肯尼亚财政分权和下放医疗服务可得性结果：来自小组动态方法的证据

IF 2.1 Q2 GEOGRAPHY

Regional Science Policy and Practice Pub Date : 2025-05-23 DOI:10.1016/j.rspp.2025.100213

Isaiah Maket , Remmy Naibei

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引用次数: 0

摘要

该研究调查了2013-2022年权力下放期间，财政权力下放对肯尼亚23个县医疗保健可获得性结果的影响。不同稳健的非内同性计量经济学方法的结果表明，财政分权对人力和技术卫生保健资源的可用性（每1万人的医务人员数量和医院床位数量）产生了重大的有害影响。该研究还揭示了县国内生产总值在提高医疗资源可得性方面的显著有益作用。然而，本文表明，县收入阻碍了肯尼亚县实现医疗资源的充分可用性。研究结果指出，需要实施积极的分散式财政政策干预，以实现有效的医疗保健系统，在人力和技术医疗资源可用。具体而言，制定政策干预措施，将有效的财政分配用于基础设施发展和人力资源能力建设，可以提高基层医疗保健的总体可得性。

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Fiscal decentralization and devolved healthcare service availability outcomes in Kenya: Evidence from panel dynamic approach

The study examined the effect of fiscal decentralization on healthcare availability outcomes from 23 Kenyan counties during the 2013–2022 devolution period. The results from different robust non-endogeneity econometric methods indicate a significant deleterious effect of fiscal decentralization on the availability of human and technical healthcare resources (number of medical personnel and number of hospital beds per 10,000 people). The study also reveals the significant beneficial role of county gross domestic product in enhancing the availability of healthcare resources. Nevertheless, the paper demonstrates that county revenue impedes realizing adequate availability of healthcare resources in Kenyan counties. The study results point to the need to implement proactive decentralized fiscal policy interventions to realize an efficient healthcare system where human and technical healthcare resources are available. Specifically, enacting policy interventions that target effective financial allocation toward infrastructural development and building human resource capacity could enhance overall healthcare availability at the grassroots level.

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来源期刊

Regional Science Policy and Practice GEOGRAPHY-

CiteScore

3.60

自引率

5.90%

发文量

期刊介绍： Regional Science Policy & Practice (RSPP) is the official policy and practitioner orientated journal of the Regional Science Association International. It is an international journal that publishes high quality papers in applied regional science that explore policy and practice issues in regional and local development. It welcomes papers from a range of academic disciplines and practitioners including planning, public policy, geography, economics and environmental science and related fields. Papers should address the interface between academic debates and policy development and application. RSPP provides an opportunity for academics and policy makers to develop a dialogue to identify and explore many of the challenges facing local and regional economies.