Does funding from donors displace government spending for health in developing countries?

Health Affairs

Volumn 28, Issue 4, 2009, Pages 1045-1055

  Farag, Marwa ^a   Nandakumar, A K ^b   Wallack, Stanley S ^a   Gaumer, Gary ^c   Hodgkin, Dominic ^a  

^a BRANDEIS UNIVERSITY   (United States)

^b BILL AND MELINDA GATES FOUNDATION   (United States)

^c SIMMONS COLLEGE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DEVELOPING COUNTRY; GOVERNMENT; HEALTH CARE; HEALTH CARE COST; HEALTH CARE FINANCING; HEALTH CARE SYSTEM; HEALTH PROGRAM; WORLD HEALTH ORGANIZATION;

DEVELOPING COUNTRIES; FINANCING, GOVERNMENT; HEALTH EXPENDITURES; INTERNATIONAL COOPERATION; MODELS, ECONOMETRIC;

EID: 67651210565     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.4.1045     Document Type: Article

References (40)

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9. Walle and Mu, "Fungibility and the Flypaper Effect."
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21. Shiffman, "Has Donor Prioritization of HIV/AIDS Displaced Aid for Other Health Issues?"
22. Pack and Pack, "Is Foreign Aid Fungible?"; and Pack and Pack, "Foreign Aid and the Question of Fungibility."
23. The data set is composed of all 193 WHO member states. We excluded forty-nine high-income countries to form the core data set used for these analyses. WHO, National Health Accounts, http://www.who.int/nha/en (accessed 20 July 2008).
24. WHO, Guide to Producing National Health Accounts with Special Applications for Low-Income and Middle-Income Countries, 2003, http://www.who.int/nha/docs/English-PG.pdf (accessed 22 April 2009).
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26. See Appendix 1, online at http://content.healthaffairs.org/cgi/content/ full/28/4/1045/DC1.
27. Gottret and Schieber, "Health Financing Revisited."
28. The data source permitted two different estimates of government health spending. We used both in the modeling work, and the results are quite similar. The first, which is the one we used, is total health spending (private health spending + donor spending). The second estimate is total health spending (out-of pocket spending + donor spending). Results of these models are available from the author; send e-mail to marwa@brandeis.edu.
29. Both results are statistically highly significant despite the relatively wide confidence intervals shown in Exhibit 3.
30. 2 was higher for the random-effects model (33 percent), we selected the fixed-effects model based on the Hausman test results.
31. R.J. Hagen, "Buying Influence: Aid Fungibility in a Strategic Perspective," Review of Development Economics 10, no. 2 (2006): 267-284.
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33. Gottret and Schieber, "Health Financing Revisited."
34. Ibid.
35. Organization for Economic Cooperation and Development, "Paris Declaration on Aid Effectiveness: Ownership, Harmonisation, Alignment, Results, and Mutual Accountability," 28 February-2 March 2005, http://www.oecd.org/ dataoecd/11/41/34428351.pdf (accessed 22 April 2009).
36. World Bank, Assessing Aid;
37. and Berg, "Increasing the Effectiveness of Aid."
38. Gottret and Schieber, "Health Financing Revisited."
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40. J. Clift, "Health and Development: A Compilation of Articles from Finance and Development" (Washington: International Monetary Fund, 2004).