Exploring Health Development Aid and Anthropogenic Stress as Drivers of Under-Five Malaria Mortality in Nigeria with Domestic Public Health Spending as a Moderator: A Bootstrap ARDL Analysis
DOI:
https://doi.org/10.35898/ghmj-931327Keywords:
Malaria deaths, Development assistance for health, Government health expenditure, UrbanizationAbstract
Background: Malaria remains a going health concern, particularly in Nigeria, where under-5 mortality related to the disease continues to undermine human capital development. Despite sustained inflows of development assistance for health, progress in reducing malaria-related child mortality has not been proportional. This study is important because it evaluates whether development assistance, domestic government health expenditure, and anthropogenic environmental stress jointly shape under-5 malaria mortality outcomes in Nigeria.
Aims: This study investigates the short-run and long-run effects of development assistance for health and anthropogenic environmental stress on under-5 malaria mortality in Nigeria. It further determines the moderating role of domestic government health expenditure, while controlling for income and urbanization.
Methods: The study uses quarterly time-series secondary data for Nigeria from 2000 to 2022, obtained from reputable sources. The Bootstrap Autoregressive Distributed Lag approach is employed to test for the existence of a long-run cointegrating relationship and to distinguish short-run and long-run dynamics among under-5 malaria deaths development assistance for health, anthropogenic stress and domestic government health expenditure. In addition, the study employs the Toda-Yamamoto causality procedure is to correctly isolate the direction of causality among the variables.
Results: The cointegration among the variables is confirmed using the Bootstrap ARDL results. Development assistance for health is found to be associated with higher under-5 malaria mortality in the long-run estimates both in the short- and long-run, and its interaction with domestic government health expenditure further strengthens this effect. Domestic government health spending independently decreases malaria deaths. However, Anthropogenic stress also increases malaria mortality risk over time, same as urbanization. The Toda-Yamamoto causality results indicate unidirectional causality running from under-5 malaria mortality to development assistance for health, suggesting that increased aid inflows is a response to increased under-5 malaria deaths rather than the cause.
Conclusion: The findings show that while domestic government health expenditure contributes to reducing under-5 malaria mortality in Nigeria, development assistance for health is associated with higher mortality and appears to reinforce adverse outcomes when interacting with domestic spending. Improved coordination between foreign health aid and domestic health spending, alongside more targeted and efficiency-oriented interventions, is necessary to reduce under-5 malaria mortality in Nigeria.
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Abberger, K., Graff, M., Müller, O. et al. Imputing Monthly Values for Quarterly Time Series: An Application Performed with Swiss Business Cycle Data. J Bus Cycle Res 19, 241–273 (2023). https://doi.org/10.1007/s41549-023-00088-y
Doucouliagos, C., Hennessy, J., & Mallick, D. (2021). Health aid, governance and infant mortality. American Journal of Biomedical and Life Sciences, 8(5), 96-102. https://www.econstor.eu/handle/10419/196664
Feng C, Wang H, Lu N, Chen T, He H, Lu Y, Tu XM (2014). Log-transformation and its implications for data analysis. Shanghai Arch Psychiatry, 26(2), 105-9. https://doi.org/10.3969/j.issn.1002-0829.2014.02.009. Erratum in: Gen Psychiatr. 2019 Sep 6;32(5):e100146corr1. https://doi.org/10.1136/gpsych-2019-100146corr1. PMID: 25092958; PMCID: PMC4120293.
Fletcher, I. K., Grillet, M. E., Moreno, J. E., Drakeley, C., Hernández-Villena, J., Jones, K. E., & Lowe, R. (2022). Synergies between environmental degradation and climate variation on malaria re-emergence in southern Venezuela: A spatiotemporal modeling study. The Lancet Planetary Health, 6(9), 739-748. https://doi.org/10.1016/S2542-5196(22)00192-9
Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political economy, 80(2), 223-255. https://www.jstor.org/stable/1830580
Institute for Health Metrics and Evaluation (2018). Financing global health 2017: Funding universal health coverage and the unfinished HIV/AIDS agenda. Seattle, WA: Institute for Health Metrics and Evaluation (IHME), University of Washington. https://www.healthdata.org/sites/default/files/files/policy_report/2018/IHME_FGH_2017_fullreport.pdf
Lee, J., & Strazicich, M. C. (2003). Minimum Lagrange Multiplier Unit Root Test with Two Structural Breaks. The Review of Economics and Statistics 85 (4), 1082–1089. https://doi.org/10.1162/003465303772815961
Lepot, M., Aubin, J.-B., & Clemens, F. H. L. R. (2017). Interpolation in Time Series: An Introductive Overview of Existing Methods, Their Performance Criteria and Uncertainty Assessment. Water, 9(10), 796. https://doi.org/10.3390/w9100796
Majeed, M.T. & Ozturk, I. (2020). Environmental degradation and population health outcomes: A global panel data analysis. Environmental Science and Pollution Research, 27(13), 15901-15911. https://doi.org/10.1007/s11356-020-08167-8
McNown, R. Sam, C.Y., & Goh, S.K., (2018). Bootstrapping the autoregressive distributed lag test for cointegration. Applied Econometrics, 50(13),1509–1521. https://doi.org/10.1080/00036846.2017.1366643
Mordecai, E.A., Ryan, S.J., Caldwell, J.M., Shah, M.M., & Labeaud, A.D. (2020). Climate change could shift disease burden from malaria to arboviruses in Africa. The Lancet Planetary Health, 4(9), 416-423. https://doi.org/10.1016/s2542-5196(20)30178-9
Pickbourn, L., & Ndikumana, L. (2018). Does health aid reduce infant and child mortality from diarrhea in sub-Saharan Africa? The Journal of Development Studies, 55(10), 2212-2231. https://doi.org/10.1080/00220388.2018.1536264
Nwude, E. C., Ugwoke, R. O., Uruakpa, P. C., Ugwuegbe, U. S., & Nwonye, N. G. (2020). Official development assistance, income per capita and health outcomes in developing countries: Is Africa different? Cogent Economics & Finance, 8(1), 1774970. https://doi.org/10.1080/23322039.2020.1774970
Oluwatoyin, M., Osabohien, R., Fasina, F, & Afolake, F. (2018). Greenhouse gas emissions and health outcomes in Nigeria: Empirical insight from ARDL technique. International Journal of Energy Economics and Policy, 8(3), 43-50. Retrieved from https://www.econjournals.org.tr/index.php/ijeep/article/view/6153
Perron, P. (1989). Testing for a unit root in a time series with a changing mean. Journal of Business and Economics, 10(4), 457- 470. https://www.princeton.edu/~erp/ERParchives/archivepdfs/M347.pdf
Pesaran, H. M., Shin, Y., & Smith, R. J. (2001). Bounds testing approaches to the analysis of level relationships. Journal of Applied Econometrics 16(3), 289–326. https://files.econ.cam.ac.uk/people-files/mhp1/pss1r1.pdf
Sam, C.Y., Mcnown, R., & Goh, S.K. (2019). An augmented autoregressive distributed lag bounds test for cointegration. Journal of Econometric Modelling, 9993(18), 30784-3. DOI: https://doi.org/10.1016/j.econmod.2018.11.001
Savi, M. K., Pandey, B., Swain, A., Lim, J., Callo-Concha, D., Azondekon, G. R., et al. (2024). Urbanisation and malaria have a contextual relationship in endemic areas: A temporal and spatial study in Ghana. PLOS Glob Public Health, 4(5) e0002871. https://doi.org/10.1371/journal.pgph.0002871
United Nations Children's Fund. (2021). Malaria. UNICEF Data: Monitoring the situation of children and women. New York, NY: United Nations Children's Fund. Retrieved from https://data.unicef.org/topic/child-health/malaria/
United Nations Programme on HIV and AIDS. (2020). Closing the HIV resource gap in Nigeria with more domestic funding. Geneva: UNAIDS. Retrieved August 6, 2022, from https://www.unaids.org/en/resources/presscentre/featurestories/2017/
World Health Organization. (2018). World health statistics 2018: Monitoring health for the SDGs, sustainable development goals. Geneva, Switzerland: World Health Organization. https://www.who.int/publications/i/item/9789241565585
Yahyoui, I., & Bouchoucha, N. (2020). Foreign aid growth nexus in Africa: Do institutions matter? Journal of the Knowledge Economy, 11(2020) 1663-1689. https://doi.org/10.1007/s13132-020-00638-0
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