Introduction Although health expenditure in sub-Saharan African countries is the lowest compared with other regions in the world, most African countries have improved their budget allocations to health care over the past 15 years. The majority of health care sources in sub-Saharan Africa are private and largely involve out-of-pocket expenditure, which may prevent healthcare access. Access to healthcare is a known predictor of infant mortality. Therefore the objective of this study is to determine the impact of health care expenditure on infant mortality in sub-Saharan Africa. Methods The study used panel data from World Bank Development Indictors (WDI) from 2000 to 2015 covering 46 countries in sub-Saharan Africa. The random effects model was selected over the fixed effects model based on the Hausman test to assess the effect of health care expenditure on infant and neonatal mortality. Results Both public and external health care spending showed a significant negative association with infant and neonatal mortality. However, private health expenditure was not significantly associated with either infant or neonatal mortality. In this study, private expenditure includes funds from households, corporations and non-profit organizations. Public expenditure include domestic revenue as internal transfers and grants, transfers, subsidies to voluntary health insurance beneficiaries, non-profit institutions serving households or enterprise financing schemes as well as compulsory prepayment and social health insurance contributions. External health expenditure is composed of direct foreign transfers and foreign transfers distributed by government encompassing all financial inflows into the national health system from outside the country. Conclusion Health care expenditure remains a crucial component of reducing infant and neonatal mortality in sub-Saharan African countries. In the region, where health infrastructure is largely underdeveloped, increasing health expenditure will contribute to progress towards reducing infant and neonatal mortality during the Sustainable Development Goals (SDGs) era. Therefore, governments in the region need to increase amounts allocated to health care service delivery in order to reduce infant mortality.

中文翻译：

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撒哈拉以南非洲卫生支出对婴儿死亡率的影响：面板数据分析的证据。

简介尽管撒哈拉以南非洲国家的医疗保健支出与世界其他地区相比是最低的，但在过去15年中，大多数非洲国家都改善了对医疗保健的预算拨款。撒哈拉以南非洲地区的大多数医疗保健来源都是私人的，并且主要涉及自费支出，这可能会阻碍医疗保健的获取。获得医疗保健是婴儿死亡率的已知预测因子。因此，本研究的目的是确定医疗保健支出对撒哈拉以南非洲婴儿死亡率的影响。方法该研究使用了2000年至2015年世界银行发展指标（WDI）的面板数据，该数据覆盖了撒哈拉以南非洲的46个国家。根据Hausman检验，从固定效应模型中选择了随机效应模型，以评估医疗保健支出对婴儿和新生儿死亡率的影响。结果公共和外部卫生保健支出均与婴儿和新生儿死亡率呈显着负相关。但是，私人卫生支出与婴儿或新生儿死亡率均无显着相关。在这项研究中，私人支出包括来自家庭，公司和非营利组织的资金。公共支出包括作为内部转移和赠款的国内收入，转移，对自愿健康保险受益人的补贴，为家庭服务的非营利机构或企业融资计划，以及强制性预付款和社会健康保险缴费。外部卫生支出包括直接国外转移支付和政府分配的国外转移支付，包括从国外到国家卫生系统的所有资金流入。结论在撒哈拉以南非洲国家，医疗保健支出仍然是降低婴儿和新生儿死亡率的重要组成部分。在该地区卫生基础设施严重落后的地区，增加卫生支出将有助于在可持续发展目标（SDGs）时代降低婴儿和新生儿死亡率。因此，该地区各国政府需要增加分配给卫生保健服务的资金，以降低婴儿死亡率。