrition in the early to mid-1990s. The study focuses on how to better monitor progress and use information to identify problems and improve health outcomes within and among different African countries. Good information about inputs, processes and results in the health sector is vital for policymakers to make intelligent choices about health strategies and investments, and often is simply not available. For purposes of the study, countries were classified as lowest-income, low-income and middle-income categories. Over three quarters of the African countries are low income or even lowest income countries, and nearly all have weak health management systems.
Link to Data Set
Citation
“Peters, David H.; Kandola, Kami; Elemendorf, A. Edward; Chellaraj, Gnanaraj. 2010. Health Expenditures, Services and Outcomes in Africa. Africa Region Findings; No. 157. © World Bank. http://hdl.handle.net/10986/9459 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication Timor-Leste Health Sector Review : Meeting Challenges and Improving Health Outcomes(Washington, DC, 2006-10-06)The Timor-Leste health sector review describes the accomplishments made by the government of Timore-Leste in the health sector since it separated from Indonesia, and analyzes the challenges still facing the government moving forward. Infant and maternal mortality, and malnutrition, are still important battles. Underutilization of services, and poor quality of services when available, are also reasons for the poor health quality indicators. Improving the quality or effectiveness of health services is difficult. However, now that most of the basic health care infrastructure is in place, the time is right for the Ministry of Health (MOH) to develop a system to monitor and upgrade the quality of health care services, starting with public sector services. One initiative put forth is health education delivered through various channels, which would make households better aware of the risks associated with certain health conditions or symptoms and the importance of using the available health services from government and NGO facilities. A second type of potential intervention is the introduction of conditional cash transfers, whereby the Government pays a subsidy to households in exchange for certain behaviors beneficial to society, such as having their children immunized. Carrying out the various interventions described above would require that the Government increased its spending on health services further.Publication The Economic Costs of Noncommunicable Diseases in the Pacific Islands : A Rapid Stocktake of the Situation in Samoa, Tonga, and Vanuatu(World Bank, Washington, DC, 2013-09)There is increasing recognition that non-communicable diseases (NCDs) are an important international and development issue globally, undermining health gains and imposing financial and economic costs on governments and households. NCDs are an important health challenge in the Pacific. First, (NCDs) can impose large but often preventable health, financial, and economic costs on countries. This is particularly important in the Pacific, where government already finances and provides the bulk of health services. Second, risk factors in the Pacific are feeding a pipeline of potentially expensive-to-treat NCDs, including diabetes and heart disease, but governments are already fiscally constrained in how much more they can provide to the health system. Third, from a public health and public finance perspective, many of the NCDs are avoidable or their health and financial costs can at least be postponed through good primary and secondary prevention. This will require a more coherent approach to health system financing and to health system operations, more generally. Improving both allocative efficiency ("doing the right things") and technical efficiency ("doing things right") are critical strategies to improve health outcomes in a financially sustainable way in the resource-constrained Pacific.Publication Fiscal Space for Health in Uganda(World Bank, 2010-03-01)This report reviews performance of Uganda's health sector and assesses options for increasing total health spending and improving efficiency of health spending to improve health, nutrition, and population outcomes. Although Uganda's health outcomes are improving, the country is unlikely to achieve its national targets for health as well as the health related Millennium Development Goals (MDG) Uganda is faced with a high disease burden from communicable diseases; in addition, the country is witnessing a growing epidemic of non communicable diseases. The main conclusion of the report is that while Uganda needs to continue exploring ways to mobilize funding for health it needs to improve the efficiency of its health spending to maximize the health benefits for its population. Uganda could reap significant savings by improving management of human resources for health; strengthening procurement and logistics management for medicines and medical supplies; and by better programming of development assistance for health. Besides, Uganda needs to take proactive steps to mitigate growing pressure to increase health spending.Publication Ethiopia : Improving Health Service Delivery(World Bank, Washington, DC, 2009-08)This case study aims to identify how Ethiopia has adopted and implemented strategies to improve health services, including the factors that enabled and inhibited success across a meaningful range of health services for the period 1996-2006. Particular emphasis has been given to the impact of utilized strategies on the poor. This case study reviewed one 'primary strategy', decentralization in the form of devolution of authority to the regional level in 1996 and to the district (woreda) level in 2002, and seven 'corollary strategies' in the context of decentralization implemented at the subnational level. The study concludes that decentralization in the health sector is likely to be more effective when it is implemented as part of a broader government decentralization policy across sectors. Sequencing in implementing Ethiopia's decentralization strategy made decentralization more manageable, although decentralization was rolled out prematurely. Moreover, the effectiveness of implementation was found to be driven largely by the institutional and management capacity at the subnational level. At the subnational level, decentralization was found to be more effective in those regions that increasingly strengthened their management and institutional capacity and where regional governments set priorities and adapted the strategies to local needs. However, decentralization was often influenced by the 'clientelistic' center, region power relationship, a problem compounded by the lack of community voice, making the available resources at risk of political capture by the local elite. Overall, the key lesson for implementing improvements in health service delivery (HSD) is that the lack of any critical inputs (facilities, health workers, and drugs) inevitably limits the overall impact of the strategy, and that the implementation of such key inputs should be carefully coordinated and properly synchronized.Publication Health Financing in Vanuatu : Challenges and Options(World Bank, Washington, DC, 2013-06)Population growth, an unfinished agenda of communicable diseases and maternal health and nutrition, and the rapid rise of Non-communicable diseases are putting increasing strain on not just the Ministry of Health budget, but also the broader financial position of the government as a whole. These pressures are ultimately financially unsustainable, given current and projected future economic conditions. But many of the health burdens and costs can be avoided, or at least delayed, with good primary and secondary prevention. There are practical options for making health financing in Vanuatu more effective, efficient, equitable, affordable, and accountable. Improving efficiency of public expenditure is a key to achieving this.
Users also downloaded
Showing related downloaded files
Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Morocco Economic Update, Winter 2025(Washington, DC: World Bank, 2025-04-03)Despite the drought causing a modest deceleration of overall GDP growth to 3.2 percent, the Moroccan economy has exhibited some encouraging trends in 2024. Non-agricultural growth has accelerated to an estimated 3.8 percent, driven by a revitalized industrial sector and a rebound in gross capital formation. Inflation has dropped below 1 percent, allowing Bank al-Maghrib to begin easing its monetary policy. While rural labor markets remain depressed, the economy has added close to 162,000 jobs in urban areas. Morocco’s external position remains strong overall, with a moderate current account deficit largely financed by growing foreign direct investment inflows, underpinned by solid investor confidence indicators. Despite significant spending pressures, the debt-to-GDP ratio is slowly declining.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication World Development Report 1994(New York: Oxford University Press, 1994)World Development Report 1994, the seventeenth in this annual series, examines the link between infrastructure and development and explores ways in which developing countries can improve both the provision and the quality of infrastructure services. In recent decades, developing countries have made substantial investments in infrastructure, achieving dramatic gains for households and producers by expanding their access to services such as safe water, sanitation, electric power, telecommunications, and transport. Even more infrastructure investment and expansion are needed in order to extend the reach of services - especially to people living in rural areas and to the poor. But as this report shows, the quantity of investment cannot be the exclusive focus of policy. Improving the quality of infrastructure service also is vital. Both quantity and quality improvements are essential to modernize and diversify production, help countries compete internationally, and accommodate rapid urbanization. The report identifies the basic cause of poor past performance as inadequate institutional incentives for improving the provision of infrastructure. To promote more efficient and responsive service delivery, incentives need to be changed through commercial management, competition, and user involvement. Several trends are helping to improve the performance of infrastructure. First, innovation in technology and in the regulatory management of markets makes more diversity possible in the supply of services. Second, an evaluation of the role of government is leading to a shift from direct government provision of services to increasing private sector provision and recent experience in many countries with public-private partnerships is highlighting new ways to increase efficiency and expand services. Third, increased concern about social and environmental sustainability has heightened public interest in infrastructure design and performance. This report includes the World Development Indicators, which offer selected social and economic statistics for 132 countries.