Which Demographic Quintile Benefits from Public Health Expenditure in Nigeria: A Marginal Benefit Analysis
Abstract
:1. Introduction
2. Literature Review
3. Data and Methods
- The eijs are the group’s percentages of overall service usage (number of people who visit a health facility in the health sector), indicating household behavior.
- Government behavior is reflected in the si, which is the share of public spending allocated to different types of services.
- How is endogeneity bias handled in the marginal benefit incidence analysis calculation? Both authors used the overall access rate means to derive the access rate in each quintile. Ajwad and Wodon use the leave-out mean as their right-hand side variable to eliminate endogeneity. Except for the quintile in which the relapse is complete, they regressed against the mean of the admission rates across all quintiles. Lanjouw and Ravallion, on the other hand, used an instrumental method to instrument the real mean, using the leave-out mean.
- Ajwad and Wodon used marginal benefit incidence analysis to constrain their estimates. Although Lanjouw and Ravallion disagree, they believe that removing the restriction will slant the numbers downward.
Analytical Technique (Marginal Benefit Analysis)
- The population was divided into equal-sized sections according to welfare standards. This made it possible to split the population into quintiles. More information was broken down by states, locales, and gender.
- Identification of the households that received government assistance (education and health). The Nigerian Living Standard Survey from 2018 served as the basis for this (NLSS). Additional data was acquired from hospitals visited and schools.
- The State Universal Basic Education Board (SUBEB) provided primary school information; the Post-Primary School Management Board (PPSMB) provided secondary school information; and the NCCoE, National Board for Technical Education (NBTE), and National Universities Commission provided tertiary school information (NUC).
- Information on primary healthcare was obtained from the Primary Health Care Development Agency (PHDA) of the southeast states, information on secondary healthcare from the Hospital Management Boards (HMB) of states, and information on tertiary healthcare from the Ministry of Health within the states. See Figure 1 for a map of Nigeria showing the area for analysis
- Data sets were matched while considering any potential biases in household data brought on by survey design, questionnaire format, and sample size. Using 2018 NLSS household data, we ranked persons in the southeast states based on household consumption per capita, and an exception was given to those who received benefits.
- The estimated cost of providing a service was determined by dividing government expenditure on the service by the total number of users of the service, and then dividing the estimated cost of providing quality service by the estimated price of providing the service to arrive at the average benefit from government expenditure on the service, using the methodology of Amakom (2012).
- Finally, a two-stage least square method was used to calculate the distributional spread of benefits across quintiles.
4. Results and Discussion
Beneficiaries of Health Expenditure across Quintiles in Southeast Nigeria
States | Abia | Anambra | Ebonyi | Enugu | Imo |
---|---|---|---|---|---|
Quintile 1 | 0.964 | 1.385 | 1.113 | 1.453 | 0.988 |
T—Stat | 2.515 | 2.335 | 2.449 | 2.262 | 1.558 |
Quintile 2 | 0.997 | 1.520 | 1.063 | 1.480 | 1.088 |
T—Stat | 1.644 | 2.521 | 2.277 | 1.734 | 1.785 |
Quintile 3 | 1.112 | 1.393 | 1.067 | 1.327 | 1.063 |
T—Stat | 2.559 | 3.060 | 2.446 | 1.555 | 2.466 |
Quintile 4 | 1.014 | 0.514 | 0.957 | 0.449 | 1.039 |
T—Stat | 1.875 | 1.768 | 1.788 | 2.150 | 1.908 |
Quintile 5 | 0.923 | 0.200 | 0.822 | 0.300 | 0.837 |
T—Stat | 6.619 | 1.997 | 5.992 | 3.908 | 8.282 |
Total | 5.010 | 5.012 | 5.021 | 5.008 | 5.015 |
States | Abia | Anambra | Ebonyi | Enugu | Imo |
---|---|---|---|---|---|
Quintile 1 | 1.015 | 1.068 | 0.964 | 1.074 | 0.995 |
T—Stat | 3.747 | 3.156 | 2.246 | 3.622 | 3.889 |
Quintile 2 | 0.927 | 1.117 | 1.016 | 1.076 | 1.015 |
T—Stat | 6.721 | 2.458 | 7.400 | 2.142 | 3.556 |
Quintile 3 | 1.115 | 0.979 | 1.015 | 1.065 | 1.023 |
T—Stat | 4.832 | 2.152 | 2.720 | 2.663 | 5.956 |
Quintile 4 | 0.879 | 0.973 | 0.891 | 0.993 | 1.057 |
T—Stat | 1.445 | 1.591 | 1.958 | 1.163 | 1.727 |
Quintile 5 | 1.066 | 0.863 | 1.117 | 0.793 | 0.913 |
T—Stat | 3.887 | 3.519 | 2.847 | 2.649 | 3.483 |
Total | 5.002 | 5.000 | 5.003 | 5.001 | 5.002 |
States | Abia | Anambra | Ebonyi | Enugu | Imo |
---|---|---|---|---|---|
Quintile 1 | 0.633 | 0.700 | 0.670 | 0.760 | 0.803 |
T—Stat | 2.246 | 2.934 | 1.705 | 2.450 | 3.177 |
Quintile 2 | 0.814 | 0.850 | 0.788 | 0.882 | 0.699 |
T—Stat | 3.208 | 1.776 | 2.012 | 1.499 | 2.803 |
Quintile 3 | 1.082 | 0.974 | 1.019 | 1.070 | 0.975 |
T—Stat | 4.525 | 2.167 | 2.456 | 2.886 | 3.850 |
Quintile 4 | 1.207 | 1.132 | 1.113 | 1.067 | 1.186 |
T—Stat | 4.648 | 2.360 | 2.829 | 1.996 | 4.485 |
Quintile 5 | 1.264 | 1.344 | 1.411 | 1.223 | 1.338 |
T—Stat | 4.613 | 3.926 | 3.258 | 4.165 | 3.615 |
Total | 5.001 | 5.001 | 5.002 | 5.001 | 5.001 |
- The instrument for the real mean is the leave-out mean area service rate.
- The t-ratios are the numbers in parentheses.
- Quintile 1 (very poor); quintile 2 (poor); quintile 3 (moderate); quintile 4 (rich); and quintile 5 (extremely wealthy).
5. Conclusions
Recommendations
Funding
Conflicts of Interest
References
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Abia State | |||
---|---|---|---|
Quintiles | Primary System | Secondary System | Tertiary System |
Poor | 19.9 | 18.5 | 16.3 |
Rich | 38.6 | 38.9 | 49.4 |
Benefit/Loss | −18.7 | −20.4 | −33.1 |
Anambra State | |||
Poor | 30.3 | 22.3 | 17 |
Rich | 14.2 | 36.7 | 49.5 |
Benefit/Loss | 16.1 | −14.4 | −32.5 |
Ebonyi State | |||
Poor | 21.2 | 20.3 | 15.8 |
Rich | 35.4 | 40.1 | 50.4 |
Benefit/Loss | −14.2 | −19.8 | −34.6 |
Enugu State | |||
Poor | 29.6 | 21.5 | 17.6 |
Rich | 14.8 | 35.7 | 45.8 |
Benefit/Loss | 14.8 | −14.2 | −28.2 |
Imo State | |||
Poor | 21.7 | 20.3 | 13.9 |
Rich | 37.4 | 39.4 | 50.5 |
Benefit/Loss | −15.7 | −19.1 | −36.6 |
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Ogujiuba, K.K. Which Demographic Quintile Benefits from Public Health Expenditure in Nigeria: A Marginal Benefit Analysis. Economies 2022, 10, 253. https://doi.org/10.3390/economies10100253
Ogujiuba KK. Which Demographic Quintile Benefits from Public Health Expenditure in Nigeria: A Marginal Benefit Analysis. Economies. 2022; 10(10):253. https://doi.org/10.3390/economies10100253
Chicago/Turabian StyleOgujiuba, Kanayo K. 2022. "Which Demographic Quintile Benefits from Public Health Expenditure in Nigeria: A Marginal Benefit Analysis" Economies 10, no. 10: 253. https://doi.org/10.3390/economies10100253