Sustainable thresholds, health outcomes, health expenditures and education nexus in selected African countries: quadratic and moderation modelling.

BACKGROUND: This study aligns with Sustainable Development Goal 3 which borders on "good health and well-being for people by ensuring healthy lives and promoting well-being for all at all ages". It contributes to the health literature by evaluating the roles of health expenditures and educational quality on three health outcomes (infant mortality, maternal mortality and life expectancy at birth). METHODS: The study uses the panel spatial correlation consistent (PSCC) approach on balanced panel data on 25 selected sub-Saharan African countries from 2000 to 2020 to interrogate the nexus. RESULTS: The following findings are documented. First, health expenditures reveal significant asymmetric quadratic effects on health outcomes. Second, the interactions between health expenditures and educational quality reduce infant and maternal mortalities while enhancing life expectancy. Third, the threshold points from the interaction effects indicate that enhancing educational quality beyond some critical thresholds of 1.51 and 1.49 can induce a drop in maternal and child mortalities while a point beyond 1.84 exerts an improvement in life expectancy. CONCLUSIONS: Hence, policy makers should ensure that both health expenditures and educational quality exceed the established thresholds for sustainable health outcomes.

Health and total factor productivity nexus in selected sub-Saharan African countries: quadratic and threshold modelling.

OBJECTIVES: The sub-Saharan African (SSA) countries have been recording a decline in total factor productivity (TFP) growth, inadequate health funding and poor health outcomes are regarded as problems that might have impeded productivity in the region. This study therefore aligns with Grossman's theory that better health could be instrumental to productivity growth. In this paper, we establish a predictive TFP model that accommodates the roles of health, which has been omitted in prior studies. To corroborate our findings we examine the threshold relationship between health and TFP. METHODS: The study employs the fixed and random effect model, panel two-stage least squares, static and dynamic panel threshold regression model on a balanced panel data of 25 selected SSA countries from 1995 to 2020 as the estimating technique for the linear relationship and the non-linear relationship between health and TFP. RESULTS: The result of the analysis reveals a positive relationship between health expenditure and TFP, health expenditure per capita and TFP. Education and other non-health factors, like Information Communication Technology (ICT) and control of corruption equally have significant positive impact on TFP. The result further shows the existence of a threshold relationship between TFP and health at 3.5% level of public health expenditure. We also discover threshold relationship between TFP and some non-health variables like education and ICT at 2.56% and 21%, respectively CONCLUSIONS: More importantly, the study confirms health as a determinant of TFP and also validates the existence of a non-linear relationship between TFP and health. Overall, improvements in health and its proxies have implications for TFP growth in SSA. Therefore, the increase in public health expenditure stipulated in this study should be passed into law for optimal productivity growth rate.

Macro-economic determinants, maternal and infant SDG targets in Nigeria: Correlation and predictive modeling.

Objectives: Unambiguously, Nigeria is off-track in achieving the health-related SDGs. Consequentially, this study aligns with SDG 3 which calls for "good health and wellbeing for people by ensuring healthy lives and promoting wellbeing for all at all ages". This article examines the combined effect of health expenditure and other key macro-economic factors on health indices such as maternal and newborn and child mortality in Nigeria. Contrary to existing literature, we formulated a model that predicts the level of macro-economic determinants needed to achieve the SDG targets for maternal and newborn and child mortality in Nigeria by 2030. Methodology: The study used Autoregressive Distributed Lag (ARDL), which is usually used for large T models. The study period spans from 1995 to 2020. Results: We found a significant negative relationship between health outcomes and macro-economic determinants namely, household consumption, total health expenditure, and gross fixed capital while we determined a significant positive relationship between health outcomes and unemployment. Our findings are further supported by out-of-sample forecast results suggesting a reduction in unemployment to 1.84 percent and an increase in health expenditure, gross fixed capital, household consumption, control of corruption to 1,818.87 billon (naira), 94.46 billion (naira), 3.2 percent, and -4.2 percent respectively to achieve SDG health targets in Nigeria by 2030. Policy implication: The outcome of this result will give the Nigerian government and stakeholders a deeper understanding of the workings of the macro-economic factors, concerning health performance and will help position Nigeria, and other SSA countries by extension, toward reducing maternal mortality to 70 per 100,000 and newborn and child mortality to 25 per 1,000 births by 2030. The African leaders should consider passing into law the need for improvement in macro-economic factors for better health in Africa. We also recommend that the Nigerian government should steadily increase health expenditure to reach and move beyond the forecast level for improvement in maternal and infant mortality, given the present low and unimpressive funding for the health sector in the country.