Innocent Makuta|Bernadette O’Hare
Quality of governance, public spending on health and health status in Sub Saharan Africa: a panel data regression analysis
University of Malawi|University of St Andrews
population sub saharan africa ssa suffers poor health manifested high mortality rates low life expectancy economic growth consistently shown major determinant health outcomes however even good economic growth rates possible achieve desired improvements health outcomes public spending health psh long viewed potential complement economic growth improving health however relationship psh health outcomes inconclusive inconclusiveness may part explained governancerelated factors mediate impact former latter little empirical work done regard ssa paper investigates whether quality governance qog modifying effect impact public health spending health outcomes measured underfive mortality u5m life expectancy birth le ssa using two staged least squares regression technique panel data 43 countries ssa period 19962011 estimated effect public spending health quality governance u5m le controlling gdp per capita socioeconomic factors also interacted psh qog find latter modifying effect formers impact u5m le public spending health statistically significant impact improving health outcomes direct elasticity respect underfive mortality 009 011 semielasticity respect life expectancy 035 060 allowing indirect effect psh spending via interaction quality governance find improvement qog enhances overall impact psh countries higher quality governance overall elasticity psh respect underfive mortality 017 019 countries lower quality governance 009 corresponding semi elasticities respect life expectancy 6 countries higher qog 3 countries lower qog public spending health improves health outcomes impact mediated quality governance higher impact health outcomes countries higher quality governance lower impact countries lower quality governance may due increased efficiency use available resources better allocation qog improves improving qog would improve health outcomes ssa increase psh twice effective reducing u5m increasing le countries good qog compared countries poor qog