Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries
ABSTRACTPublic financial management (PFM) theory suggests that improvements in the allocation, execution, and monitoring of public funds can result in improved sectoral outcomes, including in health. However, the existing literature on the relationship between PFM quality and health outcomes provide...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Health Systems & Reform |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/23288604.2023.2298190 |
| _version_ | 1797265811392430080 |
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| author | Yann Tapsoba Amna Silim Kingsley Addai Frimpong Hélène Barroy |
| author_facet | Yann Tapsoba Amna Silim Kingsley Addai Frimpong Hélène Barroy |
| author_sort | Yann Tapsoba |
| collection | DOAJ |
| description | ABSTRACTPublic financial management (PFM) theory suggests that improvements in the allocation, execution, and monitoring of public funds can result in improved sectoral outcomes, including in health. However, the existing literature on the relationship between PFM quality and health outcomes provides limited empirical documentation and insufficient explanation of the mechanics of that relationship. This paper contributes to the literature by estimating the correlation between PFM quality and health outcomes from a sample of sub-Saharan African countries over the period 2005–2018, using a pooled ordinary least squares (OLS) estimator. The analysis uses Public Expenditure and Financial Accountability (PEFA) scores as proxies for PFM quality. The findings indicate that countries with high-quality PFM tended to have the lowest maternal, under-five and noncommunicable diseases (NCDs) mortality. Among the standard PFM dimensions, the one associated with the higher correlation with maternal and under-five mortality was “predictability and control in budget execution.” Better PFM quality was significantly associated with a drop in maternal and under-five mortality in countries which allocated a higher proportion of their budget to the health sector. In countries allocating a lower proportion of their budget to health, the correlations between PFM quality and the three mortality indicators were not significant. The negative correlations between PFM quality and maternal and under-five mortality were significant only in countries with more effective governance. These findings support an emphasis on strengthening PFM as a means of improving health service provision and health outcomes. |
| first_indexed | 2024-03-08T13:49:22Z |
| format | Article |
| id | doaj.art-819fd64ce59c48d793076e7e25040acc |
| institution | Directory Open Access Journal |
| issn | 2328-8604 2328-8620 |
| language | English |
| last_indexed | 2024-04-25T00:50:44Z |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Health Systems & Reform |
| spelling | doaj.art-819fd64ce59c48d793076e7e25040acc2024-03-11T16:57:17ZengTaylor & Francis GroupHealth Systems & Reform2328-86042328-86202024-12-0110110.1080/23288604.2023.2298190Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African CountriesYann Tapsoba0Amna Silim1Kingsley Addai Frimpong2Hélène Barroy3Independent consultant, Ph.D. Health Economics, Ouagadougou, Burkina FasoIndependent Consultant, Toronto, Ontario, CanadaWorld Health Organization, Health Financing & Human Resources for Health, Accra, GhanaWorld Health Organization, Health Systems Governance and Financing Department, Geneva, SwitzerlandABSTRACTPublic financial management (PFM) theory suggests that improvements in the allocation, execution, and monitoring of public funds can result in improved sectoral outcomes, including in health. However, the existing literature on the relationship between PFM quality and health outcomes provides limited empirical documentation and insufficient explanation of the mechanics of that relationship. This paper contributes to the literature by estimating the correlation between PFM quality and health outcomes from a sample of sub-Saharan African countries over the period 2005–2018, using a pooled ordinary least squares (OLS) estimator. The analysis uses Public Expenditure and Financial Accountability (PEFA) scores as proxies for PFM quality. The findings indicate that countries with high-quality PFM tended to have the lowest maternal, under-five and noncommunicable diseases (NCDs) mortality. Among the standard PFM dimensions, the one associated with the higher correlation with maternal and under-five mortality was “predictability and control in budget execution.” Better PFM quality was significantly associated with a drop in maternal and under-five mortality in countries which allocated a higher proportion of their budget to the health sector. In countries allocating a lower proportion of their budget to health, the correlations between PFM quality and the three mortality indicators were not significant. The negative correlations between PFM quality and maternal and under-five mortality were significant only in countries with more effective governance. These findings support an emphasis on strengthening PFM as a means of improving health service provision and health outcomes.https://www.tandfonline.com/doi/10.1080/23288604.2023.2298190Budget prioritization for healthhealth financinginstitutional qualitymortalitypublic financial management |
| spellingShingle | Yann Tapsoba Amna Silim Kingsley Addai Frimpong Hélène Barroy Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries Health Systems & Reform Budget prioritization for health health financing institutional quality mortality public financial management |
| title | Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries |
| title_full | Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries |
| title_fullStr | Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries |
| title_full_unstemmed | Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries |
| title_short | Does Public Financial Management Save Life? Evidence from a Quantitative Review of PFM and Health Outcomes in Sub-Saharan African Countries |
| title_sort | does public financial management save life evidence from a quantitative review of pfm and health outcomes in sub saharan african countries |
| topic | Budget prioritization for health health financing institutional quality mortality public financial management |
| url | https://www.tandfonline.com/doi/10.1080/23288604.2023.2298190 |
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