Impact of Government healthcare expenditure on malaria prevalence

In the previous article, a trend based analysis was done to present malaria prevalence incidences and risks. The aim of the study is to show that the prevalence of malaria is dependent on the health care expenditures by the Government. Therefore, in this case, the impact of expenditures by Government on malarial incidences has been assessed using inferential statistical analyses.

The analysis outcomes help the political members to strategize the capabilities of the present government in controlling malaria and implement new policy based interventions. This also helps the political strategists in planning needed expenditures and investments against malaria prevalence intervention techniques. In addition, efficient and effective expenditure gets planned from the outcome. Pharmaceutical and healthcare industries from the private sectors and foreign investors may also use this outcome to help the Indian government in malaria control expenditures.

Methodology

Inferential analysis of the impact of expenditures by the Indian government on malaria prevalence was done here on the basis of data collected from the time period of the year 2000 to 2015. The variables in this study were collected from the official site of the National Vector Borne Disease Control Program and Government database. Initially, trend-based statistics presented to show the increase or fall of public healthcare expenditure as % for a period 2009-2017. The trend-based assessment is done in case of current health expenditure in relation to domestic general government health expenditure and domestic private health expenditure.

The data collected for inferential analysis included correlation and regression statistics to show the impact of expenditure on the malaria prevalence.

Independent variables are:

  • % of total health expenditure.
  • % of health expenditure of gross domestic product (GDP).

Dependent variables

  • Total cases of and deaths from Malaria.

The trend in the financial support for the health sector

Trend of Public health expenditure (in crores) and Public expenditure on health as % of GDP (Ministry of health and family welfare, 2018)

The trend of Public health expenditure (in crores) and Public expenditure on health as % of GDP (Ministry of health and family welfare, 2018)

It is evident from the above graph that the expenditure on public health is increasing every year from 2009-2017. From 72,536 crores in 2009 the public health expenditure increased up to 2,13,719 crores in 2017 (Ministry of health and family welfare, 2018). However, a slight fluctuation in the public expenditure on health as % of GDP, but an overall increasing trend still present till 2017.

Thus, the government is efficiently using internal finances and foreign investments in controlling malarial deaths and cases. Healthcare is also a part of the expenditure as they provide treatment plans for malaria patients and control measures as precautions. Pharmaceuticals too help in the expenditure of the government of India with respect to research and development of modified drugs against malaria cases.

The trend for current expenditure on health (2000-2015)

Current expenditure on health (2000-2015) (Ministry of health and family welfare, 2018)

Current expenditure on health (2000-2015) (World Health Organization, 2017)

Current health expenditure (CHE) constitutes only recurrent expenditures for healthcare purposes net all capital expenditures. CHE as the % of Total Health Expenditure (THE) indicate the operational expenditures on the health care that impact the health outcomes of the population in that particular year. Therefore, current expenditure on health as a % of GDP for 2000–2015, whereby gross domestic product (GDP) remain stable since 2000, averaging 3.84% (World Health Organization, 2017). Domestic general government health expenditure and domestic private health expenditure remain stable over the years.

This implies an efficient expenditure by the Government of India for improving public health. In other words, stable domestic general government health expenditure and domestic private health expenditure responsible for stable current healthcare expenditure. Since the expenditures are also contributed by healthcare members and pharma, foreign members in these fields help in investments and support for controlling malarial cases.  CHE therefore not only comprises of government funds but also investments by domestic and foreign pharmaceutical and healthcare members.

Correlation between expenditures and malaria prevalence

The table below presents the correlation between expenditures by the government for public healthcare and cases of malaria.

Health expenditure, public (% of total health expenditure)
Health expenditure (% of GDP)
Total cases
Total deaths
Health expenditure, public (% of total health expenditure)
1
Current health expenditure (% of GDP)
-0.40998637 1
Total cases
-0.738294653 0.583715279 1
Total deaths
-0.527047685 0.005755005 0.649157552 1

The correlation value presents a significant relationship between health expenditure and cases of malaria and deaths from malaria. % of total health expenditure is inversely proportional to the total cases of malaria. This implies that higher the cases of malaria, lower is the expenditure. This is relevant from the previous article where with rising in expenditures there was a fall in cases of malaria and deaths from malaria. Similarly, healthcare expenditure as % of GDP too implied an inverse relationship to total cases of malaria and deaths from malaria. Thus, expenditures have a significant impact on the malaria prevalence and deaths from malaria.

Regression between expenditure and malaria cases

In the table below, regression statistics findings presented between % of total health expenditure and healthcare expenditure as % of GDP, and total cases of Malaria from 2000 to 2015.

Regression Statistics
R Square 0.549024331
Adjusted R Square 0.479643459
Co-efficient of Regression
  t Stat P-value
% of total health expenditure -2.79625 0.015138
Healthcare expenditure as % of GDP -0.33724 0.74132

Regression statistics show a higher value for adjusted R-square, implicating a high significance of % of total health expenditure and healthcare expenditure as % of GDP impacting cases of malaria. Moreover, the coefficient of regression implies that % of total health expenditure has a higher impact factor to the prevalence of malaria at p<0.05 and CI of 95%. On the other hand, healthcare expenditure as % of GDP shows poor significance to cases of malaria at p>0.05. However, since one variable has significance at p<0.05, it may be implied that expenditures by the government for public healthcare have a significant impact on the malaria prevalence.

Regression between expenditure and deaths from malaria

In the table below, regression statistics findings presented between % of total health expenditure and healthcare expenditure as % of GDP, and total cases of deaths from malaria from 2000 to 2015.

Regression Statistics
R Square 0.5814007
Adjusted R Square 0.5170008
Co-efficient of Regression
  t Stat P-value
% of total health expenditure 4.24910 0.00094
Healthcare expenditure as % of GDP -2.73394 0.01705

A high value for adjusted R-square (0.517), implicating a high significance of % of total health expenditure and healthcare expenditure as % of GDP impacting cases of deaths from malaria by 51.7%. Therefore, the coefficient of regression implies that % of total health expenditure has a significant impact on the cases of deaths from malaria at p<0.05 and CI of 95%. Similarly, healthcare expenditure as % of GDP shows significance to cases of malaria at p<0.05. Since both the independent values have significance over deaths from malaria at p<0.05, it may be implied that expenditures by the government for public healthcare have a significant impact on the prevalence of cases of deaths from malaria.

Healthcare expenditures impact on malaria prevalence

It was evident from the trend analysis performed in the previous article that, when expenditure towards public healthcare increases, the cases of malaria decreases. It is now evident that expenditures by the pharma and the healthcare as a part of total malarial expenditure in India significantly impacts malaria prevalence and deaths. Expenditures by government help pharmaceuticals in R&D to develop improved treatment methods to control malarial spread.

Expenditures also include awareness and education programmes by the government and healthcare institutions. This helps the public to adopt interventions to control malaria and other infectious diseases (World Health Organization, 2017). Healthcare expenditures also comprise of intervention strategies adopted by pharmaceuticals and government for better marketing and sales of drugs at remote locations of India. R&D expenditures by pharmaceuticals help develop advanced and new age drugs.

References

Diksha Tomer

Diksha Tomer

Research Analyst at Project Guru
She is a bachelor in Botany honours from Miranda House (Delhi University) and is pursuing her master’s in Plant Biotechnology at TERI SAS. She is a recipient of Hemendra Kothari Scholarship and her interests lie in the field of Bioinformatics and Biotechnology.
Diksha Tomer

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