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

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  • 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
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    References listed on IDEAS

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    1. 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.
    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. 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.
    4. 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.
    5. 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.
    6. Chudik, Alexander & Pesaran, M. Hashem, 2015. "Common correlated effects estimation of heterogeneous dynamic panel data models with weakly exogenous regressors," Journal of Econometrics, Elsevier, vol. 188(2), pages 393-420.
    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. 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.
    10. 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.
    11. 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.
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