IDEAS home Printed from https://ideas.repec.org/a/gam/jecomi/v13y2025i5p119-d1641454.html
   My bibliography  Save this article

Out-of-Pocket Health Expenditure in Sub Saharan Africa: The Role of Government and External Health Expenditures

Author

Listed:
  • Tewa Papy Voto

    (Auckland Park Kingsway Campus, University of Johannesburg, Johannesburg 2006, South Africa)

  • Nicholas Ngepah

    (Department of Economic and Econometrics, College of Business and Economics, Johannesburg 2006, South Africa)

Abstract

This study aims to analyze the impact of government and external health spending on OOPHE across 30 SSA countries from 1995 to 2021. Using advanced econometric techniques, including the cross-sectionally augmented autoregressive distributed Lags (CS-ARDL) model and the dynamic common correlated effects (DCCE) approach, the study examined both short-term and long-term effects. Findings reveal that in the long term, government health expenditure (GHE) has a more significant impact on reducing OOPHE compared to external health expenditure (EHE). However, in the short term, GHE initially increases OOPHE, while EHE directly reduces it. This suggests that increasing GHE is more effective for long-term progress towards SDG 3. In contrast, EHE can provide immediate relief in the short term. To achieve SDG 3, policymakers should focus on increasing GHE for sustained improvements while leveraging EHE to address short-term challenges. Combining both strategies can optimize progress toward ensuring universal health coverage and well-being for all.

Suggested Citation

  • Tewa Papy Voto & Nicholas Ngepah, 2025. "Out-of-Pocket Health Expenditure in Sub Saharan Africa: The Role of Government and External Health Expenditures," Economies, MDPI, vol. 13(5), pages 1-21, April.
    • Handle: RePEc:gam:jecomi:v:13:y:2025:i:5:p:119-:d:1641454
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2227-7099/13/5/119/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/2227-7099/13/5/119/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Im, Kyung So & Pesaran, M. Hashem & Shin, Yongcheol, 2003. "Testing for unit roots in heterogeneous panels," Journal of Econometrics, Elsevier, vol. 115(1), pages 53-74, July.
    2. Markus Eberhardt & Francis Teal, 2011. "Econometrics For Grumblers: A New Look At The Literature On Cross‐Country Growth Empirics," Journal of Economic Surveys, Wiley Blackwell, vol. 25(1), pages 109-155, February.
    3. Daron Acemoglu & Simon Johnson, 2007. "Disease and Development: The Effect of Life Expectancy on Economic Growth," Journal of Political Economy, University of Chicago Press, vol. 115(6), pages 925-985, December.
    4. Jan Ditzen, 2021. "Estimating long-run effects and the exponent of cross-sectional dependence: An update to xtdcce2," Stata Journal, StataCorp LLC, vol. 21(3), pages 687-707, September.
    5. Ottersen, Trygve & Evans, David B. & Mossialos, Elias & Røttingen, John-Arne, 2017. "Global health financing towards 2030 and beyond," Health Economics, Policy and Law, Cambridge University Press, vol. 12(02), pages 105-111, April.
    6. Ottersen, Trygve & Evans, David B. & Mossialos, Elias & Røttingen, John-Arne, 2017. "Global health financing towards 2030 and beyond," LSE Research Online Documents on Economics 72259, London School of Economics and Political Science, LSE Library.
    7. Edward Nketiah-Amponsah, 2019. "The Impact of Health Expenditures on Health Outcomes in Sub-Saharan Africa," Journal of Developing Societies, , vol. 35(1), pages 134-152, March.
    8. Menyah, Kojo & Nazlioglu, Saban & Wolde-Rufael, Yemane, 2014. "Financial development, trade openness and economic growth in African countries: New insights from a panel causality approach," Economic Modelling, Elsevier, vol. 37(C), pages 386-394.
    9. Tewa Papy Voto & Nicholas Ngepah, 2024. "Personal income tax, redistribution and income inequality in Sub-Saharan Africa," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 71(2), pages 205-223, June.
    10. Albert Opoku Frimpong & Eugenia Amporfu & Eric Arthur, 2021. "Effect of the Ghana National Health Insurance Scheme on exit time from catastrophic healthcare expenditure," African Development Review, African Development Bank, vol. 33(3), pages 492-505, September.
    Full references (including those not matched with items on IDEAS)

    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. Zhenxiong Li & Hilary Ingham, 2020. "Financial Development, Economic Performance and Democracy," Working Papers 291296033, Lancaster University Management School, Economics Department.
    2. Gangopadhyay, Partha & Jain, Siddharth & Bakry, Walid, 2022. "In search of a rational foundation for the massive IT boom in the Australian banking industry: Can the IT boom really drive relationship banking?," International Review of Financial Analysis, Elsevier, vol. 82(C).
    3. Samargandi, Nahla & Fidrmuc, Jan & Ghosh, Sugata, 2015. "Is the Relationship Between Financial Development and Economic Growth Monotonic? Evidence from a Sample of Middle-Income Countries," World Development, Elsevier, vol. 68(C), pages 66-81.
    4. Sudatta Bharati Mohapatra & Nirmal Chandra Kar, 2022. "Revisiting the Long-Run Dynamic Linkage between Dividends and Share Price with Advanced Panel Econometrics Techniques," JRFM, MDPI, vol. 15(10), pages 1-19, October.
    5. Ryan H. Murphy & Colin O’Reilly, 2023. "Freedom through taxation: the effect of fiscal capacity on the rule of law," European Journal of Law and Economics, Springer, vol. 56(1), pages 69-90, August.
    6. Rudra P. Pradhan & Mak B. Arvin & Sahar Bahmani & Sara E. Bennett, 2017. "Broadband penetration, financial development, and economic growth nexus: evidence from the Arab League countries," Macroeconomics and Finance in Emerging Market Economies, Taylor & Francis Journals, vol. 10(2), pages 151-171, May.
    7. Ayhan KULOĞLU & Eyyup ECEVİT, 2017. "The Relationship Between Health Development Index And Financial Development Index: Evidence From High Income Countries," Journal of Research in Economics, Politics & Finance, Ersan ERSOY, vol. 2(2), pages 83-95.
    8. Bloom, David E. & Canning, David & Kotschy, Rainer & Prettner, Klaus & Schünemann, Johannes, 2024. "Health and economic growth: Reconciling the micro and macro evidence," World Development, Elsevier, vol. 178(C).
    9. Dierk Herzer & Holger Strulik & Sebastian Vollmer, 2012. "The long-run determinants of fertility: one century of demographic change 1900–1999," Journal of Economic Growth, Springer, vol. 17(4), pages 357-385, December.
    10. Prempeh Kwadwo Boateng & Frimpong Joseph Magnus & Yeboah Samuel Asuamah, 2024. "The dynamics of financial development, environmental degradation, economic growth and population health in the Economic Community of West African States," Environmental & Socio-economic Studies, Sciendo, vol. 12(2), pages 13-27.
    11. Bottasso, Anna & Castagnetti, Carolina & Conti, Maurizio, 2013. "And yet they Co-move! Public capital and productivity in OECD," Journal of Policy Modeling, Elsevier, vol. 35(5), pages 713-729.
    12. repec:rfh:jprjor:v:8:y:2022:i:3:p:81-97 is not listed on IDEAS
    13. Hakimi, Abdelaziz & Hamdi, Helmi, 2016. "Trade liberalization, FDI inflows, environmental quality and economic growth: A comparative analysis between Tunisia and Morocco," Renewable and Sustainable Energy Reviews, Elsevier, vol. 58(C), pages 1445-1456.
    14. Bloom, David E. & Chen, Simiao & Kuhn, Michael & McGovern, Mark E. & Oxley, Les & Prettner, Klaus, 2020. "The economic burden of chronic diseases: Estimates and projections for China, Japan, and South Korea," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    15. Jonathan Goyette & Maroua Smaoui, 2019. "Civil armed conflicts: the impact of the interaction between climate change and agricultural potential," RIEEM Discussion Paper Series 1903, Research Institute for Environmental Economics and Management, Waseda University.
    16. Victoria P. Litvinets, 2023. "Inflation Targeting and Economic Growth in Developed and Developing Countries: Evaluation of the Policy Effectiveness Using CS-ARDL Approach," Journal of Applied Economic Research, Graduate School of Economics and Management, Ural Federal University, vol. 22(4), pages 814-833.
    17. Bayar Yilmaz, 2016. "Financial Development and Unemployment in Emerging Market Economies," Scientific Annals of Economics and Business, Sciendo, vol. 63(2), pages 237-245, June.
    18. Hakan Yıldırım & Eyyüp Ensari Şahin & Saffet Akdağ & Andrew Adewale Alola, 2023. "The causal nexus between bank indices and geopolitical risk: bootstrap causality analysis under horizontal sector dependence," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 25(2), pages 531-538, December.
    19. Mensi, Walid & Hammoudeh, Shawkat & Tiwari, Aviral Kumar & Al-Yahyaee, Khamis Hamed, 2020. "Impact of Islamic banking development and major macroeconomic variables on economic growth for Islamic countries: Evidence from panel smooth transition models," Economic Systems, Elsevier, vol. 44(1).
    20. Imen Mohamed Sghaier, 2022. "The Role of Institutional Quality in Finance-Growth Nexus: Evidence from North African Countries," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 13(4), pages 3472-3491, December.
    21. Jayasooriya, Sujith, 2020. "Movement of Exchange Rate on Balance-of-Payments Constrained Growth in South Asia: Panel ARDL," MPRA Paper 98733, University Library of Munich, Germany.

    More about this item

    Keywords

    OOPHE; GHE; EHE; CS-ARDL; DCCE;
    All these keywords.

    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:gam:jecomi:v:13:y:2025:i:5:p:119-:d:1641454. 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: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    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.