Tandon, AjayFleisher, LisaLi, RongYap, Wei Aun2014-04-162014-04-162014-01https://hdl.handle.net/10986/17824Countries vary widely with respect to the share of government spending on health, a metric that can serve as a proxy for the extent to which health is prioritized by governments. World Health Organization (WHO) data estimate that, in 2011, health's share of aggregate government expenditure in the 170 countries for which data were available averaged 12 percent. However, country differences were striking: ranging from a low of 1 percent in Myanmar to a high of 28 percent in Costa Rica. Some of the observed differences in health's share of government spending across countries are unsurprisingly related to differences in national income. However, significant variations exist in health's share of government spending even after controlling for national income. This paper provides a global overview of health's share of government spending and summarizes key theoretical and empirical perspectives on allocation of public resources to health vis-a-vis other sectors from the perspective of reprioritization, one of the modalities for realizing fiscal space for health. Theory and cross-country empirical analyses do not provide clear, cut explanations for the observed variations in government prioritization of health. Standard economic theory arguments that are often used to justify public financing for health are equally applicable to many other sectors including defense, education, and infrastructure. To date, empirical work on prioritization has been sparse: available cross-country econometric analyses suggests that factors such as democratization, lower levels of corruption, ethnolinguistic homogeneity, and more women in public office are correlated with higher shares of public spending on health; however, these findings are not robust and are sensitive to model specification. Evidence from case studies suggests that country-specific political economy considerations are key, and that results-focused reform efforts, in particular efforts to explicitly expand the breadth and depth of health coverage as opposed to efforts focused only on government budgetary targets, are more likely to result in sustained and politically-feasible prioritization of health from a fiscal space perspective.en-USCC BY 3.0 IGOABILITY TO PAYABSENTEEISMACCOUNTABILITYADVERSE CONSEQUENCESAGGREGATE EXPENDITURESAGGREGATE SPENDINGALCOHOL CONSUMPTIONALLOCATIONALLOCATION CHOICESALLOCATIVE EFFICIENCYARTICLEBUDGET ALLOCATIONSBUDGET CONSTRAINTBUDGET CONSTRAINTSBUDGET RESOURCESBUDGET SUPPORTBUDGETARY ALLOCATIONSBUDGETARY CONSTRAINTSBUDGETARY POLICYBUDGETARY TARGETSCENTRAL GOVERNMENTCENTRAL GOVERNMENT BUDGETCHILD HEALTHCOMMUNICABLE DISEASESDATA ANALYSISDEBTDEBT CRISISDEBT INTERESTDEBT LIMITSDELIVERY SYSTEMSDEMOCRATIC GOVERNMENTSDEMOCRATIC SOCIETIESDEVELOPING COUNTRIESDONOR ASSISTANCEDONOR FINANCINGDONOR FUNDINGECONOMIC GROWTHECONOMIC REVIEWEFFECTS OF CORRUPTIONEFFICIENCY GAINSEFFICIENT ALLOCATIONSEXPENDITURE LEVELSEXPENDITURESEXTERNAL AIDEXTERNAL DEBTEXTERNALITIESFAMILIESFINANCESFINANCIAL BARRIERSFINANCIAL RESOURCESFINANCIAL SUSTAINABILITYFINANCING HEALTH CAREFISCAL CAPACITYFISCAL CONSTRAINTSFISCAL CRISISFISCAL HEALTHFISCAL IMPLICATIONSFISCAL POLICYFISCAL PRESSURESFREE CHOICEFUNGIBILITYGASOLINE TAXESGENERAL REVENUESGENERAL TAXESGOVERNMENT BUDGETGOVERNMENT BUDGETSGOVERNMENT EXPENDITUREGOVERNMENT EXPENDITURESGOVERNMENT POLICYGOVERNMENT REVENUEGOVERNMENT REVENUESGOVERNMENT SPENDINGGROWTH RATEHEALTH AFFAIRSHEALTH CAREHEALTH CARE COSTSHEALTH CARE FINANCINGHEALTH CARE SERVICESHEALTH COVERAGEHEALTH ECONOMICSHEALTH EDUCATIONHEALTH EXPENDITUREHEALTH EXPENDITURE PER CAPITAHEALTH EXPENDITURESHEALTH EXPENDITURES PER CAPITAHEALTH FINANCINGHEALTH INSURANCEHEALTH INSURANCE FUNDHEALTH INSURANCE SCHEMESHEALTH INTERVENTIONSHEALTH MANAGEMENTHEALTH MINISTRIESHEALTH ORGANIZATIONHEALTH OUTCOMESHEALTH POLICYHEALTH PROMOTIONHEALTH PROMOTION ACTIVITIESHEALTH REFORMHEALTH SECTORHEALTH SERVICESHEALTH SHAREHEALTH SYSTEMHEALTH SYSTEM PERFORMANCEHEALTH SYSTEMSHEALTH WORKERSHIGHER GOVERNMENT SPENDINGHIV/AIDSHOSPITALSHUMAN DEVELOPMENTINCOMEINCOME COUNTRIESINCOME ELASTICITYINCOME TAXINDEXESINFECTIOUS DISEASESINFLATIONINFORMAL SECTORINFORMATION ASYMMETRIESINSURANCEINSURANCE PREMIUMINSURANCE PREMIUMSINTEREST PAYMENTSINTERNATIONAL BANKINTERVENTIONINVESTINGLABOR MARKETSLEVELS OF PUBLIC SPENDINGLOW INCOMELOW-INCOME COUNTRIESMACROECONOMIC CONSTRAINTSMACROECONOMIC POLICYMARGINAL BENEFITMARKET FAILUREMARKET FAILURESMEDICAL BENEFITMEDICAL SERVICESMENTAL HEALTHMERIT GOODMILITARY EXPENDITURESMILITARY SPENDINGMONETARY POLICYMORTALITYMUNICIPAL GOVERNMENTSMUNICIPALITIESNATIONAL DEFENSENATIONAL HEALTHNATIONAL HEALTH INSURANCENATIONAL HEALTH INSURANCE FUNDNATIONAL INCOMENATURAL DISASTERNEGATIVE EXTERNALITIESNUTRITIONPAYROLL TAXPAYROLL TAXESPOLICY COMMITMENTSPOLICY RESEARCHPOLITICAL ECONOMYPOLITICIANSPRIMARY CAREPRIVATE GOODSPRIVATE SECTORPROGRAMSPROVISION OF HEALTH SERVICESPUBLIC CHOICEPUBLIC CHOICE THEORYPUBLIC DEBTPUBLIC DEMANDPUBLIC ECONOMICSPUBLIC EXPENDITUREPUBLIC EXPENDITURESPUBLIC FINANCEPUBLIC FINANCE THEORYPUBLIC GOODSPUBLIC HEALTHPUBLIC HEALTH SPENDINGPUBLIC POLICIESPUBLIC PROVIDERSPUBLIC RESOURCESPUBLIC SECTORPUBLIC SPENDINGQUALITY OF PUBLIC SPENDINGRECURRENT EXPENDITURESREFORM EFFORTSREFORM PROCESSRESOURCE ALLOCATIONSREVENUE INCREASESSANITATIONSHARE OF HEALTH SPENDINGSHARE OF PUBLIC SPENDINGSIZE OF GOVERNMENTSMOKINGSOCIAL BENEFITSSOCIAL HEALTH INSURANCESOCIAL INSURANCESOCIAL PROTECTIONSOCIAL SECURITYSOCIAL SECURITY SCHEMESOCIAL WELFARESTATE BUDGETTAX ADMINISTRATIONTAX EXPENDITURETAX REFORMTAX REVENUETAX REVENUESTOTAL EXPENDITURETOTAL SPENDINGTRUST FUNDTUBERCULOSISWORKERS10.1596/17824