The Spatiotemporal Threshold Effects of Health Expenditure and Health Developmental Assistances on Health-Related Outcome in Sub-Saharan Africa Post Covid19: The Case of the Public-Private Partnerships Donors

Abstract

The COVID-19 pandemic has not only revealed pre-existing vulnerabilities in global health systems and imposed heavy costs on countries worldwide, but also exacerbated existing disparities. These institutional and financing limitations were part of the development strategy, which did not adequately accommodate the health risks accompanying the outbreak of the virus. This disruption has ongoing implications for access to healthcare and treatment, particularly in economically disadvantaged and marginalised communities. This study documents the spatial spillover and threshold effects of health development assistance per capita (HDApc) and health expenditure (HEAEXP) on health-related outcomes (HROs) in Sub-Saharan Africa (SSA), which is a potential vector of the dissimilation of viruses. The study utilises panel data from 38 SSA countries spanning the period from 2000 to 2021. Employing the fixed effect (FE), fixed effect spatial Durbin Model (FE-SDM) and the threshold methods, and adding immunisation rate, GDP per capita growth and democracy as additional variables, this study finds that (1) HDApc and HEAEXP significantly improve the health status of the population, (2) HDApc and HEAEXP have a favourable spatial effect as both significantly reduce the under-five mortality rate, infant mortality rate, age-standardized deaths from infectious diseases, and the death rate in neighbouring countries, (3) HDApc has a double threshold effect on HROs and that its effect on the HROs is higher at higher threshold level of 12%.