The role of governance in the health expenditure–health outcomes nexus: insights from West Africa
International Journal of Social Economics
ISSN: 0306-8293
Article publication date: 27 January 2021
Issue publication date: 16 March 2021
Abstract
Purpose
Despite the global attempt at achieving goal 3 of the Sustainable Development Goals by improving health outcomes, some countries (West African countries inclusive) still do not spend a significant proportion of their income on health and they exhibit health outcomes that are still far below that of developed countries. Besides countries like Nigeria, Chad and Guinea-Bissau are experiencing worsening insecurity and political instability. This study, therefore, examines the effect of health expenditure on three health outcomes in the West African sub-region, while investigating the effect of the quality of governance in this nexus.
Design/methodology/approach
This study conducts an instrumental variable approach (two-stage least squares regression) on a panel of 15 West African countries over the period 2000–2018. This study uses three proxies to measure health outcomes and six measures of the quality of governance were also considered.
Findings
The result of this study shows that all forms of health expenditures significantly influenced health outcomes. That is, there is a negative relationship between health expenditure, infant mortality and under-five mortality, but a positive relationship between health expenditure and life expectancy at birth. Besides, the general effect of the same quantity of public health spending is subject to the quality of governance because countries with a higher quality of governance benefit better from their public health spending.
Originality/value
This study, to the authors' knowledge, is the first empirical attempt to examine the role of governance in the health expenditure-health outcomes nexus in 15 ECOWAS countries, using different measures of health outcomes and governance.
Keywords
Acknowledgements
The author thanks the two anonymous reviewers for their helpful comments, and the editors of this journal for their careful copy-editing.Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.Availability of data and data materials: The data used for this work are available at the World Bank's website: https://datacatalog.worldbank.org/search?search_api_views_fulltext_op=AND andquery=current+health+expenditureandnid=andsort_by=search_api_relevanceandsort_by=search_api _relevanceAuthors' contribution: Authors' contribution is not applicable.Conflict of interest: The author declares that they have no conflict of interest.
Citation
Ibukun, C.O. (2021), "The role of governance in the health expenditure–health outcomes nexus: insights from West Africa", International Journal of Social Economics, Vol. 48 No. 4, pp. 557-570. https://doi.org/10.1108/IJSE-06-2020-0404
Publisher
:Emerald Publishing Limited
Copyright © 2021, Emerald Publishing Limited