IDEAS home Printed from https://ideas.repec.org/a/bla/afrdev/v32y2020i4p673-685.html
   My bibliography  Save this article

Governance, health expenditure and infant mortality in sub‐Saharan Africa

Author

Listed:
  • Zechariah Langnel
  • Ponlapat Buracom

Abstract

The paper examines the effect of governance and health expenditure on infant mortality with a panel data of 32 sub‐Saharan African (SSA) countries from 2000 to 2015. Having accounted for potential endogeneity issues related to maternal choices that are made due to contemporaneous infant mortality, the evidence from system generalized method of moment reveals that health expenditure and governance shows no direct influence on infant mortality. However, the coefficient of the interaction between government effectiveness and health expenditure is significant and shows a negative relationship with infant mortality, implying that the effectiveness of health expenditure may be explained by the administrative capacity of countries in SSA. To validate our model, the result from the sensitivity analysis reveals that health expenditure and its interaction with government effectiveness and political stability/absence of violence exert a reducing effect on the under‐five mortality rate. Therefore, since governance quality is lower in SSA compared to other regions, we recommend that governance should be improved consistently in order to achieve health‐related outcomes. The findings further signal the urgent need to formulate policies that directly redress health conditions, rather than through indirect instruments. This focus is critical for the advancement of sustainable development goal 3 in SSA.

Suggested Citation

  • Zechariah Langnel & Ponlapat Buracom, 2020. "Governance, health expenditure and infant mortality in sub‐Saharan Africa," African Development Review, African Development Bank, vol. 32(4), pages 673-685, December.
    • Handle: RePEc:bla:afrdev:v:32:y:2020:i:4:p:673-685
    DOI: 10.1111/1467-8268.12470
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/1467-8268.12470
    Download Restriction: no
    File URL: https://libkey.io/10.1111/1467-8268.12470?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jacob Novignon & Solomon Olakojo & Justice Nonvignon, 2012. "The effects of public and private health care expenditure on health status in sub-Saharan Africa: new evidence from panel data analysis," Health Economics Review, Springer, vol. 2(1), pages 1-8, December.
    2. Daniel Kaufmann & Aart Kraay, 2008. "Governance Indicators: Where Are We, Where Should We Be Going?," The World Bank Research Observer, World Bank, vol. 23(1), pages 1-30, January.
    3. Vanessa Simen Tchamyou, 2020. "Education, lifelong learning, inequality and financial access: evidence from African countries," Contemporary Social Science, Taylor & Francis Journals, vol. 15(1), pages 7-25, January.
    4. Asongu, Simplice A. & Le Roux, Sara & Biekpe, Nicholas, 2017. "Environmental degradation, ICT and inclusive development in Sub-Saharan Africa," Energy Policy, Elsevier, vol. 111(C), pages 353-361.
    5. Bingjie Hu & Ronald U. Mendoza, 2013. "Public Health Spending, Governance and Child Health Outcomes: Revisiting the Links," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 14(2), pages 285-311, May.
    6. Abdoulaye Diop & Gilles Dufrénot & Gilles Sanon, 2010. "Is Per Capita Growth in Africa Hampered by Poor Governance and Weak Institutions? An Empirical Study on the ECOWAS Countries," African Development Review, African Development Bank, vol. 22(2), pages 265-275.
    7. Theodore J. Davis, 2017. "Good governance as a foundation for sustainable human development in sub-Saharan Africa," Third World Quarterly, Taylor & Francis Journals, vol. 38(3), pages 636-654, March.
    8. Ndikumana, Léonce & Pickbourn, Lynda, 2017. "The Impact of Foreign Aid Allocation on Access to Social Services in sub-Saharan Africa: The Case of Water and Sanitation," World Development, Elsevier, vol. 90(C), pages 104-114.
    9. Azmat Gani, 2007. "Governance and foreign direct investment links: evidence from panel data estimations," Applied Economics Letters, Taylor & Francis Journals, vol. 14(10), pages 753-756.
    10. David Roodman, 2009. "How to do xtabond2: An introduction to difference and system GMM in Stata," Stata Journal, StataCorp LP, vol. 9(1), pages 86-136, March.
    11. Jan Wouters & Alberto Ninio & Teresa Doherty & Hassane Cissé, 2015. "The World Bank Legal Review, Volume 6. Improving Delivery in Development : The Role of Voice, Social Contract, and Accountability," World Bank Publications - Books, The World Bank Group, number 21553.
    12. Phillips, Peter C.B. & Sul, Donggyu, 2007. "Bias in dynamic panel estimation with fixed effects, incidental trends and cross section dependence," Journal of Econometrics, Elsevier, vol. 137(1), pages 162-188, March.
    13. Filmer, Deon & Pritchett, Lant, 1999. "The impact of public spending on health: does money matter?," Social Science & Medicine, Elsevier, vol. 49(10), pages 1309-1323, November.
    14. Gupta, Sanjeev & Verhoeven, Marijn & Tiongson, Erwin R., 2002. "The effectiveness of government spending on education and health care in developing and transition economies," European Journal of Political Economy, Elsevier, vol. 18(4), pages 717-737, November.
    15. Francesco Grigoli & Javier Kapsoli, 2018. "Waste not, want not: The efficiency of health expenditure in emerging and developing economies," Review of Development Economics, Wiley Blackwell, vol. 22(1), pages 384-403, February.
    16. Filmer, Deon & Hammer, Jeffrey S & Pritchett, Lant H, 2000. "Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries," The World Bank Research Observer, World Bank, vol. 15(2), pages 199-224, August.
    17. Arellano, Manuel & Bover, Olympia, 1995. "Another look at the instrumental variable estimation of error-components models," Journal of Econometrics, Elsevier, vol. 68(1), pages 29-51, July.
    18. John Anyanwu & Andrew E. O. Erhijakpor, 2009. "Health Expenditures and Health Outcomes in Africa," African Development Review, African Development Bank, vol. 21(2), pages 400-433.
    19. Jeroen Klomp & Jakob De Haan, 2008. "Effects of Governance on Health: a Cross‐National Analysis of 101 Countries," Kyklos, Wiley Blackwell, vol. 61(4), pages 599-614, November.
    20. Huck-ju Kwon & Eunju Kim, 2014. "Poverty Reduction and Good Governance: Examining the Rationale of the Millennium Development Goals," Development and Change, International Institute of Social Studies, vol. 45(2), pages 353-375, March.
    21. Mark Berger & Jodi Messer, 2002. "Public financing of health expenditures, insurance, and health outcomes," Applied Economics, Taylor & Francis Journals, vol. 34(17), pages 2105-2113.
    22. Kathleen Beegle & Luc Christiaensen & Andrew Dabalen & Isis Gaddis, 2016. "Poverty in a Rising Africa," World Bank Publications - Books, The World Bank Group, number 22575.
    23. Gloria Essilfie & Joshua Sebu & Samuel Kobina Annim, 2020. "Women's empowerment and child health outcomes in Ghana," African Development Review, African Development Bank, vol. 32(2), pages 200-215, June.
    24. Rajkumar, Andrew Sunil & Swaroop, Vinaya, 2008. "Public spending and outcomes: Does governance matter?," Journal of Development Economics, Elsevier, vol. 86(1), pages 96-111, April.
    25. Elola, J. & Daponte, A. & Navarro, V., 1995. "Health indicators and the organization of health care systems in Western Europe," American Journal of Public Health, American Public Health Association, vol. 85(10), pages 1397-1401.
    26. Vollmer, Sebastian & Ziegler, Maria, 2009. "Political Institutions and Human Development Does Democracy Fulfill its 'Constructive' and 'Instrumental' Role?," Policy Research Working Paper Series 4818, The World Bank.
    27. Eric Arthur & Hassan E. Oaikhenan, 2017. "The Effects of Health Expenditure on Health Outcomes in Sub-Saharan Africa (SSA)," African Development Review, African Development Bank, vol. 29(3), pages 524-536, September.
    28. Marwa Farag & A. Nandakumar & Stanley Wallack & Dominic Hodgkin & Gary Gaumer & Can Erbil, 2013. "Health expenditures, health outcomes and the role of good governance," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 33-52, March.
    29. Bienvenido Ortega & Jesús Sanjuán & Antonio Casquero, 2017. "Determinants of efficiency in reducing child mortality in developing countries. The role of inequality and government effectiveness," Health Care Management Science, Springer, vol. 20(4), pages 500-516, December.
    30. Gupta, Sanjeev & Verhoeven, Marijn, 2001. "The efficiency of government expenditure: experiences from Africa," Journal of Policy Modeling, Elsevier, vol. 23(4), pages 433-467, May.
    31. John C. Anyanwu, 2014. "Factors Affecting Economic Growth in Africa: Are There any Lessons from China?," African Development Review, African Development Bank, vol. 26(3), pages 468-493, September.
    32. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 58(2), pages 277-297.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hillary Chijindu Ezeaku & David Okelue Ugwunta & Godwin Imo Ibe & Ebele Igwemeka & Eze Festus Eze & Obiamaka P. Egbo, 2023. "Effect of bilateral and multilateral concessional debts on public investment in Africa: A contingency analysis," African Development Review, African Development Bank, vol. 35(2), pages 198-210, June.
    2. Kossi Atsutsè Dziédzom Tsomdzo & Yacobou Sanoussi & Kodjo Evlo, 2022. "Investissement en santé et état de santé dans les pays de l'UEMOA: entre contribution publique et privée?," African Development Review, African Development Bank, vol. 34(2), pages 244-254, June.
    3. Barnish, Maxwell S. & Tan, Si Ying & Robinson, Sophie & Taeihagh, Araz & Melendez-Torres, G.J., 2023. "A realist synthesis to develop an explanatory model of how policy instruments impact child and maternal health outcomes," Social Science & Medicine, Elsevier, vol. 339(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Olorunfemi Yasiru Alimi & Kazeem Bello Ajide, 2021. "The role of institutions in environment–health outcomes Nexus: empirical evidence from sub-Saharan Africa," Economic Change and Restructuring, Springer, vol. 54(4), pages 1205-1252, November.
    2. Issa Dianda & Idrissa Ouedraogo, 2021. "The synergistic effect of government health spending and institutional quality on health capital accumulation in WAEMU countries," Economics Bulletin, AccessEcon, vol. 41(2), pages 495-506.
    3. Hilaire Gbodja Houeninvo, 2022. "Effects of health expenditures on infant and child mortality rates: A dynamic panel data analysis of 37 African countries," African Development Review, African Development Bank, vol. 34(2), pages 255-267, June.
    4. Gebregziabher, Fiseha & Niño-Zarazúa, Miguel, 2014. "Social spending and aggregate welfare in developing and transition economies," WIDER Working Paper Series 082, World Institute for Development Economic Research (UNU-WIDER).
    5. Micheal Kofi Boachie & Tatjana Põlajeva & Albert Opoku Frimpong, 2020. "Infant Mortality in Low- and Middle-income Countries: Does Government Health Spending Matter?," Journal of Development Policy and Practice, , vol. 5(1), pages 54-73, January.
    6. Mohanty, Ranjan Kumar & Behera, Deepak Kumar, 2020. "How Effective is Public Health Care Expenditure in Improving Health Outcome? An Empirical Evidence from the Indian States," Working Papers 20/300, National Institute of Public Finance and Policy.
    7. Ssozi, John & Amlani, Shirin, 2015. "The Effectiveness of Health Expenditure on the Proximate and Ultimate Goals of Healthcare in Sub-Saharan Africa," World Development, Elsevier, vol. 76(C), pages 165-179.
    8. Kazeem Bello Ajide & Risikat Oladoyin Dauda & Olorunfemi Yasiru Alimi, 2023. "Electricity access, institutional infrastructure and health outcomes in Africa," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 25(1), pages 198-227, January.
    9. Micheal Kofi Boachie & K. Ramu & Tatjana Põlajeva, 2018. "Public Health Expenditures and Health Outcomes: New Evidence from Ghana," Economies, MDPI, vol. 6(4), pages 1-25, October.
    10. Fiseha Gebregziabher & Miguel Niño-Zarazúa, 2014. "Social Spending and Aggregate Welfare in Developing and Transition Economies," WIDER Working Paper Series wp-2014-082, World Institute for Development Economic Research (UNU-WIDER).
    11. Mongbet Zounkifirou & TOURERE Zenabou & Poutouochi Mongapna Arouna, 2021. "Health Spending, Democracy and Child Mortality in Developing Countries," International Journal of Research and Innovation in Social Science, International Journal of Research and Innovation in Social Science (IJRISS), vol. 5(09), pages 654-661, September.
    12. Mohamed Ben Mimoun & Asma Raies, 2022. "Is social spending pro‐poor in developing countries? The role of governance and political freedom," Poverty & Public Policy, John Wiley & Sons, vol. 14(3), pages 214-241, September.
    13. Yusuke Kamiya, 2010. "Determinants of Health in Developing Countries:Cross-Country Evidence," OSIPP Discussion Paper 10E009, Osaka School of International Public Policy, Osaka University.
    14. Kin Sibanda & Alungile Qoko & Dorcas Gonese, 2024. "Health Expenditure, Institutional Quality, and Under-Five Mortality in Sub-Saharan African Countries," IJERPH, MDPI, vol. 21(3), pages 1-23, March.
    15. Blane D. Lewis, 2017. "Local government spending and service delivery in Indonesia: the perverse effects of substantial fiscal resources," Regional Studies, Taylor & Francis Journals, vol. 51(11), pages 1695-1707, November.
    16. Jeffrey Kouton & Rafiou R. Bétila & Moïse Lawin, 2021. "The Impact of ICT Development on Health Outcomes in Africa: Does Economic Freedom Matter?," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 12(4), pages 1830-1869, December.
    17. Bernadette O'Hare & Steve G. Hall, 2022. "The Impact of Government Revenue on the Achievement of the Sustainable Development Goals and the Amplification Potential of Good Governance," Central European Journal of Economic Modelling and Econometrics, Central European Journal of Economic Modelling and Econometrics, vol. 14(2), pages 109-129, June.
    18. Bienvenido Ortega & Jesús Sanjuán & Antonio Casquero, 2017. "Determinants of efficiency in reducing child mortality in developing countries. The role of inequality and government effectiveness," Health Care Management Science, Springer, vol. 20(4), pages 500-516, December.
    19. Tadadjeu, Sosson & Njangang, Henri & Asongu, Simplice A. & Kamguia, Brice, 2023. "Natural resources, child mortality and governance quality in African countries," Resources Policy, Elsevier, vol. 83(C).
    20. Njangang, Henri & Asongu, Simplice A. & Tadadjeu, Sosson & Nounamo, Yann & Kamguia, Brice, 2022. "Governance in mitigating the effect of oil wealth on wealth inequality: A cross-country analysis of policy thresholds," Resources Policy, Elsevier, vol. 76(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:afrdev:v:32:y:2020:i:4:p:673-685. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://edirc.repec.org/data/afdbgci.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.