Factors influencing inequality in government health expenditures within African regional economic communities

Abstract Background The unequal distribution of government health spending within African regional economic groupings is a significant barrier to achieving Universal Health Coverage and reaching health-related Sustainable Development targets. It also hampers the progress toward achieving the African...

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Main Authors: Nicholas Ngepah, Ariane Ephemia Ndzignat Mouteyica
Format: Article
Language:English
Published: BMC 2024-03-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-024-10783-w
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author Nicholas Ngepah
Ariane Ephemia Ndzignat Mouteyica
author_facet Nicholas Ngepah
Ariane Ephemia Ndzignat Mouteyica
author_sort Nicholas Ngepah
collection DOAJ
description Abstract Background The unequal distribution of government health spending within African regional economic groupings is a significant barrier to achieving Universal Health Coverage and reaching health-related Sustainable Development targets. It also hampers the progress toward achieving the African Union’s vision of an integrated and prosperous Africa, free of its heavy disease burden. Based on panel data from 36 countries nested into eight Regional Economic Communities (RECs), this study probes the effects of countries' macro-level factors on government health expenditure disparities within eight regional economic communities from 2000 to 2019. Method We use the multilevel linear mixed-effect method to show whether countries' trade gains, life expectancy at birth, poverty, urbanization, information and communication technology, and population aging worsen or reduce the differences for two government health expenditure indicators. Results The insignificant effect of GDP per capita suggests that in most regional economic groupings, the health sector is still not considered a high-priority sector regarding overall government expenditures. Countries' poverty levels and urbanization increase the domestic general government health expenditure disparities as a percentage of general government expenditure within the regional groupings. However, trade gains and ICT diffusion reduce these disparities. Furthermore, the results reveal that external health expenditure per capita and life expectancy at birth positively impact within-regional inequalities in the domestic general government health expenditure per capita. In contrast, GDP per capita and trade gains tend to reduce them. Conclusions This study enriches the research on the determinants of government health expenditure inequality in Africa. Policies that can spur growth in trade and ICT access should be encouraged. Countries should also make more efforts to reduce poverty. Governments should also develop policies promoting economic growth and planned urbanization.
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spelling doaj.art-c65372dd1cdb4a21b627da148b0a373f2024-03-10T12:08:53ZengBMCBMC Health Services Research1472-69632024-03-0124111210.1186/s12913-024-10783-wFactors influencing inequality in government health expenditures within African regional economic communitiesNicholas Ngepah0Ariane Ephemia Ndzignat Mouteyica1School of Economics, College of Business and Economics, University of JohannesburgSchool of Economics, College of Business and Economics, University of JohannesburgAbstract Background The unequal distribution of government health spending within African regional economic groupings is a significant barrier to achieving Universal Health Coverage and reaching health-related Sustainable Development targets. It also hampers the progress toward achieving the African Union’s vision of an integrated and prosperous Africa, free of its heavy disease burden. Based on panel data from 36 countries nested into eight Regional Economic Communities (RECs), this study probes the effects of countries' macro-level factors on government health expenditure disparities within eight regional economic communities from 2000 to 2019. Method We use the multilevel linear mixed-effect method to show whether countries' trade gains, life expectancy at birth, poverty, urbanization, information and communication technology, and population aging worsen or reduce the differences for two government health expenditure indicators. Results The insignificant effect of GDP per capita suggests that in most regional economic groupings, the health sector is still not considered a high-priority sector regarding overall government expenditures. Countries' poverty levels and urbanization increase the domestic general government health expenditure disparities as a percentage of general government expenditure within the regional groupings. However, trade gains and ICT diffusion reduce these disparities. Furthermore, the results reveal that external health expenditure per capita and life expectancy at birth positively impact within-regional inequalities in the domestic general government health expenditure per capita. In contrast, GDP per capita and trade gains tend to reduce them. Conclusions This study enriches the research on the determinants of government health expenditure inequality in Africa. Policies that can spur growth in trade and ICT access should be encouraged. Countries should also make more efforts to reduce poverty. Governments should also develop policies promoting economic growth and planned urbanization.https://doi.org/10.1186/s12913-024-10783-wHealth expenditureInequalityLinear mixed-effect approachRECsAfrica
spellingShingle Nicholas Ngepah
Ariane Ephemia Ndzignat Mouteyica
Factors influencing inequality in government health expenditures within African regional economic communities
BMC Health Services Research
Health expenditure
Inequality
Linear mixed-effect approach
RECs
Africa
title Factors influencing inequality in government health expenditures within African regional economic communities
title_full Factors influencing inequality in government health expenditures within African regional economic communities
title_fullStr Factors influencing inequality in government health expenditures within African regional economic communities
title_full_unstemmed Factors influencing inequality in government health expenditures within African regional economic communities
title_short Factors influencing inequality in government health expenditures within African regional economic communities
title_sort factors influencing inequality in government health expenditures within african regional economic communities
topic Health expenditure
Inequality
Linear mixed-effect approach
RECs
Africa
url https://doi.org/10.1186/s12913-024-10783-w
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