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Public health expenditure and child mortality in Southern Africa

Chamunorwa Nyamuranga (KDI School of Public Policy and Management, Sejong, The Republic of Korea)
Jaeun Shin (KDI School of Public Policy and Management, Sejong, The Republic of Korea)

International Journal of Social Economics

ISSN: 0306-8293

Article publication date: 4 October 2019

Issue publication date: 4 October 2019



The purpose of this paper is to empirically assess the effect of public health expenditure on child mortality in the Southern African Development Community (SADC) region in comparison to the developing world as a whole and the region of Sub-Saharan Africa (SSA).


This study used panel data extracted from the World Development Indicators database for the period 2000–2013 for 98 developing countries including 15 SADC countries. A dynamic panel data model of child mortality was estimated using the system generalized method of moments technique.


Results indicate that public health expenditure has a statistically significant effect on reducing infant and under-five mortality rates in the developing world, and that this effect is strongest in the SADC. Immunization and female literacy contributed significantly to the prevention of deaths of infants and children under five in developing countries. In the region of SSA, improved water sources and the reduction in the prevalence of HIV were found to be effective in reducing childhood mortality. There was little evidence for the benefit of higher GDP per capita.

Practical implications

The findings of this study suggest four policy areas which should be prioritized in public health spending to achieve better health among children: ensuring that females have better access to education, providing immunizations, intensifying interventions against the spread of HIV/AIDS, and improving water and sanitation infrastructure.


This study, which shows that the benefits of public health expenditure may be augmented by regional collaborations like the SADC, is one of the first to explore regional heterogeneity in the effectiveness of public health expenditure for the improvement of children’s health across the developing world.



The authors are grateful to the KDI School of Public Policy and Management for providing financial support.


Nyamuranga, C. and Shin, J. (2019), "Public health expenditure and child mortality in Southern Africa", International Journal of Social Economics, Vol. 46 No. 9, pp. 1137-1154.



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