BACKGROUND Sub-Saharan African (SSA) countries that currently face enormous healthcare challenges have implemented national health policies focusing on regional or international health commitments. These health commitments generally promote new healthcare financing policies (e.g., health insurance, user fee exemption and results-based financing) with the objective of providing ever-larger population cohorts with human capital and better health in particular. To achieve this, governments must involve themselves more fully in their respective healthcare sectors through the mobilisation of public funding. OBJECTIVE This paper aims to examine convergence in health expenditure throughout SSA. The findings of club convergence will allow a robust comparison of health indicators between countries and will be suitable for the adjustment of health policies to foster the efficiency of such policies at the regional and/or country level. Such findings could also help with the conception and implementation of health policies at the regional level. METHODS We used the methodology of convergence analysis based on dynamic factor modelling leading to the logt regression to test for full convergence, club convergence and club clustering of health expenditure on a balanced panel of 44 countries in Sub-Saharan Africa spanning the period from 2000 to 2016. RESULTS Overall, our results do not support the hypothesis that all SSA countries converge to a single equilibrium state regarding public health expenditure. When testing for club convergence, the results highlight eight convergence clubs and one group of diverging countries. Indeed, performing the club clustering algorithm reveals the existence of three convergence clubs and the diverging group. The three clubs consist of 12, 14 and 14 members, respectively, where convergence is found to occur among different regional economic organisations. CONCLUSION Our findings indicate that SSA governments should increase spending on healthcare in order to align their healthcare systems with a global convergence model. To foster the convergence to a single equilibrium state in public health expenditure, attention could be paid to strengthening integration within the various regional economic organisations and to the coordination and integration of healthcare policies within and across convergence clubs throughout SSA.

中文翻译：

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撒哈拉以南非洲国家公共卫生支出的趋同：俱乐部趋同重要吗？


背景 目前面临巨大医疗保健挑战的撒哈拉以南非洲 (SSA) 国家已实施了侧重于区域或国际卫生承诺的国家卫生政策。这些健康承诺通常会促进新的医疗融资政策（例如，健康保险、用户费用豁免和基于结果的融资），其目标是为越来越多的人口群体提供人力资本，特别是更好的健康状况。为了实现这一目标，政府必须通过动员公共资金更充分地参与各自的医疗保健部门。目的 本文旨在研究整个撒哈拉以南非洲地区卫生支出的趋同性。俱乐部趋同的结果将有助于对国家之间的健康指标进行强有力的比较，并将适用于调整卫生政策，以提高区域和/或国家层面此类政策的效率。这些发现还有助于区域一级卫生政策的构思和实施。方法 我们使用基于动态因子模型的收敛分析方法，通过 Logt 回归来测试 2000 年至 2000 年期间撒哈拉以南非洲 44 个国家的平衡小组的卫生支出的完全收敛、俱乐部收敛和俱乐部聚类情况。 2016 年结果 总体而言，我们的结果并不支持所有撒哈拉以南非洲国家在公共卫生支出方面趋于单一均衡状态的假设。在测试俱乐部趋同性时，结果突出显示了八个趋同的俱乐部和一组不同的国家。事实上，执行俱乐部聚类算法揭示了三个收敛俱乐部和发散组的存在。 这三个俱乐部分别由 12、14 和 14 名成员组成，不同区域经济组织之间存在趋同现象。结论 我们的研究结果表明，SSA 政府应增加医疗保健支出，以使其医疗保健系统与全球融合模式保持一致。为了促进公共卫生支出趋同于单一均衡状态，可以注意加强各区域经济组织内部的一体化，以及整个撒哈拉以南非洲地区趋同俱乐部内部和之间医疗政策的协调和整合。