The correlation of health spending and infant mortality rate in Asian countries

Abstract

INTRODUCTION Rapid economic growth and significant increase in the literacy rate among Asian countries has spurred a desire and demand for greater state health spending and more accountability from policy makers. The health scenario in terms of vital indicators such as Infant Mortality Rate (IMR) is not uniform in the region. A study which analyzed government spending on health and public health indicators suggested that public health spending had an important influence upon health and particularly upon infant mortality. 1 A study on state health expenditure and IMR in India also showed similar results. 2 High income countries and countries with access to natural resources like oil, spend a greater proportion of their wealth on providing and building a robust health infrastructure. Low income countries have not accorded the same degree of prioritization to health and their dividends in terms of health outcomes are mixed. The marginal return on health expenditure in high-income countries is low, whereas that in low-income countries is comparatively high. 3 Western democracies have an higher Human Development Index and better parameters in terms of mortality rates in particular and health in general. In Asia however, governance models range from democracies, monarchies, communism to autocratic regimes, therefore people are not always able to voice their opinions, aspirations or preferences through a ballot. This has sometimes resulted in skewed health spending. Wealth is also unevenly distributed in Asia, Middle Eastern monarchies and the Asian tiger economies in South East Asia have much higher per capita incomes and have resulted in an imbalance on health parameters. A study used data from 133 low and middle income ABSTRACT Background: Infant Mortality Rate (IMR) is one of the most vital health indicators. A number of factors impact and influence IMR. One of the most important ones could be public health spending. Health spending however is not uniform throughout Asia and varies from region to region. Methods: Data obtained from the World Health Organization and World Bank Databases were used to assess the effect of state health spending on IMR. Factors such as per capita spending on health, proportion of GDP directed at health and private spending as a percentage of total health spending and their influence on IMR were also studied. Results: Data from 34 Asian countries was included in the study. Singapore (2) and South Korea (3) had the least IMR in the region. Afghanistan (71) had the highest IMR and also the least per capita governmental spending on health and Qatar the highest spending on health. Conclusion: Per capita state spending on health was the most important determinant of IMR in our study and countries with higher per capita spending on health had significantly lower levels of IMR.