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1.
SSRN;
Preprint in English | SSRN | ID: ppcovidwho-346139

ABSTRACT

The COVID-19 crisis poses new policy challenges and has spurred new research agendas in public economics. In this article, we selectively reflect on how the field of public economics has been shaped by the COVID-19 pandemic and discuss several areas where more research is necessary. We highlight major changes and inequalities in the labor market and K-12 education, in addition to discussing how technological change creates new challenges for the taxation of income and consumption. We discuss various policy responses to these challenges and the role of fiscal federalism in the context of worldwide crises. Finally, we summarize the key issues discussed at the 2021 International Institute of Public Finance Congress and the papers published in this special issue.

2.
Int J Health Policy Manag ; 2022 Sep 14.
Article in English | MEDLINE | ID: covidwho-2081537

ABSTRACT

Progressive realization of universal health coverage (UHC) requires health systems capacity to provide quality service and financial risk protection which supports access to services without financial hardship. Government health spending in low-income countries (LICs) has been low and heavily relied on external donor resources and out-of-pocket payment. This has resulted in high prevalence of catastrophic health spending or foregone care by those who cannot afford. Under fiscal constraints posed by pandemic, reforms in LICs should focus on efficiency through health resource waste reduction. Targeting the poor even with low level of health spending can make a significant health gain. Investment in primary healthcare and health workforce is the foundation for realizing UHC which cannot be postponed. Innovative tax on health hazardous products, conditional debt relief can increase fiscal space for health; while international collaboration to accelerate coronavirus disease 2019 (COVID-19) vaccine coverage can bring LICs out of acute phase of pandemic.

3.
Int J Environ Res Public Health ; 19(19)2022 Oct 05.
Article in English | MEDLINE | ID: covidwho-2066055

ABSTRACT

BACKGROUND: When the global COVID-19 epidemic continues to spread, residents pay more attention to their health. This paper studies the relationship between the equity of government health expenditure and the health level of residents. METHODS: The Theil index and a principal component analysis were used to measure the equity of government health expenditure and the health level of residents in the Chengdu-Chongqing economic circle. Then, an empirical study on the relationship between the equity of government health expenditure and the health level of residents in this region was conducted with the System GMM model. RESULTS: 1. The Theil index rose from 0.0115 in 2015 to 0.0231 in 2017 and gradually decreased to 0.0106 in 2020. 2. The overall health level of residents showed an upward trend, rising from 1.95 in 2015 to 2.33 in 2017, then remained high and fluctuated slightly. 3. There was a positive correlation between the Theil index and the health level of residents at a significance level of 1% (ß = 0.903, p < 0.01). CONCLUSIONS: 1. The Theil index was close to 0, indicating that the equity of government health expenditure in the Chengdu-Chongqing economic circle was generally good. 2. The health level of residents in the Chengdu-Chongqing economic circle had improved compared to before. 3. The fairer the government's health expenditure, the higher the residents' health level.


Subject(s)
COVID-19 , Health Equity , COVID-19/epidemiology , China/epidemiology , Government , Health Expenditures , Health Status , Humans
4.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-344175

ABSTRACT

With the outbreak of the COVID pandemic, many governments around the world face serious fiscal difficulties. The deteriorating fiscal condition is a critical concern, as it suggests that governments will have limited resources to address important issues of our time. Greater fiscal transparency can help governments address these fiscal challenges by fostering a well-informed debate about policy reforms and holding public finance institutions accountable with timely and accurate information. We also believe comparative analysis of public finance can elicit practical insights into how governments can reform their systems. In this article, we introduce a tool, public finance analytics, which helps us analyze and visualize public finances in comparative perspective. We then present several examples of our comparative analyses, which may help readers understand how the tool can be utilized to produce meaningful insights.

5.
International Social Security Review ; 75(3-4):121-144, 2022.
Article in English | ProQuest Central | ID: covidwho-2052632

ABSTRACT

Older people and their care workers have been disproportionately affected by the COVID‐19 pandemic. Many OECD Member countries have taken measures to contain the spread of the infection and improve the care workforce. Yet the health crisis is highlighting and exacerbating pre‐existing structural problems in the long‐term care (LTC) sector. In many OECD Member countries, recruiting enough workers in LTC remains a challenge and care workers experience difficult working conditions. Skills mismatch and poor integration with the rest of health care lie at the root of preventable hospital admissions even in normal times. Such challenges are likely to become ever more acute if no further action is taken given the speed of population ageing. Policies to improve recruitment and which also address retention through training, improvements in coordination and productivity, leveraging the effect of digital technologies, are needed.Alternate :Les personnes âgées et leurs soignants ont été touchés de manière disproportionnée par la pandémie de COVID‑19. De nombreux pays de l’OCDE ont pris des mesures pour empêcher la propagation de l’infection et augmenter le nombre de soignants. Néanmoins la crise sanitaire met en lumière et exacerbe les problèmes structuraux existants dans le secteur des soins de longue durée. Dans de nombreux pays membres de l’OCDE, le recrutement d’un nombre de travailleurs suffisants dans le domaine des soins de longue durée demeure un défi et les soignants ont des conditions de travail difficiles. L’inadéquation des compétences et une mauvaise intégration avec le reste des soins de santé donnent lieu à des hospitalisations évitables, même en temps normal. Compte tenu de la vitesse à laquelle la population vieillit, ces défis sont susceptibles de s’accentuer encore plus si aucune autre action n’est entreprise. Il est nécessaire de mettre en œuvre des politiques visant à améliorer le recrutement et permettant de maintenir les effectifs via la formation, des améliorations dans la coordination et la productivité, tout en tirant parti de l’effet des technologies numériques.Alternate :La pandemia de COVID‐19 ha afectado de forma desproporcionada a las personas de la tercera edad y sus proveedores de cuidados. Muchos países miembros de la Organización de Cooperación y Desarrollo Económicos (OCDE) han adoptado medidas encaminadas a evitar que la infección se propague y aumentar el número de proveedores de cuidados. A pesar de ello, la crisis sanitaria está poniendo de relieve y agravando los problemas estructurales existentes en el sector de los cuidados de larga duración. En muchos países miembros de la OCDE, la contratación de un número suficiente de proveedores de cuidados de larga duración sigue constituyendo un desafío y las condiciones de trabajo de dichos proveedores son complejas. Incluso en circunstancias normales, se registran hospitalizaciones evitables debido a competencias inadecuadas y a la escasa integración con el resto del sistema de atención de salud. Habida cuenta de la velocidad a la que envejece la población, es probable que estos problemas se agraven si no se adoptan medidas al respecto. Se precisan políticas que tengan por objetivo mejorar la contratación y abordar la retención mediante programas de formación, mejoras en materia de coordinación y de productividad, e iniciativas de aprovechamiento de las tecnologías digitales.Alternate :Ältere Menschen und ihre Pflegekräfte sind von der COVID‐19‐Pandemie unverhältnismäßig stark betroffen worden. Viele OECD‐Mitgliedstaaten haben Maßnahmen ergriffen, um die Ausbreitung der Infektion einzudämmen und das Pflegepersonal zu fördern. Die Gesundheitskrise verdeutlicht und verschärft jedoch bereits bestehende strukturelle Probleme im Langzeitpflegebereich. In vielen OECD‐Mitgliedstaaten ist es nach wie vor eine Herausforderung, genügend Arbeitskräfte für die Langzeitpflege zu finden, und die Arbeitsbedingungen für Pflegekräfte si d schwierig. Ein Qualifikationsdefizit und eine unzureichende Einbindung in die übrige Gesundheitsversorgung sind die Ursache für vermeidbare Krankenhauseinweisungen selbst in normalen Zeiten. Diese Herausforderungen werden wahrscheinlich immer akuter werden, wenn angesichts der raschen Alterung der Bevölkerung keine weiteren Maßnahmen ergriffen werden. Es bedarf Strategien zur Verbesserung der Personalrekrutierung und der Personalbindung durch Fortbildung, Verbesserung der Koordinierung und der Produktivität unter Nutzung der Wirkung digitaler Technologien.Alternate :Пандемия COVID‑19 оказала неравнозначное влияние на пожилых людей и персонал по уходу за ними. Многие страны‐члены ОЭСР принимают меры, чтобы контролировать распространение инфекции и улучшать качество рабочей силы в сфере ухода. Однако кризис в области здравоохранения выдвигает на первый план и усугубляет ранее существовавшие структурные проблемы в области долгосрочного ухода (ДУ). Во многих странах‐членах ОЭСР найм достаточного количества работников для ДУ остаётся проблемой, а сами работники в сфере ухода имеют тяжёлые условия труда. Даже и в обычные времена несоответствие навыков и плохое взаимодействие с остальными службами здравоохранения лежат в основе предотвратимых госпитализаций. Учитывая скорость старения населения, такие проблемы, вероятно, ещё сильнее обострятся, если в дальнейшем не будут приниматься соответствующие меры. Необходимы меры по улучшению ситуации с набором персонала, а также по удержанию работников посредством тренингов, улучшения координации работы и продуктивности, эффективного использования цифровых технологий.Alternate :老年人及其照护工作人员遭受了新冠肺炎大流行病不成比例的影响。许多经合组织成员国已采取措施控制感染传播并改善照护人员队伍。然而, 这场健康危机正凸显并加剧长期照护部门业已存在的结构性问题。在许多经合组织成员国, 招聘足够的长期照护工作人员仍然是一项挑战, 照护人员也面临着艰难的工作条件。即使在正常情况下,可避免入院问题的根源在于技能不匹配以及与其他卫生健康部门的整合不力。鉴于人口老龄化速度, 如不采取进一步行动, 这些挑战可能会变得更加严峻。需要制定政策来改善招聘, 并通过培训、改善协调和生产力以及利用数字技术成果来留住人才。Alternate :تأثر كبار السن والعاملين في مجال رعايتهم بشكل غير متناسب بجائحة كوفيد‐19. واتخذت العديد من البلدان الأعضاء في منظمة التعاون والتنمية في الميدان الاقتصادي ، لا يزال توظيف عدد كافٍ من العاملين في مجال الرعاية طويلة الأمد يمثل تحديًا ويواجه العاملون في المجال ذاته ظروف عمل صعبة. ويكمن عدم تطابق المهارات وضعف التكامل مع بقية جوانب الرعاية الصحية في أساسمنظمة التعاون والتنمية في الميدان الاقتصاديتدابير لاحت٠اء انتشار العدوى وتحسين القوى العاملة في مجال الرعاية. ومع ذلك، فإن الأزمة الصحية تسلط الضوء على المشاكل الهيكلية الموجودة مسبقًا وتؤدي إلى تفاقمها في قطاع الرعاية طويلة الأمد. وفي العديد من البلدان الأعضاء في الإستشفاءات التي يمكن الوقاية منها، حتى في الأوقات العادية. ومن المرجح أن تصبح مثل هذه التحديات أكثر حدة إذا لم يتم اتخاذ مزيد من الإجراءات بالنظر إلى سرعة شيخوخة السكان. وهناك حاجة إلى سياسات لتحسين التوظيف والتي تتناول الاستبقاء من خلال التدريب، وتحسين التنسيق والإنتاجية، والاستفادة من تأثير التكنولوجيات الرقمية.Alternate :Os idosos e seus profissionais de saúde foram desproporcionalmente afetados pela pandemia de Covid‐19. Muitos países membros da OCDE tomaram medidas para conter a propagação da infecção e melhorar a mão de obra assistencial. No entanto, a crise da saúde está destacando e agravando os problemas estruturais preexistentes no setor de cuidados de longa duração (LTC). Em muitos países membros da OCDE, o recrutamento de trabalhadores suficientes para LTC continua sendo um desafio e os profissionais de saúde vivenciam condições de trabalho difíceis. A incompatibilidade de competências e a integração deficiente com o restante dos cuidados de saúde estão na raiz das internações hospitalares evitáveis, até mesmo em tempos normais. Esses desafios provavelmente se tornarão cada vez mais intensos se nenhuma ação adicional for tomada, considerando‐se a velocidade do envelhecimento da população. Há necessidade de políticas para melhorar o recrutamento e que também abordem a retenção por meio de treinamento, melhorias na coordenação e na produtividade, aproveitando o efeito das tecnologias digitais.

6.
COVID-19 Pandemic: Lessons from the Frontline ; : 205-210, 2021.
Article in English | Scopus | ID: covidwho-2048768

ABSTRACT

India being the most populous country had to tailor made its approaches to tackle the coronavirus disease 2019 (COVID-19) pandemic. Public health expenditure in India is just above 1% of gross domestic product. The warning signs of pandemic arrival in India were knocking our health-care system since the first few cases surfaced in Kerala. Social distancing as a method of keeping the virus at bay was first officially flagged by the Prime Minister Narendra Modi on March 19 in order to call for a 1-day “Janata Curfew” on March 22. The Epidemic Disease Act was implemented, and special task force was developed to draft guidelines for personal hygiene, surveillance, contact tracing, quarantine, diagnosis, laboratory tests, and the management of COVID-19. The Aarogya Setu app was developed to alert the public about COVID-19 symptoms, contact tracing, and the nearest contact of health-care center. We need to strive to extricate our country from this situation as advised by Krishna, “Uddharet Atmanatmanam—a person has to lift himself up;a man is his own best friend as also enemy.” © 2022 Elsevier Inc. All rights reserved.

7.
J Policy Model ; 44(5): 963-980, 2022.
Article in English | MEDLINE | ID: covidwho-2049571

ABSTRACT

The present study examines covariates of food security and the impact of Covid-19 induced shocks, among households in India using a nationally representative survey. Using a 2SLS panel regression model, we find an important role of incomes, relative food prices, household characteristics, as well as mobility restrictions in response to the rising number of infections in a given region in explaining varying food expenditure shares prior to and during the Covid-19 pandemic. The disproportionate burden of the pandemic induced lockdowns on the disadvantaged and minorities calls for effective action on the part of policymakers to boost aggregate demand, fix supply chains and reduce food price volatility.

8.
Matern Child Health J ; 2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2048430

ABSTRACT

BACKGROUND: Low birthweight (LBW) as well as early childhood stunting are risk factors for increased childhood morbidity in low-and middle-income countries (LMIC). The Covid 19 pandemic has exacerbated food insecurity and unemployment globally, prompting concerns for maternal and child health. OBJECTIVES: We used data from the great recession of 2008 to examine the relationship between household food security and other risk factors with LBW and stunting using a longitudinal sample of South African women and their offspring. METHODS: Food security indicators, alcohol use, blood pressure and other characteristics were examined in relation to LBW (≤ 2500 g), stunting (height for age ≤ 2SD) and severe stunting (height for age ≤ 3SD). Regression modelling with clustering at maternal ID level were employed to adjust for maternal characteristics and women who gave birth more than once during the reference period. RESULTS: Birthweight data were available for 1173 children and height for age 1216 children. The prevalence of LBW was 14.7% while stunting and severe stunting was 17.8% and 14.5%. Child hunger in the household, maternal hypertension and alcohol use were associated with low birthweight. Food expenditure below the Stats SA poverty line and low dietary diversity was associated with stunting and severe stunting respectively. Maternal height and low birthweight were associated with both stunting and severe stunting. CONCLUSIONS FOR PRACTICE: Interventions that can improve household food security and nutritional status during the periconceptional and antenatal period may reduce the prevalence of low birthweight and subsequent stunting in low- and middle-income countries.

9.
Working Paper - Groupe de Recherche en Economie et Developpement International (GREDI) 2020. (20-10):34 pp. 30 ref. ; 2020.
Article in French | CAB Abstracts | ID: covidwho-2045283

ABSTRACT

We examine the effects of fiscal policy on the Quebec territory using data from Q1-1981 to Q1-2020. To do so, we estimate VAR models and extract government spending shocks according to the sign restriction method proposed by Uhlig (2005). The impulse responses of real GDP, household consumption, private non-residential investment, and the household confidence index to a temporary and positive government spending shock are all significantly positive in the short run. We find high multipliers for total government spending shocks-they are above 2 in the short run, while government investment spending is above 3.5 and shows greater persistence. The possible consequences of the pandemic and the stimulus package on Quebec's debt trajectory complete the analysis. Lastly, government investment spending is the best way to get the economy going and even lower the debt ratio to meet the goals for 2026.

10.
Journal of the Intensive Care Society ; 23(1):112, 2022.
Article in English | EMBASE | ID: covidwho-2043020

ABSTRACT

Introduction: Nutritional optimisation is recognised as having significant impact on clinical and functional outcomes of critically ill patients.1 Clinical recommendations suggest use of indirect calorimetry guided nutrition in the intensive care unit (ICU),2 and a recent systematic review demonstrated improved outcomes from its use.3 The COVID-19 pandemic has seen a greater proportion of patients with prolonged critical illness, a cohort for whom nutritional optimisation is a key unmet need.4 Objectives: To assess rates of over and underfeeding in a tertiary centre ICU and how these relate to markers of catabolism and persistent critical illness. Methods: Serial measurements of REE (resting energy expenditure) and RQ (respiratory quotient) by indirect calorimetry were performed using Q-NRG+ device (COSMED, Rome, Italy). Nutritional intake and estimations of requirements were recorded concurrently together with routine clinical observations, and markers of critical illness, catabolism and over or underfeeding. Results: Across 30 patients, REE was lower than estimated energy requirements, 24.2 (IQR 20.0-28.1) kcal/ day/kg IBW vs. 29.1(IQR 25.4-33.1) kcal/day/kg IBW, p<0.001. 41.8% of measurements showed overfeeding (actual calorie intake >110% of REE), and 23.3% showed underfeeding (actual calorie intake <85% of REE). Obese patients (n=15) were underfed (-98kcal/day deficit) compared to non-obese patients (n=15), who were on average overfed (+256kcal/day surplus), p=0.021. Overfeeding was also associated with greater length of ICU admission (R2 0.159, p<0.005). Median day of ICU admission in overfed patients was 39 days (IQR 24-56), and in underfed patients 21.5 (IQR 7.5-45.25). However, there was no significant association between calorie surplus or deficit, and other markers of overfeeding PaCO2, insulin use, ureacreatinine-ratio. Conclusion: This service evaluation recorded measurements of REE and RQ in critically ill patients with high lengths of ICU stay (up to 66 days). We observed increased rates of overfeeding with increased duration of ICU admission, and increased overfeeding in non-obese patients.

11.
Risk Manag Healthc Policy ; 15: 1727-1740, 2022.
Article in English | MEDLINE | ID: covidwho-2039551

ABSTRACT

Purpose: To evaluate the resulting level of fiscal medical and health expenditure in China, and to provide the scientific basis for further improving fiscal medical and health service capacity in China. Patients and Methods: The data envelopment method and Gini coefficient method were used to analyze the efficiency and regional fairness of fiscal medical and health expenditure results by using the relevant provincial and municipal data of China from 2007 to 2019. Results: 1.Overall, from 2007 to 2019, the total expenditure continued to increase, the expenditure efficiency increased first and then decreased, and the expenditure fairness continued to improve. 2. From the perspective of subregions, there are apparent differences between regions in terms of total expenditure, expenditure efficiency, and expenditure fairness, showing a better situation in the central, western, northeast and a lower situation in the east. Conclusion: The overall level of fiscal medical and health expenditure in China shows an upward trend, but there is still much room for improvement. At the same time, there are pronounced regional differences, and the problems of efficiency and fairness coexist among regions. Therefore, in the future, we should increase medical and health investment and enhance the government's close attention; Improve the expenditure performance appraisal system; Formulate policies according to local conditions and avoid "one size fits all.".

12.
Economics Letters ; : 110302, 2022.
Article in English | ScienceDirect | ID: covidwho-1647909

ABSTRACT

We investigate the effect of equity market volatility due to infectious disease on U.S. firms’ corporate activities from 1985 to 2020. Consistent with the theoretical framework, firms decrease their debt levels, debt maturity, corporate investments and dividend payout, and increase their cash holdings, research and development expenditure.

13.
Sustainability ; 14(17):10647, 2022.
Article in English | ProQuest Central | ID: covidwho-2024188

ABSTRACT

Education for sustainable development poses high challenges to governments and public finance. Compared with OECD countries, China’s local governments bear too much expenditure responsibilities with respect to compulsory education, which theoretically affects the high-quality equity of compulsory education. Through empirical analysis using cross-country data with the panel spatial model, it is found that the proportion of central government expenditure and the government’s educational effort both have a steady and negative impact on the regional variable coefficient of compulsory education completion rate. Unitary or federal regime does not have a significant impact on the result. This paper suggests establishing a sharing financing system among all levels of government. According to the minimum standard guarantee principle of basic public services, the central government, which has the strongest fiscal capacity, should establish the national standard and take the responsibility on coordinating and balancing education service among regions and promoting the inter-regional equity. Local governments are encouraged to provide education services above national standard in accordance with their fiscal capacities.

14.
Sustainability ; 14(16):10431, 2022.
Article in English | ProQuest Central | ID: covidwho-2024165

ABSTRACT

This study analyzes the dynamics between public expenditure and economic growth in Peru for 1980Q1–2021Q4. We used quarterly time series of real GDP, public consumption expenditure, public expenditure, and the share of public expenditure to output. The variables were transformed into natural logarithms, wherein only the logarithm of public expenditure to output ratio is stationary and the others are non-stationary I1. The study of stationary time series assesses whether Wagner’s law, the Keynesian hypothesis, the feedback hypothesis, or the neutrality hypothesis is valid for the Peruvian case according to Granger causality. We found cointegration between real GDP and public expenditure, and public consumption expenditure and real GDP. Estimating error correction and autoregressive distributed lag models, we concluded that Wagner’s law and the Keynesian hypothesis are valid in the Peruvian case, expressed as dynamic processes that allow us to obtain short-run and long-run impacts, permitting the mutual sustainability of economic growth and public expenditure.

15.
JMIR Ment Health ; 9(9): e37354, 2022 Sep 07.
Article in English | MEDLINE | ID: covidwho-2022367

ABSTRACT

BACKGROUND: An anticipated surge in mental health service demand related to COVID-19 has motivated the use of novel methods of care to meet demand, given workforce limitations. Digital health technologies in the form of self-tracking technology have been identified as a potential avenue, provided sufficient evidence exists to support their effectiveness in mental health contexts. OBJECTIVE: This literature review aims to identify current and potential physiological or physiologically related monitoring capabilities of the Apple Watch relevant to mental health monitoring and examine the accuracy and validation status of these measures and their implications for mental health treatment. METHODS: A literature review was conducted from June 2021 to July 2021 of both published and gray literature pertaining to the Apple Watch, mental health, and physiology. The literature review identified studies validating the sensor capabilities of the Apple Watch. RESULTS: A total of 5583 paper titles were identified, with 115 (2.06%) reviewed in full. Of these 115 papers, 19 (16.5%) were related to Apple Watch validation or comparison studies. Most studies showed that the Apple Watch could measure heart rate acceptably with increased errors in case of movement. Accurate energy expenditure measurements are difficult for most wearables, with the Apple Watch generally providing the best results compared with peers, despite overestimation. Heart rate variability measurements were found to have gaps in data but were able to detect mild mental stress. Activity monitoring with step counting showed good agreement, although wheelchair use was found to be prone to overestimation and poor performance on overground tasks. Atrial fibrillation detection showed mixed results, in part because of a high inconclusive result rate, but may be useful for ongoing monitoring. No studies recorded validation of the Sleep app feature; however, accelerometer-based sleep monitoring showed high accuracy and sensitivity in detecting sleep. CONCLUSIONS: The results are encouraging regarding the application of the Apple Watch in mental health, particularly as heart rate variability is a key indicator of changes in both physical and emotional states. Particular benefits may be derived through avoidance of recall bias and collection of supporting ecological context data. However, a lack of methodologically robust and replicated evidence of user benefit, a supportive health economic analysis, and concerns about personal health information remain key factors that must be addressed to enable broader uptake.

16.
African Journal of Economic and Management Studies ; 13(3):452-467, 2022.
Article in English | ProQuest Central | ID: covidwho-2018431

ABSTRACT

Purpose>Innovation is regarded as a crucial determinant of growth and development in South Africa, and small, medium and micro enterprises (SMMEs) have been earmarked as instruments for the achievement of the socio-economic goals and innovation as set out in the National Development Plan. The purpose of this study is to investigate the effect of innovation on SMME performance in South Africa.Design/methodology/approach>The empirical analysis was conducted using the quantile regression technique to examine the effect of innovation on the performance of firms at different sales levels. Data from the World Bank's enterprise survey was used for the analysis.Findings>The results of the empirical analysis showed that R & D expenditures have a positive and significant effect on performance for firms with higher sales (high growth or larger firms). There is evidence that the introduction of new products/services promotes performance for low growth/ smaller firms.Practical implications>The empirical results imply that innovation is crucial for SMMEs’ development and growth. However, smaller/low growth firms are not able to spend on R & D due to a lack of funds which could be the reason for their low survival rate. More support needs to be provided to smaller firms with lower sales growth, given the large financial outlay required for R & D expenditures. Despite the lack of funding for R & D expenditure, smaller firms are encouraged to introduce new products and methods of production that do not require major financial outlays.Originality/value>There is scant empirical evidence on the impact of innovation on firm performance in South Africa. Most studies investigate the challenges faced by SMMEs and the different types of innovation approaches used by firms. Furthermore, the study employs the quantile regression approach which highlights the effect of innovation on firms of different sizes.

17.
Research Series - Economic Policy Research Centre 2022. (157):52 pp. 39 ref. ; 2022.
Article in English | CAB Abstracts | ID: covidwho-2011810

ABSTRACT

Background: Uganda's budget authority has faced increased fiscal pressure caused by a sudden drop in revenues from the economic slowdown and new expenditure pressures associated with COVID-19 impacts. Consequently, the country has responded by reprioritizing the budget towards 7 sectors, i.e., agriculture, health, education, trade and industry, social development, works and energy. These sectors respond to the government's objective of increasing household and firm production and productivity, providing jobs, reducing the health impacts of coronavirus, supporting poverty reduction efforts, promoting exports and enhancing economic growth. Methods and Data: This paper estimates public development budget allocative and technical efficiency for 7 priority sectors that address government policy objectives. Both allocative and technical efficiency are analysed using ratio calculation. However, for some cases, technical efficiency is analysed based on the difference between target and actual outcomes. We calculate the ratios for the 7 sectors based on the votes and outputs. Furthermore, we use a threshold of 80%, which we deem sufficient to determine whether a budget output is inefficient or not. Budget outputs below 80% are considered to be underperforming. Data on allocative efficiency was provided by MoFPED directorate of budget and that on technical efficiency from budget performance reports. The study period considered for this paper runs from 2016/17 to 2020/21. Findings: While we observe high allocative efficiency in a majority of the proposed reprioritisation sectors, there is much variation in budget funds and their utilisation due to: i. A missing link between policy objectives and budgets. Notably, there is a mismatch between wage and non-wage or capital expenditure (CAPEX) allocations, implying inadequate human resources are required to implement the policy objectives, consequently leading to poor outcomes despite the funding provided for CAPEX. This was endemic in the agriculture and health sectors. ii. Duplication of budget outputs reduces flexibility and accountability and increases monitoring costs. This calls for the consolidation of similar budget outputs, but this should be done with consultation from key stakeholders. iii. There are variations in utilisation of domestic relative to the external development financing with unmet outcomes. This could be a case of stringent donor monitoring requirements and delays in procurement. This calls for strict monitoring of the domestic development financing to ensure results. iv. Relatedly, health budgets exhibit an over-reliance on external financing. However, donor funds are largely not integrated into government budgets and may challenge any planned re-allocation. Hence, there is a need to open a discussion with the donors on the possibility of re-channelling financing to other key priority sectors/outputs in line with the country's short-term goals. v. Generally, as observed in the health and education sectors, budgeting is still based on the output/ institution-based system rather than service. This makes it complex to pool resources, spend and strategically purchase goods and services. There is a need to build stronger linkages between budget allocations and sector priorities. This can also enable the implementation of strategic purchasing and incentivize accountability for sector performance. vi. In addition, there is generally an absence of proper transition towards programme-based budgeting (PBB). For example, numerous budget outputs in the trade, tourism and industry sector do not have performance indicators that weaken the link between strategies, annual plans, sector policies and budgets. vii. Generally, we recommend that new road construction should be paused in the short term so that the available funds can be rechannelled to other urgent and critical areas.

18.
Indian Journal of Critical Care Medicine ; 26:S88-S89, 2022.
Article in English | EMBASE | ID: covidwho-2006375

ABSTRACT

Objective: Primary objective: To study the energy expenditure in a significant number of mechanically ventilated COVID-19 patients in ARDS. Secondary objective: 1. To compare the deviations seen with predictive equations based on actual and ideal body weight. 2. To compare the EE derived versus the VCO2 based estimation. Materials and methods: The Resting Energy expenditure (REE) of 60 patients was measured with the help of the ESCOVYX-module for indirect calorimetry using the GE CARESCAPE R860 ventilator. The steady-state was validated by ensuring a respiratory quotient of 0.7-0.8 and variation of 5% for VCO2 and VO2 for at least 30 minutes. It was ensured that for 60 minutes the patient was not disturbed by endotracheal tube suction, no ventilatory changes were performed, and no vasopressors alteration was done. The absence of a leak was ascertained on the ventilator. The calculation was done from day 2 onwards after mechanical ventilation and subsequently every 2nd day till the patient was on ventilator. The resting energy expenditure was also calculated by the simple predictive equations as per ESPEN COVID-19 guidelines, i.e., 25-30 kcal/kg of which the mean of 27 kcal/kg was chosen. Bodyweight was estimated by height equation 50 kg for 5 ft plus 2.3 kg for each inch >5 feet. The quantitative measures were studied by Bland and Altman plot to describe an agreement between the two by constructing a line of agreement. The limits were calculated by using the mean and standard deviation of the difference between the two measurements. Statistics: The EE derived from the two methods is compared by Bland and Altman plots. Reliability and adequacy between the methods are tested using ROC curves with kappa coefficient (reliability coefficient). For the coefficient of variation, ANOVA is used when applicable. IBM SPSS Statistics for Windows, version 24.0 (IBM Corporation, Chicago, USA) was used to perform analyses. MedCalc version 19 (MedCalc bv, Ostend, Belgium) was used to create BlandeAltman plots. Results: No 1: The estimated mean energy expenditure derived from weight-based calculations was 2576 ± 469 kcal/24 hours, which was significantly higher when compared with an estimation of EE from indirect calorimetry of 1507 ± 499 kcal/24 hours (15-20 kcal/kg/day). This correlation is significant but not useful for prediction (R = 0.345). No 2: The estimated mean EEVCO2 was 1388 ± 467 kcal/24 hours compared with an estimation of EE from indirect calorimetry of 1507 ± 499 kcal/24 hours. The Bias and precision, as visualized by the limits of agreement, are shown in the Bland-Altman plot where there was a significant bias of only 118 kcal/day (95% CI (-187 to 422 kcal);p < 0.001. The regression analysis reveals that for every one unit change in EEVCO2 value, there is one unit change in EE by IC. This correlation is significant (R = 0.951). Similarly, the Bland-Altman plot was tested between the estimated mean EEVCO2 and EE derived from weight-based calculations. The difference was wide with significant bias of 1187 kcal/day (95% CI (-2256 to (-118) kcal);p < 0.001). Conclusion: The ESPEN guidelines (30 kcal/kg through the disease state) for energy estimation may not be right in COVID-19 patients and the study calls for more personalisation of energy estimation by the correct use of indirect calorimetry.

19.
Nutrients ; 14(17)2022 Aug 31.
Article in English | MEDLINE | ID: covidwho-2006149

ABSTRACT

In this study, we explore how to use household expenditures and income surveys (HEIS) to provide replicable and comparable measures of nutrients availability at the population level. Our method formalizes the common practice in the literature and consists of three steps: identification of relevant food categories, pairing of food contents food groups in HEIS data, and calculation of the typical amount of nutrients by food group. We illustrate the usage of the method with Mexican data and provide a publicly available data set to readily convert food purchases into six nutrients: calories, proteins, vitamins A and C, iron, and zinc. We perform a descriptive analysis of the evolution of nutrients intake among Mexican households between 2008 and 2020, considering differences by income level. Our results reflect the effect of the COVID-19 pandemic on nutrient availability in Mexican households, mainly driven by a substantial reduction in the expenditure in food consumed away from home, although for most nutrients the trend was stable over most of the period.


Subject(s)
COVID-19 , Health Expenditures , COVID-19/epidemiology , Humans , Mexico , Pandemics , Vitamins
20.
International Journal of Ethics and Systems ; 2022.
Article in English | Web of Science | ID: covidwho-2005048

ABSTRACT

Purpose This paper aims to examine the dynamic relationship among energy efficiency, health expenditure and economic growth in Malaysia over the sample period of 1980-2016. Design/methodology/approach This study uses autoregressive distributed lag cointegration analysis and the causality approach by the vector error correction model to analyse the relationship among energy efficiency, which is proxied by energy intensity and the determinant factors. Findings The findings of this paper suggest long-run cointegration causal links between economic growth and health expenditure. However, a mixed conclusion for both determinants exists: an increase in real income contributes to more efficient use of energy sources, whereas an increase in government spending on health intensifies energy usage. Originality/value Most previous relevant research has focussed on energy efficiency as measured by economic intensity and economic growth and do not relate to the issue of health expenditure. The recent health catastrophe brought on by the COVID-19 epidemic emphasises the significance of allocating more resources to health care. The findings will be helpful in the development of energy efficiency and economic policies in pursuit of sustainable development goals.

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