Health Expenditure And Maternal Mortality Rate In Sub-Sahara Africa

Abstract

This study investigates the impact of health expenditure on maternal mortality rate in 12 Sub-Saharan African (SSA) countries over the period 1990–2024 using balanced panel data obtained from the World Development Indicators (WDI, 2024). Maternal mortality rate serves as the dependent variable, while recurrent health expenditure, capital health expenditure, private health expenditure, urban population, and basic sanitation are included as explanatory variables. The study adopts the model specification of Boachie, Ramu, and Põlajeva (2018) and applies advanced panel econometric techniques, including descriptive statistics, Pesaran cross-sectional dependence test, CrossSectionally Augmented Im-Pesaran-Shin (CIPS) unit root test, Westerlund panel cointegration test, and the Panel Autoregressive Distributed Lag (P-ARDL) model to estimate both short-run and longrun relationships. The findings confirm the presence of cross-sectional dependence and a mixed order of integration among the variables, justifying the use of second-generation panel methods. The cointegration results indicate a long-run equilibrium relationship between health expenditure and maternal mortality. Empirical estimates show that recurrent and capital health expenditures have negative but statistically insignificant effects on maternal mortality, suggesting inefficiencies in public health spending and weak implementation mechanisms. In contrast, private health expenditure and basic sanitation exhibit negative and statistically significant impacts, indicating that increased private healthcare spending and improved sanitation significantly reduce maternal deaths. Urban population shows a negative but insignificant relationship with maternal mortality. The study concludes that strengthening private sector participation, improving accountability in public health spending, and expanding access to basic sanitation are essential for achieving sustainable reductions in maternal mortality across SubSaharan Africa.