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.

中文翻译：

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治理在卫生支出与健康结局之间的作用：西非的见解

目的

尽管全球都在尝试通过改善健康状况来实现可持续发展目标的目标3，但一些国家（包括西非国家）仍未将其收入的很大一部分用于健康，并且其健康状况仍远低于健康状况。发达国家。除尼日利亚外，乍得和几内亚比绍等国家的安全局势和政治动荡也在加剧。因此，本研究考察了卫生支出对西非次区域三项健康成果的影响，同时调查了这一联系中治理质量的影响。

设计/方法/方法

这项研究在2000-2018年期间对15个西非国家的小组进行了工具变量方法（两阶段最小二乘回归）。这项研究使用了三个代理来衡量健康结果，并且还考虑了六个治理质量的衡量指标。

发现

这项研究的结果表明，各种形式的卫生支出都会显着影响卫生结果。也就是说，卫生支出，婴儿死亡率和五岁以下死亡率之间存在负相关关系，而卫生支出与出生时预期寿命之间存在正相关关系。此外，相同数量的公共卫生支出的总体效果取决于治理的质量，因为治理质量较高的国家可以从其公共卫生支出中更好地受益。

创意/价值

据作者所知，这项研究是首次实证尝试，使用不同的卫生结果和治理方法来检验15个西非国家经济共同体国家中治理在卫生支出与健康结局之间的作用。