P.H 4

4

Hamat

Country Profile - Kenya and Iran

Kenya is in East Africa with a democratic system of governance and a current population of 56,456,969 million (WHO, 2020). The life expectancy in Kenya for males is 63.7 years and for females, 68.4 years. GDP is expected to reach 107.00 USD billion by the end of 2022 (Kamer, 2022).

Iran is in the middle East and has Theocracy as a system of governance. The population of Iran is 86,335,817, with life expectancy for males being 75.7 years and for females 79 years (WHO, 2020; Worldometers, 2022). Iran’s GDP is expected to reach 270.00 USD billion by the end of 2022.

Type of Study and Data Collection Tools

The study on the impact of macroeconomics policies on public health in Iran used descriptive longitudinal data and time series analysis, while that of Kenya to analyze factors influencing the quality of services used Kentikelenis conceptual framework model of health inequities (Pakdaman et al., 2019; Munala et al., 2020).

Bias and Assumptions 

The Kenyan study is grounded on the assumption that macroeconomic policies established by the International Monetary Fund and World Bank, with their conditionalities that influence the allocation of resources to address health inequities in Kenya, whereas the Iran study relied on the assumptions that health care expenditure and health services are dependent on changes in macroeconomic conditions and business cycles, including more spending on health care during economic boom time and less spending in recessions.

Political Environment and Transparency

Health services and health system in Kenya is driven by government decision based on global political-economic policies, including international political, economic, and health organizations such as the Abuja Declaration that set a threshold for healthcare spending in Africa (Munala et al., 2020). On the other hand, uncertainty in political fluctuations and decisions by Iranian governments, coupled with national and international factors, influence decision-making for the health systems and impacts health outcomes in Iran (Pakdaman et al., 2019).

Importance to The Public and Government

The issue of macroeconomic policies is significant to the public and governments in each country because increased health expenditure influences health coverage and improves public health outcomes.

Conclusion

In conclusion, the impact of the global political economy is evident in the lack of resources and financial support for healthcare services in Kenya. In contrast, macroeconomic variables showed significant and positive effects on health expenditure and are the most important determining factor in Iran.

References

Kamer, L (August 1, 2022). Ethnic groups in Kenya 2019.  https://www.statista.com/statistics/1199555/share-of-ethnic-groups-in-kenya/

Munala, L., Welle, E., Okunna, N & Hohenshell, E (2020). The Impact of Macroeconomic Policies on Healthcare Delivery in Kenya: An Analysis of the National Sexual Violence Prevention and Care Response.  journals.sagepub.  DOI: 10.1177/0272684X20982596.

Pakdaman, M., Geravandi, S., Askari, R., et al., (2019). HR. The effect of macroeconomic indicators on healthcare expenditure in Iran. J Educ Health Promot. Doi: 10.4103/jehp.jehp_453_18. PMID: 31334275; PMCID: PMC6615124.

World Health Organisation (2020). Life Expectancy. Worldhealthrankings live longer live better.  https://www.worldlifeexpectancy.com

 Worldometers (2022). Iran Population (LIVE)  https://www.worldometers.info/world-population/iran-population/

Felic

For this week’s reading and discussion I chose the country of Kenya, and macro economic policies and health in developing countries that included Ghana, Uganda, Zambia, Bangladesh, Indonesia and the Philippines. The articles I read had many similarities in that the macroeconomic programs on the outside look like helpful investments into these developing countries, but it also showed the incredible lack of funding and resources to accomplish real healthcare change. Many of these programs, for example in Kenya, the loans from the IMF require significant budget cuts to vital healthcare programs across the country. IMF loan criteria for loans to Kenya to improve public health require stringent fiscal policies that consequently hurt the overall healthcare goal. (Munala, Welle, Okunan, Hohenshell, 2020) The lack of healthcare funding for medical supplies and staff lead to decreased quality of care for patients in both of these research articles, this is the similarity thread in Kenya, Ghana, Uganda, Zambia, Bangladesh, Indonesia and the Philippines. 

     Another comparison thread among these countries found in both articles is the decline in life expectancy rates in three of the four African countries since the implementation of global health initiatives to help improve public health outcomes. The Philippines, Indonesia and Bangladesh however showed improved mortality rates over the same research timeline from 1980 to 2000. (Dzator, Hopkins, N.A) Determining factors in public health outcomes for all of these countries in Africa and Asia continue to be Malaria, HIV/AIDs, drug resistant diseases and natural disasters, for example, droughts. These public health issues have received billions of dollars in funding globally from the United Nations, World Health Organization and the IMF, but the results have shown for each step forward with healthcare funding and awareness, there has been regression because of lack of hospitals and medication, these continue to be the healthcare determinants that hinder real and effective progress across the continents of Africa and Asia.

References

Leso Munala, Emily Welle, Nene Okunan, Emily Hohenshell. (2020). The Impact of Macroeconomic Policies on Healthcare Delivery in Kenya. International Quarterly of Community Health Education. Retrieved From:  https://learn.umgc.edu/content/enforced/746362-M_004635-01-2228/The%20Impact%20of%20Macroeconomic%20Policies%20on%20Healthcare%20Delivery_Int%20Q%20Community%20Health%20Educ%2010-2021%20(2).pdf?_&d2lSessionVal=1HK9Bt1P6H5HviBrN3vrhCf1Z

Janet A. Dzator, Sandra Hopkins. (N.A) Macroeconomic policies and health in developing countries. Retrieved From:  https://esacentral.org.au/images/DzatorJ.pdf

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