Public Health Expenditure and Sustainable Health Outcomes in 45 Sub-Saharan African Countries: Does Government Effectiveness Matter?

Abstract

This paper examines the interaction between health expenditure and health outcomes with due consideration for government effectiveness across developing African economies. The rich data for this study draw from forty-five Sub-Saharan African (SSA) countries covering the period 1960 to 2022. The analysis follows a country-specific comparative manner using the Autoregressive Distributed Lag (ARDL) model as the major estimation technique. The results indicate that poor health outcomes are not due to inadequate budgetary allocations alone. Specifically, this study found a cointegrating relationship and strong adjustment of health outcomes deriving from the shocks and dynamics of not just health expenditures, but also government effectiveness. It is therefore recommended that strong institutions and safety nets be created to guard against corruption and leakages that derail the beneficial impact of public health spending. Also, government expenditures should be focused more on cottage and primary health dimensions to better mitigate adverse health conditions in SSA countries.