Evidence map›Paper›PMID 29515915›Full record

ArticleBMJ global health2018

Do less populous countries receive more development assistance for health per capita? Longitudinal evidence for 143 countries, 1990-2014.

Lene Martinsen, Trygve Ottersen, Joseph L Dieleman, Philipp Hessel, Jonas Minet Kinge, Vegard Skirbekk

Abstract read
In one paragraph

Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Lene MartinsenDepartment of International Health, Norwegian Institute of Public Health, Oslo, Norway.
Trygve OttersenDepartment of International Health, Norwegian Institute of Public Health, Oslo, Norway.
Joseph L DielemanInstitute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, USA.
Philipp HesselAlberto Lleras Camargo School of Government, University of the Andes, Bogotá, Colombia.
Jonas Minet KingeDepartment of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Vegard SkirbekkCentre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPer capita allocation of overall development assistance has been shown to be biased towards countries with lower population size, meaning funders tend to provide proportionally less development assistance to countries with large populations. Individuals that happen to be part of large populations therefore tend to receive less assistance. However, no study has investigated whether this is also true regarding development assistance for health. We examined whether this so-called 'small-country bias' exists in the health aid sector.

methodsWe analysed the effect of a country's population size on the receipt of development assistance for health per capita (in 2015 US$) among 143 countries over the period 1990-2014. Explanatory variables shown to be associated with receipt of development assistance for health were included: gross domestic product per capita, burden of disease, under-5 mortality rate, maternal mortality ratio, vaccination coverage (diphtheria, tetanus and pertussis) and fertility rate. We used the within-between regression analysis, popularised by Mundluck, as well as a number of robustness tests, including ordinary least squares, random-effects and fixed-effects regressions.

resultsOur results suggest there exists significant negative effect of population size on the amount of development assistance for health per capita countries received. According to the within-between estimator, a 1% larger population size is associated with a 0.4% lower per capita development assistance for health between countries (-0.37, 95% CI -0.45 to -0.28), and 2.3% lower per capita development assistance for health within countries (-2.29, 95% CI -3.86 to -0.72).

conclusionsOur findings support the hypothesis that small-country bias exists within international health aid, as has been previously documented for aid in general. In a rapidly changing landscape of global health and development, the inclusion of population size in allocation decisions should be challenged on the basis of equitable access to healthcare and health aid effectiveness.

Indexed as

health economicshealth policypublic health

Identifiers

PMID29515915
PMCPMC5838402

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