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On the efficiency of public health expenditure in Sub-Saharan Africa: Does corruption and quality of public institutions matter?

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  • Novignon, Jacob

Abstract

Health expenditure in Sub-Saharan Africa (SSA) has improved over the years with several recent efforts to improve resource commitments to the health sector. Health outcomes in the region have, however, seen little improvements over the years. Several reasons, including the efficiency of health expenditure, have been given to justify this mismatch. Studies on health expenditure efficiency have mainly focused on developed regions with little attention to SSA. The objective of the study was, therefore, to examine The effects of corruption and public institution quality on efficiency. The efficiency of health expenditure was also compared across selected SSA countries. Data for the study was sourced from the World Bank's World Development Indicators for 45 countries covering the period 2005 to 2011. The two-stage Data Envelopment Analysis (DEA) was employed for the analysis. The first stage computes efficiency scores while the second stage examines the determinants of efficiency using the Tobit model. Per capita health expenditure was used as input while infant, under-five mortality and crude death rates were used as outputs. The results show that health expenditure efficiency was low with average scores of approximately 0.5. This suggests that there exist significant potential for SSA countries to improve population health outcomes given the level of expenditure. There was significant variation across countries with Cape Verde, Eritrea and Mauritius among the efficient countries while Equatorial Guinea, Sierra Leone and Swaziland were relatively inefficient. High corruption and poor public sector institutions reduced health expenditure efficiency. The findings emphasize the fact that, while increased health spending is necessary, it is also important to ensure efficiency in resource use across SSA countries. This can be achieved by effective monitoring and evaluation programmes that ensure reduced corruption and improved public institutions.

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  • Novignon, Jacob, 2015. "On the efficiency of public health expenditure in Sub-Saharan Africa: Does corruption and quality of public institutions matter?," MPRA Paper 39195, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:39195
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    1. Afonso, Antonio & St. Aubyn, Miguel, 2005. "Non-Parametric Approaches to Education and Health Efficiency in OECD Countries," Journal of Applied Economics, Universidad del CEMA, vol. 8(2), pages 1-20, November.
    2. Vasanthakumar Bhat, 2005. "Institutional arrangements and efficiency of health care delivery systems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(3), pages 215-222, September.
    3. Herrera, Santiago & Pang, Gaobo, 2005. "Efficiency of public spending in developing countries : an efficiency frontier approach," Policy Research Working Paper Series 3645, The World Bank.
    4. Selma J. Mushkin, 1962. "Health as an Investment," NBER Chapters, in: Investment in Human Beings, pages 129-157, National Bureau of Economic Research, Inc.
    5. McDonald, John, 2009. "Using least squares and tobit in second stage DEA efficiency analyses," European Journal of Operational Research, Elsevier, vol. 197(2), pages 792-798, September.
    6. Alan M. Garber & Jonathan Skinner, 2008. "Is American Health Care Uniquely Inefficient?," NBER Working Papers 14257, National Bureau of Economic Research, Inc.
    7. Alan M. Garber & Jonathan Skinner, 2008. "Is American Health Care Uniquely Inefficient?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 27-50, Fall.
    8. Pablo Hernández de Cos & Enrique Moral-Benito, 2011. "Health care expenditure in the oecd countries: efficiency and regulation," Occasional Papers 1107, Banco de España.
    9. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    10. 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.
    11. Yoram Ben-Porath, 1967. "The Production of Human Capital and the Life Cycle of Earnings," Journal of Political Economy, University of Chicago Press, vol. 75(4), pages 352-352.
    12. Martin Neil Baily & Alan M. Garber, 1997. "Health Care Productivity," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 28(1997 Micr), pages 143-216.
    13. Selma J. Mushkin, 1962. "Health as an Investment," Journal of Political Economy, University of Chicago Press, vol. 70(5), pages 129-129.
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    Cited by:

    1. Douanla Tayo Lionel, 2015. "Determinants of Health Spending Efficiency: a Tobit Panel Data Approach Based on DEA Efficiency Scores," Acta Universitatis Danubius. OEconomica, Danubius University of Galati, issue 11(4), pages 56-71, August.
    2. 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.
    3. Roni Factor & Minah Kang, 2015. "Corruption and population health outcomes: an analysis of data from 133 countries using structural equation modeling," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(6), pages 633-641, September.
    4. Novignon, Jacob & Nonvignon, Justice, 2015. "Fiscal space for health in Sub-Saharan African countries: an efficiency approach," MPRA Paper 63015, University Library of Munich, Germany.
    5. Zhizhong Liu & Qianying Chen & Guangyue Liu & Xu Han, 2022. "Do Deep Regional Trade Agreements Improve Residents’ Health? A Cross-Country Study," IJERPH, MDPI, vol. 19(21), pages 1-16, November.

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    More about this item

    Keywords

    Health expenditure efficiency; Tobit model; DEA; SSA; Corruption; Public institutions;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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