رابطه کیفیت حکمرانی با سلامت در کشورهای منطقه جنوب غربی آسیا

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  • پور احتشام, محمد
Abstract:

Introduction: The role of good governance as a key to development effectiveness has been emphasized in recent years. It has been argued that merely allocating public resources for the right goods and services may not lead to desirable outcomes if budget institutions–involving the budget formulation, execution and monitoring–are malfunctioning. In a way that merely allocating budget resources for goods and services, may not lead to positive health outcomes. In other words, governance is central in determining the efficacy of public spending.  Studies show that improved governance leads to better development outcomes. So that, there is a close relationship between governance and broader development outcomes such as infant and maternal mortality, life expectancy at birth, years of schooling, etc. Given the poor state of health services in developing countries due to inappropriate management of government policies in this sector , low investment in social sectors such as health, the purpose of the study is to “Investigate the effects of governance quality index  on health indicators during the period 1996 to 2014 for the countries of Southwest Asia. Poor budget management has frequently been cited as one of the main reasons why governments in developing countries find it difficult to translate public spending into effective services. A reasonable proposition, therefore, can be made: managing public resources to promote health sector -outcomes  requires well- trained, skillful personnel, working in an institutional  setting with an incentive system that reduces fraud and promotes cost efficiency. These studies have -analyzed the effects of corruption and institutions on other variables including  economic growth, public investment, and social infrastructure.  It can be said that governance indicators (including clarity and accountability, political stability, nonviolence and terrorism, government effectiveness, the quality of laws and regulations, the rule of law and the control of corruption) have a strong direct negative impact on infant mortality. Method: The panel data method and the Stata.ver12 software were used to estimate data and information. The present study was conducted among some countries and given the fact that government data have been published since 1996, the study period is limited to the number of years that cannot be used for time series econometrics. Hence, for estimating the model, the combined data econometric method (data panel) was used. Also, the estimation of the time series data during the 21-year period 1996-1995 was done using the software Stata.ver12. The data estimation using the panel data method has advantages beyond the mere cross-sectional method. So that working with the panel allows it to be taken into account how healthcare governance over time may affect the performance of another health care system in a country. Panel data yields more degrees of freedom by adding the variability of time series dimension. Based on economic and econometric reasoning, data availability and previous studies on health outcome, the specification, we adopt here is a fixed effects model. Also,  data from a sample of 23 Southwest Asia countries were used. The criterion for selecting the countries was based on the availability of data. Data governance from Worldwide Governance Indicator (2014) and, other data were obtained from World Development Indicator (2014). Findings: According to the result of this research it can be stated that index of quality of the governance index on the indicators of the health sector in selected countries in Southwest Asia by calculating a weighted average of indicators of good governance based on the Guni and Duncan (2004), quality of governance and its impact on the sector indicators is discussed. Four components, including infant mortality rate, mortality rate of children under 5 years, life expectancy at birth and crude death rates have been used as indicators of the health sector. The results show that in all four models, governance quality index has a significant effect on the components of health sector development.  In other words, it should be stated that countries with better governance in the health sector and health status are more efficient. Discussion: In this paper, the effect of good governance on health sector indicators over the period 1996-2014 using the Hunino model (2014) 1996 is based on the panel data technique. Regarding the statistical results, it can be stated that the promotion of governance indicators and the improvement of health expenditure and education of the health sector by governments, more than what the econometric and statistical results show, affect the actual variables of the health sector. Therefore, it can be said that with consideration the six indicators of governance, measured by the quality governance index (with these indicators), have had a greater impact on health outcomes. This has led to a reduction in the mortality rate and consequently an increase in life expectancy at birth. The results also indicate that the role of the GDP as a measure of per capita income influences health sector indicators.  Also, the disadvantage of the region in terms of adult education and its impact on health can be seen as a serious effort by educational institutions to eliminate illiteracy from these communities. Also, given that the growth of urbanization in developing countries is inevitable, taking into account the positive impact on the indicators of this section should not be ignored by the positive dimensions of this variable, that is, by planning appropriately for controlling and directing the migrant population from rural to cities and marginal concerns, which is the negative aspect of this case, can improve indicators of this section.  

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Journal title

volume 18  issue 69

pages  184- 159

publication date 2018-07

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