Factors affecting health outcomes: case study of low and middle income countries

Abstract

The thesis entitled “Factors affecting Health Outcomes: Case Study of Lowand Middle-Income Countries” was aimed at investigating the factors influencing health outcomes in two dimensions: 1) Conventional health status, the indicator of which was the under-five morality rate per 1,000 live births and 2) Health equity, the indicator of which was the under-five morality rate per 1,000 live births in the wealthiest class divided by the under-five morality rate per 1,000 live births in the poorest group of the population in the country. Secondary data used in the analysis was collected from 1996 to 2015 from a pool of 139 low- and middle-income countries.

For conventional health status, balance panel data analysis was carried out using four groups of predictive factors. The first group was composed of public health system factors: the rate of improved rural sanitation facilities and the percentage of children aged 12-23 months with DPT immunization. The second group consisted of good governance factors: the government effectiveness index and the corruption control index. The third group consisted of financial factors: health expenditure per capita and the gross national income (GNI) per capita. The fourth group was the effective transition rate from primary to lower secondary general education for both sexes. This study revealed that these variables had panel cointegration (the long-run relationships). The random-effect test of the models produced results which were in line with the theories used in this research – preventive public health, corruption control, and the effective transition rate from primary to lower secondary general education for both sexes significantly reduced the under-five morality rate per 1,000 live births at a statistical significance level of 0.05.

ths at a statistical significance level of 0.05. With regard to health equity, this research employed multiple regression analysis, in which the variables were developed using the means of data from 2002- 2014. These variables consisted of the rate of improved rural sanitation facilities, the percentage of children aged 12-23 months with DPT immunization, the gross national income (GNI) per capita, the effective transition rate from primary to lower secondary general education for both sexes, the government effectiveness index, the corruption control index, and health expenditure per capita. Only the corruption control index had an influence on it, with statistical significance at 0.05.

The major findings of this research consisted of: 1) Corruption control was a key predictor of a reduction in the under-five mortality rate and improved health equity, 2) Preventive public health was a key factor affecting in a reduction in the under-five mortality rate, and 3) Health expenditure per capita had no impact on the under-five mortality rate or health equity. In addition, financially, only the gross national income (GNI) per capita resulted in a reduction in the under-five mortality rate.