Papers by Akanni Lawanson
International Journal of Social Economics
PurposeThe purpose of this paper is to examine the determinants of catastrophic household health ... more PurposeThe purpose of this paper is to examine the determinants of catastrophic household health expenditure in Nigeria, with particular focus on Out-of-Pocket (OOP) health expenditure. Payments for healthcare through OOP are the major means of channeling funds to healthcare providers in many developing countries including Nigeria. It has great consequence on household well-being, especially when it is difficult for household to meet up with spending on other necessity goods.Design/methodology/approachThe demand for health theory provided the theoretical framework. The study used data from 2018/2019 Nigeria Living Standard Survey (NLSS) with catastrophic thresholds of 10 and 25%. A logistic regression model was used, while Pearson chi-squared test was used for models' goodness of fit.FindingsBased on the obtained result using Pearson chi-squared, at 10% threshold of total non-food expenditure, the likelihood of experiencing catastrophic health expenditure increased with secondar...
Journal of Innovation and Entrepreneurship, 2017
Entrepreneurial interest among the youth population is a panacea for unemployment especially due ... more Entrepreneurial interest among the youth population is a panacea for unemployment especially due to high turnout of educated individuals in the labour force. This paper provides findings on the factors that determine entrepreneurship interest among the youth population in Nigeria using the University of Ibadan as a case study. Empirical results on whether engagement in entrepreneurial activities interferes with academic performance; extent of involvement and gender differences are also presented. The logit and multinomial logit models were used to examine the factors that influence entrepreneurship interest and interference with academic performance, respectively. Descriptive statistics and the T test were employed in examining the extent of involvement and whether there is a statistically significant difference across gender. The results showed that subjective norm, perceived behavioural control and family business background significantly predicts students' interest in entrepreneurship. Engagement in entrepreneurial activity has no significant effect on students' academic performance. Findings suggest relatively low entrepreneurial engagement among students with significant differences across gender.
PLOS ONE
Background Cardiovascular diseases (CVDs) present a huge threat to population health and in addit... more Background Cardiovascular diseases (CVDs) present a huge threat to population health and in addition impose severe economic burden on individuals and their households. Despite this, there is no research evidence on the microeconomic impact of CVDs in Nigeria. Therefore, this study estimated the incidence and intensity of catastrophic health expenditures (CHE), poverty headcount due to out-of-pocket (OOP) medical spending and the associated factors among the households of a cohort of CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan, Nigeria. Methods This study adopts a descriptive cross-sectional study design. A standardized data collection questionnaire developed by the Initiative for Cardiovascular Health Research in Developing Countries was adapted to electronically collect data from all the 744 CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan between 4th November 2019 to the 31st J...
BMJ Global Health
IntroductionThere are concerns about the impact of the COVID-19 pandemic on the continuation of e... more IntroductionThere are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women’s, Children’s and Adolescents’ Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation.MethodsMonthly routine health facility data by district for the period 2017–2020 were compiled by 12 country teams and adjusted after extensive quality assessments. Mixed effects linear regressions were used to estimate the size of any change in service utilisation for each month from March to December 2020 and for the whole COVID-19 period in 2020.ResultsThe completeness of reporting of health facilities was high in 2020 (median of 12 countries, 96% national and 91% of districts ≥90%), higher than in the preceding years and extreme outliers were few...
African Journal of Health Economics, 2013
The financing of healthcare by government in Nigeria is complemented by contributions from the ho... more The financing of healthcare by government in Nigeria is complemented by contributions from the household, donor agencies, and the private sector. This paper examines the disparity in healthcare financing flows between the northern and southern regions of Nigeria and the implication for health outcomes. The paper uses data from the latest round of Sub-National Health Accounts for 17 states in Nigeria, from 2003 to 2005. The methodology was structured to give a complete accounting of all spending on health, regardless of the origin, destination, or object of the expenditure. The paper found that healthcare financing in the north is relatively lower, accompanied by significant poor health status, with heavy dependence on the households in both regions. The share of households in the north was proportionally disproportionate, because of the high poverty incidence visa -vis public providers. This raises equity concerns as those least able to pay were made to bear more burden. The stewardship role of the government has to increase in terms of funding health care, in the light of low income of majority of the people, especially in the north, if the health status of the populace is to improve. Without government being directly involved in the provision of healthcare services, attempt should be made to subsidise the private sector and increase regulatory capacities to improve the overall availability and accessibility of health services to the citizenry. The pooling mechanism approach is identified to be an appealing alternative to finance healthcare.
African Journal of Health Economics, 2015
Despite provisions for people in both formal and informal sectors are contained in the Nigerian N... more Despite provisions for people in both formal and informal sectors are contained in the Nigerian National Health Insurance Scheme as an alternative financial mechanism for healthcare, there has been a disproportionate focus on the formal sector. Central to the health insurance coverage is the determination of the premium paid by beneficiaries of the plan. While this is straightforward for people in the formal sector, the non-deterministic income base in the informal sector has made actuary determination of premium a challenge. Thus Community Based Health Insurance (CBHI) is designed to cater for the inclusion and uptake of the rural poor, subject to payment of the often arbitrarily prescribed premium. This paper investigates the willingness to pay (WTP) for CBHI and its determinants by the rural people of the Shonga and Afon communities of Kwara State. Using the CBHI scheme in Afon and Shonga communities of Kwara State, the paper applied the contingent valuation method (binding game format) and Probit regression to track the extent of WTP for the plan, and its determinants. Administering a pre-tested questionnaire, information was collected from a total of 220 households selected through a simple stratified random sampling method. Relative to N300 ($1.36) currently being charged participants as premium, the mean amount respondents are willing to pay is N720 ($3.27) with the minimum and maximum amounts being N200 ($0.91) and N5,000 ($22.73), respectively. Results from Probit regression revealed that WTP is significantly driven by age, gender, marital status, frequency of illness, and income level of respondents. Higher WTP is associated with males, the married and youthful respondents with more education and income, and higher frequency of illness. Given that the mean WTP is higher than the currently charged premium, there are indications that additional resources can easily be raised for the scheme. This points to viability of replicating the scheme in more communities across the country, and thus expands coverage. Extension of the scheme to other rural communities should be preceded with empirical analysis of amount the population is willing to pay for the scheme.
MPRA Paper, 2014
The purpose of the current study was to estimate efficiency of health systems in sub-Sahara Afric... more The purpose of the current study was to estimate efficiency of health systems in sub-Sahara Africa (SSA) and to compare efficiency estimates from various time-varying frontier models. The study used data for 45 countries in SSA from 2005 to 2011 sourced from the Word Bank World Development Indicators. Parametric time-varying stochastic frontier models were used in the analysis. Infant survival rate was used as the outcome variable, while per-capita health expenditure was used as main controllable input. The results show some variations in efficiency estimates among the various models. Estimates from the 'true' random effect model were however preferable after controlling for unobserved heterogeneity which was captured in the inefficiency terms of the other frontier models. The results also suggest a wide variation in the efficiency of health systems in sub-Sahara Africa. On average health system efficiency was estimated to be approximately 0.80 which implies resource wastage of about 0.20. Cape Verde, Mauritius and Tanzania were estimated to be relatively efficient while Angola, Equatorial Guinea and Sierra Leone were among the least performers in terms of health system efficiency. The findings suggest that the omission of unobserved heterogeneity may lead to bias in estimated inefficiency. The 'true' random effect model was identified to address the problem of unobserved heterogeneity. The findings also suggest a generally poor performance of health systems in terms of efficiency in the use of resources. While resource commitment to the health sector is critical, it is important to also ensure the efficient use of these resources. Improving the performance of institutions in the health sector may go a long way in improving the general health status of the African population
This paperprovides findings on cost burden of malaria in Nigeria. Cost computations were extrapol... more This paperprovides findings on cost burden of malaria in Nigeria. Cost computations were extrapolated to monthly income fraction and GDP lost to the illness. Results of the study are shown across different employment groups. Computations for indirect and direct costs were conducted using the Human capital and Bottom up approach respectively. The results show that one in two persons employed in the labour force will experience loss in labour contribution as a result of malariawith indirect cost of about N 5,532.59($37.16) and N 4,828.73 ($32.43) per person per day for the patient and care giver, respectively. Individuals spend approximately N 2,730.46($18.34) on the average for treatment of one bout of the illness which translates to approximately3% of monthly income. Overall, indirect and direct costs related to one episode of malaria in Nigeria sum up to approximately N1, 906.08 billion ($12,801.07 million) implying about 8% of GDP. GDP fraction lost to malaria is higher for the in...
— The paper investigated the funding pattern of healthcare in Nigeria based on the National Healt... more — The paper investigated the funding pattern of healthcare in Nigeria based on the National Health Accounts framework. Two rounds of National Health Accounts estimation covering the eight-year period, 1998-2005 were analyzed in this paper. The first round covering 1998-2002 was funded by donors and characterized by limited access to data, which accounted for its seeming underestimation. The second round funded by Federal Ministry of Health enjoyed access to wider data set, and allowed for state level sub- National Health Accounts estimates covering 17 out of 36 states of the federation. The estimates generally revealed that the households constitute the main source of financing healthcare in the Nigeria, accounting for over 66 % of Total Health Expenditure, while government contributes average of 29%. Though resource pooling through health insurance appreciably grew over the years, it is still at its infancy, contributing minimally to Total Health Expenditure. While the private faci...
African Population Studies, 2011
African Journal of Health Economics
African Population Studies, 2012
Changes in age structure that results from demographic transition have economic consequences. Thi... more Changes in age structure that results from demographic transition have economic consequences. This paper identifies the period of potential window of opportunity or demographic dividends created by Nigeria's demographic transition. This is done by simulating the period of the demographic window of opportunity in Nigeria. In a simulation covering 1950-2050 our results reveal that Nigeria entered the window of opportunity in 2003 and will last beyond year 2050. The highest benefit will accrue in years 2032 and 2033 when the dividend can account for more than 10% of the growth of GDP per capita even if the current performance scenario continues to exist. However, the paper notes that the demographic dividend is not automatically realized and Nigeria needs to embark on strategies that will develop her human capital and position her towards not only capturing the first dividend but the second dividend as well.
This paper examines the structure of financing the consumption of youths in Nigeria. Nigeria is c... more This paper examines the structure of financing the consumption of youths in Nigeria. Nigeria is currently in the middle of demographic transition with the implications that the structure of the resource flows from the surplus of the working age group to the dependent age group keeps changing calling for the need to understand the dynamics of the consumption and income flows if the economic lifecycle deficit in the country will be adequately financed. The methodological approach was grounded on the theoretical tool of overlapping generation’s model (OLG) and the analytical approach of the National Transfer Approach. The paper reveals that by year 2009, life cycle deficit is positive for Nigerians aged 29 to 60 years, and deficit for other age groups. The implication of this is that on the average, Nigerians younger than 29 years do not produce enough to finance their consumption. In order to finance this consumption, our results indicate that intergenerational transfers, both private...
This paper analysis the extent of inequity in the utilization of healthcare services in Nigeria, ... more This paper analysis the extent of inequity in the utilization of healthcare services in Nigeria, and the determinants of healthcare utilization inequity. Applying the concept of horizontal inequity, the paper used the Nigeria Living Standard Survey (NLSS) 2010 data set to investigate the disproportionality in healthcare utilization. The result shows that inequity in utilization of healthcare in the country is generally skewed against the poor, as the analysis established evidence about the poor with similar medical needs as the rich having access to lesser healthcare service. The observed inequality in utilization of healthcare is mainly driven by the differences in health expenditure, residence location (rural or urban), and morbidity rate. The utilization rate of healthcare services is found to be positively related to household expenditure It is recommended that government should intensify greater equity measure to guarantee healthcare to all with minimal discrimination. While th...
Asian Journal of Humanities and Social Studies, 2016
This paperprovides findings on cost burden of malaria in Nigeria. Cost computations were extrapol... more This paperprovides findings on cost burden of malaria in Nigeria. Cost computations were extrapolated to monthly income fraction and GDP lost to the illness. Results of the study are shown across different employment groups. Computations for indirect and direct costs were conducted using the Human capital and Bottom up approach respectively. The results show that one in two persons employed in the labour force will experience loss in labour contribution as a result of malariawith indirect cost of about N 5,532.59($37.16) and N 4,828.73 ($32.43) per person per day for the patient and care giver, respectively. Individuals spend approximately N 2,730.46($18.34) on the average for treatment of one bout of the illness which translates to approximately3% of monthly income. Overall, indirect and direct costs related to one episode of malaria in Nigeria sum up to approximately N 1, 906.08 billion ($12,801.07 million) implying about 8% of GDP. GDP fraction lost to malaria is higher for the i...
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Papers by Akanni Lawanson