Technical Report on Data Analysis: SAFH Fund Allocation in Africa

This technical report analyzes health data to guide the Sub-Saharan Africa Fund for Health (SAFH) in allocating its funds among several African countries. The report employs a quasi-experimental design, utilizing both descriptive and inferential statistics to evaluate key indicators such as population growth rate, out-of-pocket expenses, and current health expenditures per capita. The analysis focuses on ten Sub-Saharan African countries, with a detailed examination of Ethiopia, highlighting its high population growth rate, increasing health expenditures, and prevalence of diseases like Meningitis and Diarrheal. The report presents summary statistics, graphical representations, and interpretations of the data, ultimately recommending that SAFH prioritize funding for Ethiopia. The analysis includes data on various health expenditure components, disease incidence, and mortality rates, providing a comprehensive overview to support the fund allocation decision. Recommendations are provided to the officials of SAFH and other factors as to why Ethiopia qualifies to acquire funds.

Running Head: STATISTICS 1
Technical Report on Data Analysis
Name
Affiliation
Date

STATISTICS 2
Executive Summary
This paper explored the technical report through analyzing the data. The purpose of the
technical part in this analysis was to provide clear basement on the the SAFH can provide its funds
among the Sub-Saharan African countries. Basing on the analysis presented using two methods that is;
descriptive and inference, Ethiopia was chosen as the country in which SAFH should prioritize its
funds. Among the indicators used in the technical part, population growth rate, Out-of-pocket and the
current health expenditures per-capita among the countries was evaluated. Ethiopia, has been
associated mostly by five diseases especially Meningitis, transport injuries, mental disorders among
others. Conclusions and recommendations t the officials of SAFH are provided and other factors as to
why Ethiopia qualifies to acquire funds.

STATISTICS 3
Statement of the purpose of the Analysis
This report is hoped to identify several analytical presentations, conclusions and
recommendations on how Sub-Saharan Africa Fund for health (SAFH) should allocate its funds to the
countries in the identified region in Africa. The study comprises of countries like; Ethiopia, Ghana,
Kenya, Malawi, Mozambique, Sierra Leone, South Africa, Tanzania, Uganda and Zimbabwe. The
main aim is to provide the officials of SAFH with the reliable information about the health status,
financial expenditure on purchasing medication of certain diseases among others. This is because
SAFH has been reviewing most of several changes in their decision making (Micheal et al, 2017). This
has resulted from the lavish expenditure to some countries which did not show a clear image of an
organization. The organization recently funded the activity of fighting malaria in Uganda, which in
turn reduced the scourge of malaria among the pregnant mothers and other groups of people. However,
the struggle of fighting malaria in Uganda took a lot of funds to other unknown ventures though the
process of eradicating malaria was done.
Methodology and data cleansing methods used to obtain results
The analysis adopted the Quasi-Experimental design type of methodology. This is to examine
the cause-effect correlation between variables. This is because the researcher could not recognize the
dependent or independent variable (s). Therefore, control indicators’ results such as diseases,
population growth rate among countries, out-of-pocket expenses, current health expenses, changing
years, locations among others are exposed and compared to the paired groups out of the purpose of the
analysis.
Data analysis
The data analysis is presented in two phases. These phases include the following; the
descriptive statistics and inferential statistics. Descriptive statistics involves the presentation of tables
and graphs to summarize tables about the indicators in the country. Also, inference statistics includes
building of models, graphical representation among others.
Summary statistics about the level of Current Health Expenditure (CHE) per Capita in
US$ per year in selected 10 countries of sub-Saharan countries
Table 1: Summary Statistics
summary
statistics 2000 2001 2002 2003 2004 2005 2006 2007
Mean
1818.7627
74
1890.50
8
1913.14
1
2178.06
9
2448.77
6
2577.75
4
2792.89
6
3014.15
1
Standard Error
617.05530
74
621.272
8
610.887
9
794.522
9 980.136
1051.70
1
1144.20
3
1250.80
8
Median 26.5 21 22 23 24 28 27 30

STATISTICS 4
StandardDeviati
on
10214.082
79
9940.36
6
9774.20
6
12786.6
4 15773.8
17217.0
9 18414.2
20129.8
4
Sample
Variance
104327487
.2
9881086
7
9553509
6
1.63E+0
8
2.49E+0
8
2.96E+0
8
3.39E+0
8
4.05E+0
8
Kurtosis
117.79994
44
91.9324
2
82.9713
3
134.883
3
166.801
6 183.537
178.690
7
184.600
4
Skewness
9.9528121
42
8.79429
2
8.37147
9 10.711
12.0922
6 12.7556
12.5856
8
12.8304
6
Range 136361 121515 115482 175256 228590 257772 271637 299417
Maximum 136361 121515 115482 175256 228590 257772 271637 299417
Sum 498341 483970 489764 564120 634233 690838 723360 780665
Count 274 256 256 259 259 268 259 259
Source: Researcher, 2019
Table 1 shows summary statistics of the level of current health expenditure per capita in US$
from 2000-2007. The average distribution of CHE per capita on a household level increases as the
years go on increasing. This means as the years go on increasing, the people in the Sub-Saharan
countries increase on the level of expenditure in terms of purchasing of drugs in relation to the
diseases faced by them.
Figure1: Distribution of population of the people from 2007-2015 for ten selected countries
Source: Authors, 2019
Series1 =2015, series2 =2014, series3 =2013, ……………, series8 =2007.
Figure 1 shows the distribution of population among the countries in Sub-Saharan region from
2007 to 2015. From the comparison above, Ethiopia shows the rapid and continuous increase in
population as the years go on increasing. It is evident from the figure above that; Uganda follows

STATISTICS 5
Ethiopia in the rate of increase in population. Ethiopia shows a gradual increase of population growth
rates as the years go on increasing. Due to the Ethiopia’s population growth rate, most diseases arise
from the amount of people in the area. High pressure in the streets and provinces of the country may
attribute to several causes of diseases. Therefore, SAFH should invest its funds to Ethiopia due to the
high rate of Current Heath Expenditure per capita, population growth rates, Out -of- pocket
expenditure among other indicators (Minghui, 2015).
Figure 2: Distribution of Out of pocket as percentage of the CHE among the selected six
countries
Source: Authors, 2019
Figure 2 shows the distribution of Out-of-pocket CHE per capita in countries of Ethiopia,
Ghana, Malawi, Mozambique, Uganda and Zimbabwe. According to the distribution in figure 2 above,
Ghana has got a high rate of OOP as a percentage of current Health Expenditure (CHE). Out of pocket
payments can be referred to as payments done by the households to provide health care services to
them. These oops can be categorized in the form of insurance on medication, taxes being attached on
the medication. OOPs some times are part of financial in health terms among countries basing on the
household’s fees, revenue and health system costs in order to improve efficiency of health services.
Figure 3: Distribution of the increasing diseases in the years of 2015 and 2016 in Ethiopia

STATISTICS 6
Source: Authors, 2019
Where; Series1= 2015 and series2= 2016 in the legendary values in figure 3
Interpretations, Conclusions and Recommendations
Data extracted from the health data GBD excel tools provided reliable data to produce visual
illustrations. The data showed four diseases which are showing a positive trend in Ethiopia. These
diseases include the following; Diarrheal diseases, Meningitis, Mental disorders, and Transport
Injuries. From the output in figure3 above shows that the leading disease in the current years of 2015
and 2016 is the Diarrheal. According to the above output over sixty million people in two years suffer
Diarrheal in Ethiopia.
The SAFH organization should prioritize in Ethiopia because of the increasing population.
Transport injuries, meningitis among others are due to the increasing pressure from the populace.
Funding and Outcome
If the Sub-Saharan African Fund for Health (SAFH) ejects money in Ethiopia, it will help the
construction of public residents and emergence of communication and transport routes. This will
reduce on the accidents arising from transport due to high pressure of population.
The funding of SAFH will help the citizens of Ethiopia to increase on their Current Health
Expenditure (CHE) so that the out-of-pocket expenses among the people are reduced.
Funds by the SAFH hope to help the residents of Ethiopia especially those below poverty line
and rural based to increase their per-capita income. This increases purchasing power of drugs by the
people in case of any outbreak of diseases such as diarrheal, injuries among others.

STATISTICS 7
Discussion of results and recommendations
In Sub-Saharan Africa, the out-of-pocket expenses on health averagely are estimated to be 30%
of the total household expenditure. But the essence of several data on health and the performances in
different nations is to curb the gaps which limit the citizens to acquire proper medication. This
therefore seeks for help from organizations to fund in the economies of the countries so as to increase
on the current health expenses. Several committees of different countries have been putting forward
the proposal projects in order to minimize packages of health care that would be acquired by the
people in form of Universal Health Coverage’s. This therefore brings up the clear image of services
which could be given out through the nation for steady health statuses among the people of the
country. However, there still exits a great gap between funds required by the ministry of health and the
revenues of the governments. Averagely, each country allocates in about 3 % of its Growth Domestic
Product to health services. This however constrains the totality of the budgets attached to the public,
the assistances and the external funds should be recognized and realize that they depend on the amount
of share the government of the specific country whether to attain adjustments in help or not.
Furthermore, it is hoped that there shall be adequate funds provided by the organizations such
as the WHO, SAFH among others to eject a lot of funds to the Sub-Saharan countries in African since
there is political will by the governments. However, some of the African countries have got several
options to pay for their people the health services in terms of insurance or through allocations of
services in the financial year’s budgets. The volunteering organizations to incur in health ministries in
Africa should focus on the providing insurances to residents of the countries according to the
statements made by the data obtained from the National hospitals in order to fund in the country
efficiently. Also, it is not clear that the organization’s funds will create the success of the eradication
of diseases in Africa especially in Ethiopia since the areas of the country are scattered. This therefore
seeks for other means from the government to devise plans being advocated to establish measures of
the scourge of diseases in the country. For the completion of risks related to health issues especially

STATISTICS 8
the Diarrheal, HIV/AIDS, Mental disorders, injuries and other kind of diseases to governments should
eject 75% of their GDP to attain stable economy free from time to time diseases in the countries.
Though the solution of health related problems in Africa is based on the delivery of doctors and
nurses in health care centers in order to reduce the ratio of patient-doctor, the potential and ability of
the doctors fail to curb health problems. This is because not only those doctors can solve the outbreak
of diseases but also a lot of funds are required for many purposes. These purposes of funds may
include; researches for the emanation of diseases, payment of doctors, giving direct funds to the people
among others. It is evident that most of the people about the percentage of 2-3 in Africa go under the
drama of being sick and no way of the resources allocated to them for treatment. However, the
ministries of health in African countries cannot approach the status of health like the way how UK
does in various developmental stages. In most cases, diseases which are not necessarily counted as
primary healthcare. This is not the case with Africa where there are many rural populations that need
primary health care by the voluntary organizations and other agencies.
In addition, it is approximated that 1.6 million people from Sub-Saharan African countries died
of Meningitis, HIV/AIDS, accidents, mental disorders among other diseases in 2015. However, such
sicknesses and diseases can be cured or prevented with regular and timely access to medicines,
vaccines and several health services. According to the World Health Organization, less than 2 percent
of the total medicines utilized in Sub-Saharan African countries are produced on the regional basis.
This implies that most of the people do not get access the locally made drugs for medication thus they
may not be able to get drugs from abroad. Therefore, this seeks for the funds especially in African
countries. The denial of medication in Africa is susceptible to the major killer diseases. These diseases
include the following; diarrheal, tuberculosis, meningitis, trauma, mental disorders among others. In
comparison with the global statistics, 50% of the young children always below the age of five die of
diarrheal and measles but the greatest number out of the percentage comes from Africa. For instance,
in Ethiopia some nurses provide to patients who are even badly off with the painkillers assuming they
will cure the diseases. Some of the households attend to government aided hospitals to seek for

STATISTICS 9
medications but however they do not get because of the unavailability. Therefore, this call upon the
help of SAFH and other organizations to intervene in the situations Africans does face in the struggle
of curing diseases. Most of the system being advocated by most medical personnel’s in health centers
is to advise the transfer of patients to other better hospitals which in turn does not favor the poor
people who have got empty pockets to purchase curable drugs.
The Overview of Ethiopia’s health status
From the time Ethiopia experienced HIV/AIDs for the first time; many people have acquired
better treatment and also free medical services from the government. Their health changed greatly.
Through government intervention where patients have been supported and given treatment regularly at
a free cost, there is easy access to the services provided both nationally and within their local areas.
The president of Ethiopia introduced the President’s Emergency Plan for Aids Relief. The United
States Agency for International Development that is responsible for assisting and providing aid has
supported diseases treatment to the Ethiopians through their service delivery programs. This has been
done by intermediating the supply of drugs and helping healthy workers in rural areas by giving
technical assistance to economists and statisticians. With all this, the United States is said to have
played a great role in the lives of Ethiopians health wise. In a shorter period, many Ethiopians have
been able to access health services which are counseling, testing and provision of treatment from
500,000 to over 9,000,000 people. People on treatment also increased from 900 in 2005 to 394,000 in
2015. However, even though there has been much effort invested in the healthy sector for almost a
decade, death, diseases and misery is still disturbing the Ethiopian people. The country of Ethiopia is
highly populated handling the second position in the sub-Saharan African countries following Nigeria.
The country’s population is estimated to be 104 million persons of whom forty five percent are under
the dependent class of below 15 years, eighty percent are village dwellers. In Ethiopia, above 350,000
children lose their lives annually and almost ninety percent are caused by preventable diseases such as
injuries, pneumonia, diarrhea, poor nutrition and HIV/AIDs. Very many women give birth without the
help of skilled health workers ad due to this, about 19,000 mothers die in the process of giving birth

STATISTICS 10
annually. Since Ethiopian women are fertile but unable to meet their requirements as pregnant
mothers, for every 100,000 live births, 420 are reported to die after giving birth which is ranked very
high compared to other countries. Malnutrition still holds in the country and many children die of it
and it is said that forty four percent of children below the age of five years do suffer from stunted
growth. For the Ethiopian government to have a better health status there has to be a strong policy that
will improve the health of people and also facilitate the entire health system. Special attention should
be given to the women, young children, babies and the old people by fighting preventable diseases and
equally distributing health services in the community so that people become healthy and energetic in
the process.
With support from the United States Agency for Development and other donors like United
Kingdom Agency for Development, the government of Ethiopia health service is currently a model to
other African countries that have few health sector workers and resources. The health care program in
the country mainly focuses on promoting maternal, child and neonatal heath, teaching about family
planning methods and reproductive health, treating and preventing of diseases like mentor disorder,
meningitis, diarrhea, HIV/AIDs and transport injuries, promoting sanitation and distribution of clean
water and finally increasing the nutritional habits of mothers, infants, young children and the elderly.
There is also support in development of human resources and health financing schemes in the country
where United States Agency for Development has supported the government of Ethiopia in training
and employing about 38,000 local people as healthy workers and 4,000 health officers. The struggle
continues in training midwives, nurses and anesthesiologists. More than 100 governments owned
hospitals and 2,500 private health centers in the country have been supported financially and this has
brought an improvement in the quality of services provided by these health centers. To support healthy
policies, there has been support to Government of Ethiopia to use legislation promoting and
community-level health insurance which is said to be the first of its kind in the country.
Meningitis is a disease caused by the damage of the membrane around the brain or the spinal
cord. This disease has got symptoms such as headache, confusion, nausea, vomiting, sensitivity to

STATISTICS 11
light, loss of appetite, stiff neck, fever to mention but a few. In new borne, meningitis leads to constant
crying, poor feeding and it becomes hard to comfort them (Mayo Clinic, 2019). Meningitis is in most
cases caused by a viral infection but also parasites, bacterial and fungal infections cause it. At times,
meningitis improves with no treatment within a short period but again it can also be dangerous
requiring special quick attention. When early treatment is attained, bacterial meningitis can be
prevented. However, this type of meningitis is very dangerous and fatal if not given antibiotics early
enough. Delayed treatment increases the risks of death or permanent brain damage. Bacterial
meningitis is caused when bacteria enters the bloodstream, travels to the brain and spinal cord. These
bacteria cause diseases like; streptococcus pneumonia, Neisseria meningitides, Haemophilus influenza
and Listeria monocytogenes. Viral meningitis is mainly caused by enteroviruses. Risks in acquiring
meningitis include age 9 children below 20 years), living in a community setting with infected people,
skipping vaccinations, pregnancy. Meningitis can be spread through coughing, sneezing, sharing
eating utensils, kissing, and other related practices.
Performance Measures
According to the World Bank reports, 80% of the Sub-Saharan Africans more especially those
in the middle income range and below depend on the health services from public facilities. And with
public facilities, there is ever the cry of shortages of drugs and medication services and this in turn
leads to the death of patients by easily treatable diseases. Various factors restrain the access of drugs
but the vital ones are; the lack of resources (well equipped facilities), incomes and the well trained
health personnel. In Sub-Saharan African countries especially Uganda, Zimbabwe, Kenya among
others has low incomes or revenues more especially the out-of-pocket expenditure per capita. These
countries have got poor medications in their national and regional health facilities, treatments which
are of substandard qualities and stock outs from the hospitals.

STATISTICS 12
Also, the Sub-Saharan African countries have got inefficient, bureaucratic and improper ways
of procuring drugs to the health facilities. This makes the drugs to become more scarce and costly.
Besides this, there are poor transportation services, poor storage facilities for pharmaceuticals and the
low capacity of manufacturing drugs. The capacity for Africa to conduct drugs’ research and
development (R&D) and the production of the local drugs is seen to be low. Recent reports say that
only 37/54 states in Africa have got the improved level of drugs production with exception of South
Africa which has got drugs ingredients than the countries which import the ingredients. However, the
results indicate that Sub-Saharan African countries import 70% of its drugs production. Also, some
African nations spend lavishly on medicines which is in relation to the amount of funds and resources
they owe. More so, there are many limitations and rules which govern the countries in producing their
own medications. Countries have to first abide by the regulations by the Good Manufacturing
Practices (GMP), this however is enforced by the US and several governments to keep the quality and
standards of the process of manufacturing drugs. In this case, most of the African countries lack
technical and financial or at times the human resources need the high drug production scale. However
with the progress of some countries in the production of the local pharmaceuticals cannot limit the
issuance of assistance by the organizations to the African countries. These countries with better and
production levels of local drugs include; Egypt, South Africa, Morocco and Tunisia. Morocco has got
the high level of local pharmaceuticals after South Africa. In addition, most countries in Sub-Saharan
African Countries such as Ethiopia, Kenya, Nigeria, Tanzania, Uganda and others have got the slow
rate in the production of their own pharmaceuticals to boost health facilities among the people in the
country. Therefore, this seeks for assistance from SAFH, WHO, ILO and many other organizations.
Scope of disease in Sub-Saharan Africa
In Sub-Sahara African countries, the national representative studies especially the DHS do not
often identify and report on the cases of death. However, the number of diseases such as diarrheal and
other diseases associated with the occurrence of deaths. This can be attained through the reliable
statistics registrations-systems and from the populations under the study. From the analytical part of

STATISTICS 13
this study, the proportion of the people who die of injuries, meningitis, Trauma, diarrheal and many
others are estimated using the HMIS-systems at the Nations level. Therefore, the reliability, accuracy
and representative of health data depends on the nature of sources and design used to obtain the data.
The main challenges of getting Vital systems of registrations are; underreporting in terms of deaths
rates and coding in wrong ways which at times cause the scourge of diseases. Most of the challenges
are altered to be used in the studies longitudinally to estimate morbidity and to estimate the mortality
rates more especially because of insufficient representativeness, occurrences of biasness and miss-
identification of cause-effect frame work of death.
Some of the countries in Africa whereby there are reliable and sufficient coverage of vital
registrations are; Mauritius, South Africa and Zimbabwe. The vital coverage of in registrations was
estimated to be 100% in 2000. This is because below 2 percent of the children under the age of five
who died were due to the cause of Diarrheal. The current information obtained from the health
ministries of South Africa and Zimbabwe estimated the coverage which is fewer than 50 percent.
Thus, In African regions especially the Sub Saharan areas the most acquired information on the
specific causes of mortality depends on co-current reports in different literatures. The reports
performed by different authors on diseases and mortality rate in Sub-Saharan Africa involved the data
from the cross-sectional empirical reports and the National Disease programs. According to the recent
reviews, longitudinal studies have been considered. The criterions used to obtain the data in Sub-
Saharan Africa involve the cause and effect relationship which is more seasonal.

STATISTICS 14
References
Mayo Clinic Staff . (2019). An overview of Meningitis. Retrieved from:
https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508
Micheal,G., Goss,S & Gelister,Y. (2017).Global funding trends for malaria research in sub-Saharan
Africa: a systematic analysis. Retrieved from:
https://www.thelancet.com/journals/langlo/article/PIIS2214-
109X%2817%2930245-0/fulltext
Minghui, R. (2015).
The Global Fund in China: success beyond the numbers. Retrieved from:
https://www.google.com/search?q=Global+funding+journals&ie=utf-8&oe=utf-8

STATISTICS 15