Do Political Factors affect Government Health Spending? Empirical Evidence from Sub-Sahara African Countries

Dianda Issa


In Sub-Saharan Africa (SSA), access to essential health care services remains problematic. The financing of health care is mainly provided by private sources, mainly out-of-pocket payments which represent respectively 53.12% and 36.73% of total health expenditure in 2016. As for public health expenditure, essential for ensuring universal health coverage, it represents only about 35% of health expenditure. Thus, the increase in public spending on health from domestically sources proves to be a major challenge for the countries of the region in the prospect of reaching the SDG relating to health by 2030. This paper aims to analyse the determinants of domestic government health spending in SSA by focusing on political factors. We use data from 39 SSA countries covering the period 2010-2016 and panel-corrected standard errors method for empirical investigation. The results show that democracy favours an increase in government health spending. Furthermore, a political competitive environment, the guarantee and the protection of civil liberties and political right, accountability, government effectiveness and political stability are decisive for increasing government health spending. The results also showed that political participation does not affect public health spending. These results indicate that improving political factors is essential to increase public spending in SSA.

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