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Using cross-country data on gross domestic product and national expenditure on vaccines, we estimate and compare the income elasticity of vaccine expenditure and general curative healthcare expenditure. This study provides the first evidence on the national income elasticity of vaccination spending. Both fixed and random effects models are applied to data from 84 countries from 2010 to 2011. The income elasticities for healthcare expenditure and vaccine expenditure are 0.844 and 0.336, respectively. Despite vaccines' high cost-effectiveness, the national propensity to spend income on vaccines as income increases lags behind general health care. The low income elasticity of vaccine spending means that relying on economic growth alone will provide an unacceptably slow trajectory to achieving high vaccine coverage levels. Copyright © 2015 John Wiley & Sons, Ltd., (Copyright © 2015 John Wiley & Sons, Ltd.)

Certain nutrients can stimulate appetite making them fattening in a way that is not fully conveyed by the calorie content on the label. For rational eaters, this information gap could be corrected by more labeling. As an alternative, this paper proposes a set of positive and negative taxes on the fattening and slimming nutrients in food rather than on the food itself. There are conditions under which this tax plus subsidy system could increase welfare by stopping unwanted weight gain while leaving the final retail price of food unchanged. A nutrient tax system could improve welfare if fattening nutrients, net of their effect on weight, are inferior goods and the fiscal cost of administering the tax is sufficiently low. More data on the price elasticity of demand for nutrients as well as data on how specific nutrients affect satiety and how total calorie intake would be necessary before one could be sure a nutrient tax would work in practice., (Copyright © 2014 John Wiley & Sons, Ltd.)

We analyze deaths among prime-aged men and women during a 13-year period in a high AIDS mortality setting and examine the distribution of deaths by the economic status of these individuals at baseline using the 1991-2004 Kagera Health and Development Survey (KHDS). We investigate whether the distribution of subsequent prime-age adult deaths as measured by concentration indices depends on the measure of living standards used. We compare the performance of three measures: (1) per capita expenditure; (2) a modern wealth asset index replicating the asset index included in the 2004 Tanzanian AIDS Indicator Survey data file; and (3) a traditional wealth asset index, which includes only measures of traditional wealth. We find no evidence that economic status is linked to prime-age adult deaths, for both men and women, regardless of the measure of economic status used. This finding suggests both that more generally the measure of economic status used does not appear to be crucial, and specifically that relationships using traditional measures of wealth do not seem to differ from those using conventional measures., (Copyright © 2010 John Wiley & Sons, Ltd.)

Objective: To determine the cost-effectiveness of prenatal iron supplementation and misoprostol use as interventions to prevent maternal mortality in home births in rural India., Methods: A cost-effectiveness analysis depicted three hypothetical cohorts of 10,000 pregnant women delivering at home in rural India: one with no intervention, one receiving standard prenatal iron supplements, and 1 receiving 600 microg of misoprostol in the third stage of labor., Results: Misoprostol used to prevent postpartum hemorrhage resulted in a 38% (95% CI, 5%-73%) decrease in maternal deaths, while prenatal iron supplementation resulted in a 5% (95% CI, 0%-47%) decrease. Misoprostol cost a median US $1401 (IQR US $1008-$1848) prenatal iron supplementation cost a median US $2241 (IQR No Lives Saved-$3882) per life saved compared with the standard care outcome., Conclusion: Misoprostol is a cost-effective maternal mortality intervention for home births. Iron supplementation may be worthwhile to improve women's health, but it is uncertain whether it can prevent mortality after hemorrhage.

The goal of this paper is to measure the marginal change in facility-level costs of medical care for children under five due to an increase in service quality achieved through the integrated management of childhood illness (IMCI) strategy. Since the beneficial effects of IMCI training on child health outcomes are due to IMCI's effects on service quality, costs of IMCI are regressed against measures of service quality in this paper. Our model shows that quality, as measured by a WHO-index of integrated child assessment is 44% higher in facilities with at least one health worker trained in IMCI as compared to facilities with no health workers trained in IMCI, adjusting for facility utilization as well as type of facility ownership. Our marginal analysis that tied IMCI training to quality and quality to costs shows that on the margin, investing in IMCI training at a primary facility level can yield a significant 44.3% improvement in service quality for a modest 13.5% increase in annual facility costs., (Copyright (c) 2007 John Wiley & Sons, Ltd.)

Objective: This paper explores why traffic fatalities increase with GDP per capita in lower income countries and decrease with GDP per capita in wealthy countries., Methods: Data from 41 countries for the period 1992-1996 were obtained on road transport crashes, injuries, and fatalities as well as numbers of vehicles, kilometers of roadway, oil consumption, population, and GDP. Fixed effects regression was used to control for unobservable heterogeneity among countries., Results: A 10% increase in GDP in a lower income country (GDP/Capita <1600) is expected to raise the number of crashes by 7.9%, the number of traffic injuries by 4.7%, and the number of deaths by 3.1% through a mechanism that is independent of population size, vehicle counts, oil use, and roadway availability. Increases in GDP in richer countries appear to reduce the number of traffic deaths, but do not reduce the number of crashes or injuries, all else equal. Greater petrol use and alcohol use are related to more traffic fatalities in rich countries, all else equal., Conclusion: In lower income countries a rise in traffic-related crashes, injuries, and deaths accompanies economic growth. At a threshold of around 1,500 dollars-8,000 dollars per capita economic growth no longer leads to additional traffic deaths, although crashes and traffic injuries continue to increase with growth. The negative association between GDP and traffic deaths in rich countries may be mediated by lower injury severity and post-injury ambulance transport and medical care., (Copyright (c) 2005 John Wiley & Sons, Ltd.)

Objectives: This paper asks whether measles vaccination can reduce socioeconomic differentials in under five mortality rates (U5MR) in a setting characterized by extreme poverty and high levels of childhood mortality., Design: Longitudinal cohort study based on quasi experimental design., Setting: Data come from the phased introduction of a measles vaccine intervention in Matlab, Bangladesh in 1982., Subjects: There were 16 270 Bangladeshi children aged 9-60 months., Intervention: The intervention cohort received measles vaccine., Main Outcome Measures: Socioeconomic differentials in U5MR between the lowest and highest socioeconomic status (SES) quintiles in a cohort of 8135 vaccinated children and a cohort of unvaccinated age matched controls. Mantel-Haenszel rate ratios for the lowest to highest SES quintile were computed. SES was measured by factor analysis of maternal schooling, land holdings, dwelling size, and number of rooms., Results: The U5MR ratio of lowest SES to highest was 2.27 (95% CI=1.62-3.19) in the unvaccinated population and 1.42 (95%CI=0.94-2.15) in the vaccinated population. The difference between unvaccinated and vaccinated U5MR ratios was statistically significant (p<0.10) and robust across alternative measures of SES., Conclusion: Children from the poorest quintile were more than twice as likely to die as those from the least quintile in the absence of measles vaccination. Universal distribution of measles vaccination largely nullified SES related mortality differentials within a high mortality population of children., (Copyright 2002 John Wiley & Sons, Ltd.)