Impacts of public health expenditures on health outcomes: infant mortality and under-five mortality rates in Kenya

IMPACTS OF PUBLIC
HEALTH EXPENDITURE
ON HEALTH OUTCOMES
IN KENYA

A Research Paper Submitted to the School of Economics, in Partial
Fulfillment of the Requirements for the Award of the Degree of Master of Arts (Economics) of the University of Nairobi.
Chris Shimba Ochieng
REG. No. X50/70144/2007

Supervisors:
Dr. Mugo
Dr. Nyandemo

Dedication
This paper is dedicated to my lovely twin boys Joash Chris and Josiah Chris who never lived to see my face or even to experience my love as I was far away studying in a foreign country and to my lovely daughter, Catina Jayden who came at the right time to wipe away my painful loss.

i

Declaration
This research paper is my original work and has not been presented for a degree award in any other university.

__________________________

____________________

Chris Shimba Ochieng

Date

The research paper has been submitted for examination with our approval as University supervisors ___________________________

____________________

Dr. Mercy Mugo

Date

______________________________

_______________

Dr. Samuel Nyandemo

Date

ii

Acknowledgement
Even though the writing of this paper is an individual’s endeavor, what goes into it, is a collaboration of many efforts. First and foremost, I wish to thank the Almighty God for seeing me through this academic journey and for giving me good health. I am greatly indebted to my supervisors Dr. Mugo and Dr. Nyandemo who made the research a real learning process through their valuable but firm comments, advice and guidance. I also extend my special thanks to Dr. Adekunle, for his intellectual assistance and support.

I wish to express my sincere gratitude to my parents; Mr. and Mrs. Robert Achieng, for the sacrifices they have made to enable me undertake this study. Your guidance, and efforts were not in vain and I now realize why you were so strict on me. A small but powerful voice speaking from a far, my

References: Akinkugbe, A. and Mohanoe M (2009). ‘Public health Expenditure as a determinant of Health Status in Lesotho,’ Social work in public, 24:1,131-147. Anyanwu, J. C and A.O. Erhijakpor (2008). ‘Health expenditures and health outcomes in Africa.’ Economic Research Working Paper series: African Development Bank. Bhalotra S (2007). ‘Spending to save? State health expenditure and infant mortality in India.’ Health Economics 16: 911-28. Bidani, B., Ravallion (1997). Decomposing social indicators using distributional data. Bera, A and Jarque, C M (1981). ‘Efficient Tests for Normality, Heteroskedasticity and Serial Independence of Regression Residuals: Monte Carlo Evidence,’ Economic Letters, Bloom D.E, Canning, D (2000). The health and wealth of nations, science 2000, 287, 1207-1209. Bokhari FAS, Gai. Y, Gottret P (2007). ‘Government health expenditures and health Outcomes.’ Health Economics 16: 257-73. Caldwell, J. C (1990) ‘Cultural and social factors influencing mortality levels in developing countries.’ The Annals of the American Academy 510, 44-59. Cochrane, A. L., St. Leger, A. S., and Moore, F. (1978), “Health Service Input and Mortality output in Developed Countries,” Journal of epidemiology and Community Cornia G.A., Mwabu G. (1997), “Health Status and Health Policy in Sub- Saharan Africa: A Long-Term Perspective” Discussion Paper, UNU/WIDER, Helsinki. Cremieux P.Y, P.Oullette and C. Pillon (1999). ‘Health care spending as determinants of health outcomes.’ Health economics 8(7), 627-639 David H.P, Kami K., Edward A and Gnanaraj C(1999). ‘Health expenditures, services and outcomes in Africa: Basic data and gross-national comparisons 1990-1996.’Human Desai, S., & Alva, S (1998). ‘Maternal education and child health: Is there a strong causal relationship?’Demography, 35(1), 71-81 matter?” Social Science and Medicine, 49, 1300-1323 Gani, A (2005) Glewwe, P. (1999). ‘Does mother’s schooling raise child health in developing countries? Evidence from Morocco.’ Journal of Human Resources, Vol Government of Kenya (2002) National development plan: Government Printer. Grossman, M (1972). ‘On the concept of Health Capital and the Demand for Health.’ Journal of Political Economy 80(2): 223-55. Gupta S, Verhoeven M and Tiongson E (1999): “Does higher government spending buy better results in education and health?” IMF Working Paper No Imam B.M (2003). ‘The determinants of Infant, Child, and Maternal Mortality in SubSaharan Africa,’ University of Pretoria, Masters in Commerce Essay, 58pp Kim, K., Moody, P Martin S, N. Rice and P. Smith (2007). ‘Does health care spending improve health outcomes? Evidence from English programme budgeting data.’ Health Economics 27: Mosley, W.H. and Chen, L.C. (1984). ‘An analytical framework for the study of child survival in developing countries.’ Population and Development Review, Vol Musgrove P., (1996), “Public and Private Roles in Health: Theory and Financing Patterns” World Bank Discussion Paper No Nixon, J and Ulmann, P (2006). ‘The relationship between healthcare expenditure and health outcomes.’ Health Economics 7: 7-18. Or, Z (2000b). ‘Determinants of health outcomes in Industrialized Countries: A pooled, cross-country, Time series Analysis.’ OECD Economic Studies No Republic of Kenya (2007) Economic Survey. Nairobi: Government Printer 45 Schultz, T. Paul, (1993), “Mortality Decline in the Low Income World: Causes and consequences, American Economic Review, 82: 337-342 Schultz (1984). ‘Studying the impact of Household Economic and Community Variables on Child Mortality.’ Population and Development Review, Vol The Tribune (2002) Reducing the infant mortality rate: A big challenge, perspective feature on the Editorial page, Sunday, 16 June, Chandigarh, India. UN (2004) Progress towards the millennium Development Goals, 1990-2004.Discussion Paper. UNDP (2003) Millennium Development Goals: A compact Among Nations to End Human Poverty United Nations; the Millennium Development Goals Report 2005 UN, New York; 2003 Wang L (2002) Determinants of Child Mortality in Low-Income Countries: Empirical White, H (1980) A heteroskedasticity-consistent covariance matrix and a direct test for heteroskedasticity Wolfe , B., (1986). ‘Health status and medical expenditures: is there a link?’Social Science and Medicine 22 (10), 993-999 World Bank (1993), World Development Report: Investing in Health. New York: Oxford University Press, New York. World Health Organization (2003), World Health Report 2003, Geneva. World Bank (2008) The world development Indicators (2008) Washington, DC: World Bank (Online) World Bank (2004) Attaining the millennium Development Unit, South Asia Region, World Bank: Washington D.C, 45-50. WHO (1978) Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, 19-22 June, 1946 No Zakir, M (1999). ‘Factors affecting infant mortality rates: evidence from cross-sectional data.’ Applied Economics Letters, 1999, 6, 271-273.