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All Journal Global Health Management Journal CSID Journal of Infrastructure Development
Makoni, Patricia Lindelwa
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Civil Engineering, Building, Construction & Architecture Decision Sciences, Operations Research & Management Education Engineering Health Professions Medicine & Pharmacology Nursing Public Health Social Sciences

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Decision Framework For Enhancing The Adoption Of Alternative Infrastructure Funding Models In Ghana Aidoo, Samuel Kojo; Makoni, Patricia Lindelwa
CSID Journal of Infrastructure Development Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

This paper examines the socio-economic and infrastructure conditions that determine Ghana’s readiness to adopt alternative infrastructure funding models (AIFMs) for sustainable road development. The objective of the study is to identify the macroeconomic and sectoral drivers of AIFMs’ adoption and to develop policy frameworks for the sustainable financing of infrastructure within Ghana’s context. Ordinary Least Squares (OLS) regression analysis is applied to annual data from 2003 to 2023 to examine the relationship between macroeconomic and infrastructure indicators and economic growth , which is used as a proxy for the viability of AIFMs. The results show that employment growth, educational attainment, and road network expansion are positive contributors to growth. On the other hand, per capita income and governance indicators exhibit a negative relationship with economic growth, suggesting institutional inefficiencies and governance gaps. The impacts of access to healthcare and electricity are mixed and relatively modest, indicating that their role in the adoption of AIFMs depends on institutional and policy integration. The results highlight that fiscal capacity and socio-institutional quality affect AIFMs’ preparedness in Ghana. Based on these results, this study proposes a locally contextualised decision-making framework that incorporates macroeconomic indicators, infrastructure capacity, and social access considerations into infrastructure policy evaluation and funding decisions. The framework translates quantitative findings into a practical model for use in decision-making, providing policymakers with an effective tool for selecting sustainable AIFMs in Ghana.
Climate Variability, Catastrophic Health Expenditure, and Non-Communicable Disease Outcomes in Nigeria Ali, Jude Igyo; Makoni, Patricia Lindelwa
GHMJ (Global Health Management Journal) Vol. 9 No. 2 (2026)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35898/ghmj-921328

Abstract

Background: The challenges posed by climate change and non-communicable diseases (NCDs) are among the most pressing but least explored areas in health economics. Aims: This study examines the impact of climate shocks, non-communicable diseases (NCDs), and catastrophic health expenditure (CHE) in a single micro-econometric model. Methods: The study estimates probit, logit, IV-probit, fixed-effects logit, and IV-2SLS models with temperature anomalies instrumented using the values of the ENSO Oceanic Niño Index to overcome the endogeneity problem, using a harmonized panel of 22,110 households in three waves of the Nigeria General Household Survey-Panel (2010/11, 2012/13 and 2015/16). Results: A 1 °C rise in temperature increases the likelihood of CHE by 4.3-6.1 percentage points and flood vulnerability by 7.1-8.3% points. Across the population affected by non-communicable diseases (NCDs), climate stressors increase the Propensity to experience catastrophic health expenditure (CHE) by approximately 9.4%. Climate variables account for 31.3% of the CHE inequality, with temperature alone explaining 13.6% of the index, and they have a disproportionate impact on poorer households. Instrumental variable projections suggest that an additional 1.9-2.7 million households could experience catastrophic health expenditure (CHE) by 2030 under continued warming trends. Conclusion: Health financing vulnerability in Nigeria is also a function of uneven climate variability, which requires increased health insurance, an enhanced NCD response, and climate-sensitive social protection policies. These results indicate the need for much-needed policy coordination among health, climate, and fiscal governance systems.
Co-Authors Aidoo, Samuel Kojo Ali, Jude Igyo