Does financial development improve the effect of public health expenditure on out-of-pocket payments for healthcare in the WAEMU?

To achieve Sustainable Development Goal 3, namely to ensure healthy lives and promote well-being for all, it is important to have a sustainable health expenditure model. However, countries in the West African Economic and Monetary Union (WAEMU) are characterized by higher levels of out-of-pocket payments for healthcare. This situation limits access to medical care, makes many people vulnerable to poverty and deviates from the goal of universal health coverage (UHC). This article analyzes the effect of public health expenditure on out-of-pocket payments for healthcare in WAEMU over the period 2000–2020 by taking into account financial development. With the quantile regression technique for panel data, the results show that the increase in public health expenditure leads to a reduction in out-of-pocket payments for healthcare. Moreover, the decrease becomes more significant when public health expenditure interacts with financial development. Thus, improving protection against financial risk related to health expenditure borne by households in the WAEMU requires the establishment of a well-developed health financing system oriented towards an increase in public health expenditure. Policies aimed at further developing the financial sector could have a multiplier effect on the reduction of out-of-pocket payments for healthcare through public expenditure.