Thesis and Dissertation for the Department of Economics

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    DETERMINANTS OF CHILD HEALTH STATUS AMONG UNDER-FIVE YEARS OF AGE IN KWARA STATE, NIGERIA
    (University Of Ilorin, 2024) ABDULMALIK, Iyabo Belawu
    Child health, as a prerequisite to national development, represents a public health condition, while national health condition is a reflection of the state health status. From the available literature, Kwara State experienced deteriorations of social and economic well-being, as reflected especially in age under-five years. Most existing studies on the determinants of the under-five child health status in Kwara State were health facility-based which was a supply side phenomenon, while neglecting the demand side. The aim of this study is to determine the child health status among under-five years of age in Kwara State, Nigeria. The objectives were to: (i) examine the impact of background factors on under-five child health status; (ii) investigate the effect of proximate factors on under-five child health status; (iii) evaluate the relationship between background and proximate factors among under-five child health status; and (iv) examine, if proximate factors significantly moderate the nexus between background factors and under-five child health status in Kwara State, Nigeria. The study was based on Mosley-Chen Model of the determinants of child survival. A simple random sampling technique was used to collect data through a structured questionnaire from the sample. The sample population of the study consists of 900 respondents selected from nine Local Government Areas covering the three senatorial districts in Kwara State, through the used descriptive statistics and binary logistics model to achieve objectives i, ii, iii and iv. The study used primary data to source for the necessary information needed. The findings of the study were that: i background factors: mother’s education (P=0.000), child age (P=0.001), child sex (P=0.000), mother’s marital status (P=0.075), mother’s age (P=0.003), wealth index (P=0.022), mother’s occupation (P=0.000), place of residence (P=0.007) and tribe (P=0.013)) were significant determinants of age under-5 health status; ii proximate factors: birth order (P=0.003), immunization (P=0.005), toilet facility (P=0.000), type of cooking fuel (P=0.000) and place of delivery (P=0.012)) were significant determinants of age under-5 health status; iii Pearson Chi-square test of association showed that among the proximate factors, source of drinking water (0.000), toilet facility (0.000), type of cooking fuel (0.000) and place of delivery (0.000)) had a significant relationship with all the background factors; and iv estimated log ratio (lr) test statistic of 100.13 which is statistically significant implies that proximate factors (birth order, immunization, child breastfeeding, source of drinking water, toilet facility, type of cooking fuel and place of delivery) jointly moderate the effect of background factors on under-five child health status in Kwara State. The study concluded that under-five child health is still a major concern that needs timely intervention of the government and non-governmental organisations. The study therefore, recommended that health intervention policies that focus on children and nursing mothers should be strengthened to achieve the targeted 3.2 by 2030. In addition, special education and health programs should be included in the formal education for better parenting.
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    ESTIMATING THE RELATIVE EFFICIENCY OF PUBLIC AND PRIVATE HOSPITALS IN THE SOUTH-WEST, NIGERIA
    (UNIVERSITY OF ILORIN, 2018-06) AFOLABI, IBIKUNLE JOSEPH
    The objective of health systems includes effectiveness, efficiency, equity and quality. To achieve these, depend on the health policy, health expenditure, national income and access to health services. Nigeria is ranked 187 of the 191member nations of WHO based on her health system performance. Some literature blamed this performance on health expenditure, price and income, others opined that some low-income countries have sufficiently better health outcomes depending on political will, but not much has been done on efficiency and its spread across both the public and private hospitals. This study therefore, estimates the relative efficiency of public and private hospitals in the South–west, Nigeria. The objectives were to: i) estimate the technical efficiency of the hospitals; ii) determine the allocative and cost efficiency; iii) assess the role of technical efficiency change and technological change in driving their total factor productivity; and iv) measure the pattern of efficiency growth in total factor productivity (TFP) among the health care providers. The input-oriented constant returns to scale theory was used. Given that most hospital data are not readily available, convenience sampling method was employed to select 10 private and 10 public hospitals from each of Lagos, Ogun, Ondo, Osun and Oyo States from 2007 to 2016. Data Envelopment Analysis was used to calculate the efficiency while Malmquist Productivity Index (MPI) measured the productivity growth at MPI>1 = progressing, MPI<1= deteriorating and MPI=1 denote stagnating. The findings of the study were that: i. both public and private hospitals are technically efficient but the former are more efficient than the latter with general mean (0.722 and 0.661) respectively; ii. both allocative and cost efficiency (0.675 and 0.438) are higher in the public hospitals than private (0.411 and 0.256), respectively; iii. productivity growth displayed inconsistency for both public and private hospitals with technical efficiency change (1.262 and 1.103= progressing for 2007/2008; 0.691 and 0.865= deteriorating for 2008/2009) and technological change (0.681 and 0.929= deteriorating for 2007/2008; 1.877 and 1.113= progressing for 2008/2009); iv. total factor productivity (the product of technical efficiency change and technological change) behaved prototype with technical efficiency change and technological change for both public and private hospitals, but are generally deteriorating with productivity scores of 0.971 and 0.968, respectively; and v. cost efficiency score in descending order ranked Lagos, Ogun, Oyo, Ondo and Osun States for public, while Ogun, Osun, Ondo, Oyo and Lagos for private. The study concluded that public hospitals are more technically efficient than private hospitals, but both are cost-inefficient and deteriorating in productivity growth. The study recommended that the Ministries of Health should equip the hospitals towards the changing health demands. While ensuring compliance to operational policy by private hospitals, cost of operation should be competitive for both the private and public hospitals.