Effectiveness of public health spending in Sub-Sharan Africa: The moderating role of health system efficiency

Public health spending (PHS) has been extensively investigated concerning population health outcomes (PHO), but its effectiveness has been less analysed. To this end, this study examines the association between domestic general government health expenditure (DGGHE) and PHO in terms of disability-adjusted life year (DALY) while testing the role of health system efficiency (HSE) in its effects. The under-five mortality(U5MR) is also used in the analysis to assess the effectiveness of services. The study uses publicly available data from 2008 to 2018 across forty-three countries in SSA and applies the GMM estimator based on linear and nonlinear moment conditions. The findings indicate that an increase in DGGHE was significantly associated with a decrease in DALY and U5MR, with the lowest decrease in countries with the lowest HSE scores. Therefore, the study urges governments in SSA countries to consider mechanisms that enhance health system efficiency while planning interventions based on increased spending on health.