Public health spending and under-five mortality rate in East Africa (2000-2018)

Abstract

Over time there has been literature on public health expenditure that has informed implementation of health policy initiatives in developing countries translating into better health outcomes. Despite other contributing factors like female literacy rate, increased per capita incomes among others, governance also plays a central role in ensuring effectiveness in the use of the allocated resources hence achieving the desired health outcomes. This paper therefore examines the effect of public health expenditure on under five mortality rate in the five selected East African Countries using secondary data from 2000 to 2018. Fixed effects method was chosen over pooled OLS and random effects. However, due to the econometric problems of serial correlation, panel heteroscedasticity and cross sectional dependence identified in the fixed effects, the study applied Feasible generalized least square method to mitigate these problems and obtain efficient results. Based on the results obtained, public health expenditure as a percentage of GDP has a significant effect on reducing under five mortality rate by 0.176 percent. Real GDP per capita and female literacy rate also influence the health outcome. Governance directly and indirectly impacts health status. Directly, political stability and rule of law reduce under five mortality by 0.26 and 0.407 percent respectively. Indirectly, we find that an improvement in the governance indicators; government effectiveness, control of corruption, regulatory quality enhances the overall impact of public health spending on under five mortality rate by 0.78,1.3 and 1.49 percent respectively. This implies that countries with good governance have efficient allocation and proper management of health resources hence a decline in under five mortality rate. Therefore, the governments of the selected countries should not only increase their public funding on health but address the governance bottlenecks so as to attain the SDG target of 25 per 1000 live births by 2030 and other short term and long-term developmental plans like Africa Agenda 2030.