Economics, School of Economics, Finance and Accounting, Faculty of Business and Law, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Health Policy Plan. 2017 Dec 1;32(10):1437-1448. doi: 10.1093/heapol/czx125.
Studies on global health and development suggest that there is a strong correlation between the burden of disease and a country's level of income. Poorer countries tend to suffer more deaths from preventable causes such as communicable, maternal, perinatal and nutritional conditions, compared with high-income countries. In low-income countries, the government health expenditure share in the general government budget is low and out-of-pocket payments for healthcare relatively high. They also rely heavily on external resources for health funding, yet sustainability of external resource flows is not guaranteed. This article explores increasing public healthcare funding from domestic resources mobilization, and evaluates the impact of measures to achieve this on sectoral growth and poverty reduction rates in Uganda using a dynamic computable general equilibrium model. This article shows that increasing the government health budget share, facilitates expanded healthcare services, improved population health, higher sectoral growth and reduced poverty. The agricultural sector is predicted to post the highest growth when compared with services and industry sectors under both domestic taxation and aid funding scenarios, while national poverty is predicted to decline from 31 to 12% of the population by 2020. This article demonstrates that the most effective measure is to frontload investment in healthcare and generate additional domestic funding for health from a household tax earmarked for health.
全球健康与发展研究表明，疾病负担与国家收入水平之间存在很强的相关性。与高收入国家相比，较贫穷国家往往因可预防的原因（如传染病、孕产妇、围产期和营养状况）而导致更多人死亡。在低收入国家，政府卫生支出占政府总预算的份额较低，而用于医疗保健的自费支出相对较高。这些国家还严重依赖外部资源来为卫生提供资金，但外部资源流动的可持续性无法得到保证。本文探讨了从国内资源调动中增加公共医疗保健资金，并利用动态可计算一般均衡模型评估乌干达为实现这一目标而采取的措施对部门增长和减贫的影响。本文表明，增加政府卫生预算份额有助于扩大医疗服务、改善人口健康、促进部门增长和减少贫困。与国内税收和援助供资情景下的服务业和工业部门相比，农业部门的增长预计是最高的，而到 2020 年，全国贫困人口预计将从占总人口的 31%下降到 12%。本文表明，最有效的措施是为医疗保健预先投资，并从专门用于卫生的家庭税中为卫生筹集额外的国内资金。
