Public health spending, climate-driven health risks, and under-five mortality in Tanzania. Does governance quality matter?

Abstract

This study investigates the relationship between public health expenditure, climate-driven health risks, governance quality, and under-five mortality in Tanzania. Anchored in the Health Production. Current climate-related health risks and under-five mortality have become pressing public health challenges, particularly in vulnerable countries such as Tanzania. This study examines how public health expenditure, climate-driven health risks, and governance quality influence under-five mortality. Grounded in the Health Production Function theory, it views child health as an outcome of sustained health investments shaped by environmental and institutional conditions. Using annual time-series data utilized from World Bank and an Autoregressive Distributed Lag (ARDL) model, the study analyzes both short- and long-run relationships. Findings indicate that increased public health expenditure significantly reduces under-five mortality in both the short and long run. Governance quality plays a crucial role by strengthening the effectiveness of health spending and reducing the negative effects of climate-related risks. Conversely, factors such as malaria incidence, drought, and carbon monoxide emissions are associated with higher child mortality, especially over time. Interaction results further show that strong governance lessens the impact of climate shocks on child health. The study concludes that improving child survival requires not only increased health spending but also stronger institutions and climate-responsive health policies.