医疗保健支出对乌干达孕产妇死亡率的影响

Phionah Atuhaire, Elizabeth Ekirapa-Kiracho, John Mutenyo
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摘要

乌干达的孕产妇死亡率为每 10 万活产 189 例,仍然高于每 10 万活产 70 例的全球目标。有证据表明,医疗保健支出模式影响着孕产妇医疗保健服务的提供和孕产妇死亡率的降低。了解医疗保健支出如何影响乌干达的孕产妇保健成果对制定政策非常重要。研究利用 1985-2019 年期间世界发展指标的数据,采用自回归分布式滞后模型探讨了医疗保健支出对孕产妇死亡率的影响。研究结果表明,针对孕产妇健康状况的国内政府支出可显著降低孕产妇死亡率。护士人数的增加也与孕产妇死亡率的显著降低有关;因此,政府应增加投资,在大多数乌干达人就医的公共医疗机构培训和派驻足够的护士。同样,自付医疗支出和人均医疗支出总额在短期内都与孕产妇死亡人数减少有关。然而,虽然自付医疗支出与孕产妇死亡率的降低有关,但这是不公平的。乌干达国家医疗保险应确保对穷人实施财务风险保护,以实现全民医保。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Healthcare Expenditure on Maternal Mortality in Uganda
The maternal mortality rate in Uganda of 189 per 100,000 live births remains above the global target of 70 per 100,000. Evidence shows that the mode of healthcare expenditure impacts the provision of maternal healthcare services and reduction in maternal mortality. Understanding how healthcare expenditure impacts maternal health outcomes in Uganda is important for policy. Data from World Development Indicators for the period 1985-2019 were used to explore the effect of healthcare expenditure on maternal mortality using an auto-regressive distributed lag model. The findings showed that domestic government expenditure targeted on maternal health conditions significantly reduces maternal mortality. An increase in nurses was also associated with significant reductions in maternal mortality; hence, the government should increase investment in training and posting adequate nurses at public health facilities, where the majority of Ugandans seek care. Similarly, out-of-pocket health expenditure and total health expenditure per capita were both associated with a reduction in maternal deaths in the short-run. However, while out-of-pocket health expenditure is associated with a reduction in maternal mortality, it is inequitable. The Uganda National Health Insurance should ensure that financial risk protection for the poor is implemented to move towards universal health coverage.
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