Muhammad Khalid, Christian Lorenz, Madiha Amjad.
Influence Factors on Mortality Rates at Punjab District Level.
Pak J Med Health Sci Jan ;6(3):509-16.

Even within the same country the quality of health services might differ significantly between regions, whether the area is more or less prosperous, urban or rural and capital area or in the province. Aiming at equity of health systems, governments are paying attention on the geographical distribution of sub national health expenditures. Accounting these expenditures on disaggregated levels allows decision makers to adjust tailor made health policies. Health expenditure data for Pakistan published in 2009 allow for further analysis on impacts of health expenditures on the health situation of the population at district level. This paper couples expenditures with outcome measures by measuring the impact of public health expenditures on people’s health status, which is reflected by mortality rates. We aim in measuring the importance of public health expenditures compared to private health expenditures, availability of health facilities and other influence factors on mortality rates in district wise estimations. Our findings show in two models that public expenditure, private facilities in urban areas, private urban health expenditure and distance to the next health care facility are significantly related to both IMR and U5MR. Possible reasons for these results are that people have easy access to private facilities as their number is higher than that of public facilities, the quality of services is better and people have better purchasing power as socioeconomic status of urban population is relatively better compared to rural population.

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