Health and Growth

This volume, comprising six articles and related commentary, examines the relationship between economic growth and investment in health. It emerged from the Commission on Growth and Development, which convened from 2006 through 2008 to discuss the diverse causes and impacts of economic growth.

While evidence clearly shows that positive economic growth contributes to better health outcomes, as measured by better nutrition, longer life expectancy, and lower communicable disease rates, among other indicators, the extent of the reverse relationship—that is, whether improved population health directly contributes to economic growth—is less clear. The lack of comprehensive metrics to measure health makes determining the degree of this causation challenging, as do other potential compounding factors; for example, countries with more effective health systems often benefit from greater institutional strength overall, complicating the identification of individual causal relationships. The articles in this volume explore existing evidence around this relationship, which is tenuous.

The final article explores the impact of early childhood investment in health and nutrition on future individual and household earnings. On this topic, the scientific evidence demonstrates clearly that investing in health and nutrition at an early age can lead to higher incomes, help break cycles of intergenerational poverty, and contribute to long run economic growth.

 

Co-editor Michael Spence is a senior fellow at the Hoover Institution and Philip H. Knight Professor and Dean, Emeritus, at Stanford University. He was awarded the Nobel Memorial Prize in Economic Sciences in 2001. 

 

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Sustainability of Global Fund Supported Programs: Brazil Country Case Study

This report summarizes the policies, programs and levels of investment in malaria, tuberculosis and HIV/AIDS in Brazil, linking these to broader Brazilian healthcare initiatives and to both general and specific investments. It provides the background necessary to understanding the contribution of the Global Fund, and the country’s transition away from that support once funding for malaria and tuberculosis ended. Brazil’s strong commitment to health, early establishment of excellence, its depth of technical expertise, and its ability to implement complex health programs has translated into a level of independence that relies on outside support for only part of its agenda. That in turn facilitates adapting to declining external transfers, and an understanding that transition means establishing functioning and funded institutions.

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Hospital Performance in Brazil: The Search for Excellence

This book combines a comprehensive overview of the Brazilian hospital sector with in-depth analyses of the key elements of interest in promoting and ensuring excellence in hospital performance. The book offers specific recommendations that go to the heart of the problem, weighing in context on implementation and specifically highlighting the need to strengthen governance arrangements, improve accountability, and sharpen resource management.

La Forgia, G. and B. Couttolenc. 2008. Hospital Performance in Brazil: The Search for Excellence. Washington, DC: World Bank.

 (published in English and Portuguese)

 

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Government-Sponsored Health Insurance in India: Are You Covered?

Since independence, India has struggled to provide its people with universal health coverage. Whether defined in terms of financial protection or access to and effective use of healthcare, the majority of Indians remain irregularly and incompletely covered. Finally, and most recently, a new generation of Government-Sponsored Health Insurance Schemes (GSHISs) has emerged to provide the poor with financial coverage. Briefly, the main objective of these new GSHISs was to offer financial protection against catastrophic health shocks, defined in terms of an inpatient stay. Between 2007 and 2010, six major schemes have emerged, including one sponsored by the Government of India (GOI) and five state-sponsored schemes. This new wave of schemes provides fully subsidized coverage for a limited package of secondary or tertiary inpatient care, targeting below-poverty populations. Similar to the private voluntary insurance products in the country, ambulatory services including drugs are not covered except as part of an episode of illness requiring an inpatient stay. The schemes have organized hospital networks consisting of public and private facilities, and most care funded by these schemes is provided in private hospitals. Ostensibly, the objective of any health insurance scheme is to increase access, utilization, and financial protection, and ultimately improve health status. Due to lack of evaluations and analyses of household data, the authors of this book do not examine the impact of health insurance in terms of these objectives. This book is not meant to highlight problems of the GSHISs, but rather to raise potential challenges and emerging issues that should be addressed to ensure the long-term viability of these schemes and to secure their place within the health finance and delivery system.

 

La Forgia, G. and S. Nagpal. 2012. Government-Sponsored Health Insurance in India: Are you Covered? Washington, DC: World Bank.

 

 

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