Masaryk University, Brno, Czechia.
Glob Health Res Policy. 2021 Feb 3;6(1):4. doi: 10.1186/s41256-020-00176-x.
Foreign aid has been shown to be favourably biased towards small countries. This study investigated whether country size bias also occurs in national malaria policy and development assistance from international agencies.
Data from publicly available sources were collected with countries as observational units. The exploratory data analysis was based on the conceptual framework with socio-economic, environmental and institutional parameters. The strength of relationships was estimated by the Pearson and polychoric correlation coefficients. The correlation matrix was explored by factor analysis.
Malaria burden is strongly correlated with GDP per capita, total health expenditure per capita, HDI; moderately with latitude, weakly with elevation, urban population share, per capita funding from the Global Fund, PMI USAID, UK government and UNICEF. Small country status is strongly correlated with population size, land area, island status; moderately with development assistance received per capita, weakly with funding per capita from Global Fund, government NMP and PMI USAID. Policy score 1, a variable derived from our factor analysis and related to malaria endemicity, is significantly strongly correlated with the malaria burden, moderately with HDI, GDP per capita, total health expenditure per capita, PMI USAID funding; weakly with island status, urban population share, latitude, coastal population share, total government expenditure and trade openness, Global Fund funding, World Bank funding, UK government funding, and UNICEF funding per capita. Policy score 2, which captures variation not related to malaria endemicity, is significantly weakly related to the ICRG index, PMI USAID funding per capita and small country status.
The results suggest that malaria burden and economic development are bidirectionally related. Economic development can contribute to a reduction in the malaria burden. Country size does not negatively impact malaria burden, but it does account for greater development assistance per capita from selected international agencies. National malaria policy is associated with parameters related to public governance and is modified in small countries. Small country bias is present in the distribution of socio-economic resources and the allocation of foreign aid. Small countries are characterized by distinct environmental and socio-political properties.
有研究表明，对外援助对小国更为有利。本研究旨在探讨国家规模是否也会影响国际机构的国家疟疾政策和发展援助。
以国家为观测单位，从公开来源收集数据。探索性数据分析基于包含社会经济、环境和制度参数的概念框架。使用 Pearson 和多项相关系数估计关系强度。使用因子分析探索相关矩阵。
疟疾负担与人均 GDP、人均总卫生支出、人类发展指数高度相关，与纬度中度相关，与海拔、城市人口比例、全球基金人均拨款、美国国际开发署 PMI、英国政府和儿基会人均拨款弱相关。小国地位与人口规模、领土面积、岛国地位高度相关，与人均发展援助中度相关，与全球基金人均拨款、政府国家疟疾规划和美国国际开发署 PMI 弱相关。政策得分 1，是我们的因子分析得出的与疟疾流行程度相关的变量，与疟疾负担显著高度相关，与人类发展指数、人均 GDP、人均总卫生支出、美国国际开发署 PMI 资金中度相关；与岛国地位、城市人口比例、纬度、沿海人口比例、政府总支出和贸易开放度、全球基金资金、世界银行资金、英国政府资金和儿基会人均资金弱相关。政策得分 2，反映与疟疾流行程度无关的差异，与 ICRG 指数、美国国际开发署 PMI 人均拨款和小国地位显著低度相关。
结果表明，疟疾负担和经济发展是相互关联的。经济发展有助于降低疟疾负担。国家规模不会对疟疾负担产生负面影响，但会导致特定国际机构的人均发展援助增加。国家疟疾政策与与公共治理相关的参数相关，并在小国家中进行调整。在社会经济资源的分配和对外援助的分配中存在国家规模偏见。小国家具有独特的环境和社会政治属性。
