The role of governance in the health expenditure–health outcomes nexus: insights from West Africa

What is it about?

Health expenditure in West Africa is largely out of pocket and insurance to this sector is also minimal. Given the need to achieve the Sustainable Development Goals (SDGs) one of which targets a reduction in mortality rates, this study focuses on examining the effect of health expenditure on health outcomes. Additionally, the study investigates the mediating effect of governance in the relationship between public health spending and health outcomes using six measures of governance as robustness checks and three types of outcomes (infant mortality, under-five mortality and life expectancy). 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.

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