IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v40y2025i2p427-441.html

Health Expenditure, Governance Quality, and Health Outcomes in West African Countries

Author

Listed:
  • Michael Kouadio
  • Aloysius Njong Mom

Abstract

The study investigates the role of governance quality on the effect of health expenditure on health outcomes captured by life expectancy at birth, infant mortality, under‐five mortality, crude mortality and maternal mortality rates in West African Countries. Although these countries have made significant efforts to increase health expenditure over the years, health outcomes have only responded marginally in West African Countries, raising concerns about the importance of health expenditure in improving health outcomes. This study analyses the relationship between the role of governance and health expenditure and health outcomes using the feasible generalised least squares estimation techniques. The data for the study were sourced from the World Development Indicators and World Governance Indicators for the 15 West African countries from 1996 to 2022. The findings indicate that improving the governance composite index improves selected health outcomes in West African Countries. Furthermore, improving the interaction term between the composite index of governance and health expenditure improves health outcomes in West Africa. Therefore, the study recommends that governments make conscious efforts to allocate more resources to the health sector to improve health outcomes; and fully implement universal healthcare coverage (UHC) as the Côte d’Ivoire government in 2012 to alleviate high poverty levels and health expenses for people. Also, to improve public funds' efficiency and effectiveness and achieve better health outcomes, it is imperative to implement national policies on the institutional environment, and consistently improve governance issues plaguing the health sector. Increasing the salaries of public health workers could help to curb corruption and income inequality and improve their living and working conditions. Doing so will enable the West African countries to achieve health goals and agenda, as outlined in the SDGs.

Suggested Citation

  • Michael Kouadio & Aloysius Njong Mom, 2025. "Health Expenditure, Governance Quality, and Health Outcomes in West African Countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 40(2), pages 427-441, March.
  • Handle: RePEc:bla:ijhplm:v:40:y:2025:i:2:p:427-441
    DOI: 10.1002/hpm.3887
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3887
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hpm.3887?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. Mihaela Onofrei & Anca-Florentina Vatamanu & Georgeta Vintilă & Elena Cigu, 2021. "Government Health Expenditure and Public Health Outcomes: A Comparative Study among EU Developing Countries," IJERPH, MDPI, vol. 18(20), pages 1-13, October.
    2. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1.
    3. 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, April.
    4. Robert J. Barro, 1998. "Determinants of Economic Growth: A Cross-Country Empirical Study," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262522543, December.
    5. Badi Baltagi & Alain Pirotte, 2011. "Seemingly unrelated regressions with spatial error components," Empirical Economics, Springer, vol. 40(1), pages 5-49, February.
    6. Yemin Ding & Lee Chin & Fangyan Li & Peidong Deng, 2022. "How Does Government Efficiency Affect Health Outcomes? The Empirical Evidence from 156 Countries," IJERPH, MDPI, vol. 19(15), pages 1-18, August.
    7. Omar Azfar & Tugrul Gurgur, 2008. "Does corruption affect health outcomes in the Philippines?," Economics of Governance, Springer, vol. 9(3), pages 197-244, July.
    8. Girmay Tsegay Kiross & Catherine Chojenta & Daniel Barker & Deborah Loxton, 2020. "The effects of health expenditure on infant mortality in sub-Saharan Africa: evidence from panel data analysis," Health Economics Review, Springer, vol. 10(1), pages 1-9, December.
    9. Idrissa Ouedraogo & Issa Dianda & Iyewumi Titilope Adeyele, 2020. "Institutional Quality and Health Outcomes in Sub-Saharan Africa," Research in Applied Economics, Macrothink Institute, vol. 12(4), pages 22-45, December.
    10. Gary S. Becker, 1964. "Human Capital: A Theoretical and Empirical Analysis with Special Reference to Education, First Edition," NBER Books, National Bureau of Economic Research, Inc, number beck-5.
    11. 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.
    12. 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.
    13. Uche Abamba Osakede, 2020. "Public health spending and health outcome in Nigeria: the role of governance," International Journal of Development Issues, Emerald Group Publishing Limited, vol. 20(1), pages 95-112, June.
    14. Dhrifi, Abdelhafidh, 2018. "Health-care expenditures, economic growth and infant mortality: evidence from developed and developing countries," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), August.
    15. Stijn Claessens & Erik Feijen, 2006. "Financial Sector Development and the Millennium Development Goals," World Bank Publications - Books, The World Bank Group, number 7145, April.
    16. Akinlo, Anthony E. & Sulola, Abiola O., 2019. "Health care expenditure and infant mortality in sub-Saharan Africa," Journal of Policy Modeling, Elsevier, vol. 41(1), pages 168-178.
    17. David Bloom & David Canning, 2003. "The Health and Poverty of Nations: From theory to practice," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 4(1), pages 47-71.
    18. Daniel Hoechle, 2007. "Robust standard errors for panel regressions with cross-sectional dependence," Stata Journal, StataCorp LLC, vol. 7(3), pages 281-312, September.
    19. 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.
    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. Olorunfemi Yasiru Alimi & Bonuola Victoria Oyeku & Fatimah Ololade Bolarinwa, 2025. "Achieving Sdg 3 In Africa: The Role Of Institutions, The Environment, And Socioeconomic Factors," Economic Annals, Faculty of Economics and Business, University of Belgrade, vol. 70(246), pages 97-139, July – Se.

    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. Jaison Chireshe & Matthew K. Ocran, 2020. "Health care expenditure and health outcomes in sub‐Saharan African countries," African Development Review, African Development Bank, vol. 32(3), pages 349-361, September.
    2. Olorunfemi Yasiru Alimi & Bonuola Victoria Oyeku & Fatimah Ololade Bolarinwa, 2025. "Achieving Sdg 3 In Africa: The Role Of Institutions, The Environment, And Socioeconomic Factors," Economic Annals, Faculty of Economics and Business, University of Belgrade, vol. 70(246), pages 97-139, July – Se.
    3. VĂTAVU Sorana & ȚĂRAN Alexandra-Mădălina & MOLDOVAN Nicoleta-Claudia & LOBONȚ Oana-Ramona, 2022. "Does Technical And Democratic Governance Have The Potential To Enhance Health Spending Allocations?," Studies in Business and Economics, Lucian Blaga University of Sibiu, Faculty of Economic Sciences, vol. 17(3), pages 251-268, December.
    4. 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.
    5. 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.
    6. 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.
    7. Issa Dianda, 2025. "Does Corruption Impede the Accumulation of Human Capital in Developing Countries?," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 33(4), pages 767-783, October.
    8. Cyrille Dominick Bitting & Cristina Chaves, 2025. "Effect of Disasters Induced by Natural Hazards on Child Mortality in Africa," Economics of Disasters and Climate Change, Springer, vol. 9(1), pages 1-28, March.
    9. 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.
    10. Iyad Dhaoui, 2019. "Healthcare system efficiency and its determinants: A two-stage Data Envelopment Analysis (DEA) from MENA countries," Working Papers 1320, Economic Research Forum, revised 21 Aug 2019.
    11. 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.
    12. Ebere Ume Kalu & Chuck Augustine Arize & Felicia Osondu Okwueze & Ndubuisi Udemezue, 2025. "Evaluating the nexus between health expenditure and health outcomes with consideration for income characteristics in SSA countries," Future Business Journal, Springer, vol. 11(1), pages 1-22, December.
    13. Grossbard, Shoshana, 2025. "Spouses as home health workers, childcare workers and cooks: Insights for applied research," Economics & Human Biology, Elsevier, vol. 59(C).
    14. Qiang Li & Lian An & Jing Xu & Mina Baliamoune-Lutz, 2018. "Corruption costs lives: evidence from a cross-country study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 153-165, January.
    15. Seemab Gillani & Muhammad Nouman Shafiq & Tusawar Iftikhar Ahmad, 2019. "Military Expenditures and Health Outcomes: A Global Perspective," iRASD Journal of Energy and Environment, International Research Association for Sustainable Development (iRASD), vol. 1(1), pages 1-20, June.
    16. Hiroyuki Takeshima, 2024. "Public Expenditure’s Role in Reducing Poverty and Improving Food and Nutrition Security: Cross-Country Evidence from SPEED Data," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 36(5), pages 1045-1073, October.
    17. Ziyu Guo & Muhammad Hafeez & Wenxin Wang & Md Abdul Kaium & Ahmer Bilal & Israt Zahan, 2023. "Is the economic uncertainty– human health relationship nonlinear? An empirical analysis for the China," PLOS ONE, Public Library of Science, vol. 18(12), pages 1-17, December.
    18. Muhammad Tariq Majeed & Tania Luni, 2026. "Assessing the Effects of Water Quality on Population Health Outcomes: Does the Level of Economic Development Matter?," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 17(2), pages 4175-4212, April.
    19. Roland Craigwell & Danielle Bynoe & Shane Lowe, 2012. "The effectiveness of government expenditure on education and health care in the Caribbean," International Journal of Development Issues, Emerald Group Publishing Limited, vol. 11(1), pages 4-18, April.
    20. Coronel Vicente J. & Díaz-Roldán Carmen, 2024. "Government Expenditure, Education, and Productivity in the European Union: Effects on Economic Growth," Economics - The Open-Access, Open-Assessment Journal, De Gruyter, vol. 18(1), pages 1-24.

    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:ijhplm:v:40:y:2025:i:2:p:427-441. 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: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    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.