The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations
The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations
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DOI：
10.1016/j.socscimed.2016.12.016
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发表时间：
2017-02-01
影响因子：
5.4
通讯作者：
King, Lawrence
中科院分区：
文献类型：
--
作者：
Stubbs, Thomas;Kentikelenis, Alexander;King, Lawrence
国际货币基金组织（货币基金组织）的政策改革所谓的“条件”如何影响政府的卫生支出？我们收集了1995年至2014年国际货币基金组织项目的档案文件，以确定16个西非国家政府卫生支出条件的途径和影响。基于对数据的定性分析，我们发现，国际货币基金组织的政策改革减少了卫生投资的财政空间，限制了医生和护士的人员扩张，并导致卫生系统的预算执行挑战。此外，我们使用跨国固定效应模型来评估国际货币基金组织授权的政策改革和政府卫生支出之间的关系，调整混杂的经济和人口因素以及选择偏差。每增加一项具有约束力的国际货币基金组织政策改革，人均政府卫生支出就会减少0.248%（95%CI 0.435 - 0.060）。总的来说，我们的研究结果表明，国际货币基金组织的条件阻碍了实现全民健康覆盖的进展。(C)2016爱思唯尔有限公司版权所有
How do International Monetary Fund (IMF) policy reforms so-called 'conditionalities' affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI 0.435 to 0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage. (C) 2016 Elsevier Ltd. All rights reserved.