Impact of fiscal policy shocks on health outcomes in Sub-Saharan Africa: A panel structural VAR approach
This study investigates the impact of fiscal policy shocks on health outcomes in Sub-Saharan Africa (SSA). It is motivated by health systems’ increasing reliance on public funding despite growing macroeconomic uncertainties. This study adopts a regional analysis, sampling five countries with the highest per capita public health expenditure from the Central, Eastern, Southern, and Western African regions. The study employs the panel structural vector autoregression technique and expresses health outcomes as a function of fiscal policy and private health expenditure shocks. The results suggest that fiscal policy shock significantly and positively affects health outcomes in Central and Western Africa. However, health outcomes are resilient to fiscal policy shock in Eastern and Southern regions and to private health expenditure shock in all regions. The study indicates that achieving sustainable improvement in health outcomes in SSA would require policies designed to expand health financing options beyond the traditional public and private funding arrangements.
- Arthur, E., & Oaikhenan, H.E. (2017). The effects of health expenditure on health outcomes in Sub-Saharan Africa. African Development Review, 29(3):524-536. https://doi.org/10.1111/1467-8268.12287
- Boachie, K., Ramu, M., & Põlajeva, T. (2018). Public health expenditures and health outcomes: New evidence from Ghana. Economies, 6(4):58. https://doi.org/10.3390/economies6040058
- Boiciuc, I. (2015). The effects of fiscal policy shocks in Romania. A SVAR approach. Procedia Economics and Finance, 32:1131-1139. https://doi.org/10.1016/S2212-5671(15)01578-6
- Byaro, M., Mgale, Y., & Mafwolo, G. (2022), Economic growth benefits more from population health than foreign direct investment: Evidence from Tanzania. African Journal of Economic Review, 10(3):110-129.
- Caldara, D., & Kamps, C. (2008). What are the Effects of Fiscal Policy Shocks? A VAR-based Comparative Analysis. In: European Central Bank Working Paper Series No. 877.
- Cazacu, A.M. (2015). Fiscal-monetary Policy Interaction. SVAR Evidence from a CEE Country. In: Proceedings: Eurasian Forum on Law and Economics, Tbilisi.
- Edeme, R.K., Emecheta, C., & Omeje, M.O. (2017). Public health expenditure and health outcomes in Nigeria. American Journal of Biomedical and Life Sciences, 5(5):6-102. https://doi.org/10.11648/j.ajbls.20170505.13
- Gatome-Munyua, A., & Olalere, N. (2020). Public Financing for health in Africa: 15% of an Elephant is Not 15% of a Chicken. Africa Renewal. Available from: https://www.un.org/ africarenewal/magazine/october-2020/public-financing-health-africa-when-15-elephant-not-15-chicken [Last accessed on 2024 Apr 15].
- Ifanti, A.A., Argyriou, A.A., Kalofonou, F.H., & Kalofonos, H.P. (2013). Financial crisis and austerity measures in Greece: Their impact on health promotion policies and public health care. Health Policy, 113(1-2):8-12. https://doi.org/10.1016/j.healthpol.2013.05.017
- Im, K.S., Pesaran, M.H., & Shin, Y. (2003). Testing for unit roots in heterogeneous panels. Journal of Econometrics, 15(1):53‐74. https://doi.org/10.1016/S0304-4076(03)00092-7
- Karanikolos, M., Mladovsky, P., Cylus, J., Thomson, S., Basu, S., Stuckler, D., et al. (2013). Financial crisis, austerity, and health in Europe. The Lancet, 381(9874):1323-1331. https://doi.org/10.1016/S0140-6736(13)60102-6
- Levin, A., Lin, C., & Chu, C.J. (2002). Unit root tests in panel data: A symptotic and finite‐sample properties. Journal of Econometrics, 108(1):1‐24. https://doi.org/10.1016/S0304-4076(01)00098-7
- Oluwatoyin, M.A., Folasade, A.B., & Fagbeminiyi, F.F. (2015). Public health expenditure and health outcomes in Nigeria. International Journal of Financial Economics, Research Academy of Social Sciences, 4(1):45-56.
- Onofrei, M., Vatamanu, A.F., Vintila, G., & Cigu, E. (2021). Government health expenditure and public health outcomes: A comparative study among EU developing countries. International Journal of Environmental Research and Public Health, 18:10725. https://doi.org/10.3390/ijerph182010725
- Pedroni, P. (2013). Structural panel VARs. Econometrics, 2:180-206. https://doi.org/10.3390/econometrics1020180
- Remes, J., Wilson, M., & Ramdorai, A. (2020). How Investing in Health has a Significant Economic Payoff for Developing Economies. United States: Brookings Institute.
- Rezapour, A., Mousavi, A., Lofti, F., Mohaved, S.M., & Alipour, S. (2019). The effects of health expenditure on health outcomes based on the classification of public health expenditure: A panel data approach. Shiraz E-medical Journal, 20(12):e88526. https://doi.org/10.5812/semj.88526
- Schakel, H.C., Wu, E.H., & Jeurissen, P. (2018). Fiscal rules, powerful levers for controlling the health budget? Evidence from 32 OECD countries. BMC Public Health, 18:300. https://doi.org/10.1186/s12889-018-5198-y
- Stubbs, T., Kentikelenis, A., Stuckler, D., McKee, M., & King, L. (2017). The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations. Social Science and Medicine, 174:220-227. https://doi.org/10.1016/j.socscimed.2016.12.016
- World Development Indicator. World Bank, Washington D.C. (2022). Available from: https://databank.worldbank.org/ source/world-development-indicators [Last accessed on 2023 Feb 14].