Determinants of health outcomes in Sub-Saharan Africa: A dynamic Panel Analysis

Abstract

This study analyzes determinants of health outcomes in Sub-Saharan Africa using a balanced panel dataset. The System GMM health production model with maternal mortality, infant mortality, and life expectancy as dependent variables was employed. Findings indicate that public health expenditure has weak and insignificant effects on mortality outcomes, while private health expenditure significantly improves life expectancy. Conversely, out-of-pocket spending reduces life expectancy, highlighting financial barriers to healthcare. Urbanization is associated with higher maternal mortality, whereas access to clean water and immunization coverage contribute positively to life expectancy. Post-estimation diagnostics confirm model validity. Overall, Sub-Saharan Africa remains off-track in achieving SDG 3 health targets, constrained by low public investment, excessive reliance on out-of-pocket financing, and governance weaknesses. Policy recommendations stress enhancing the efficiency of public health spending, expanding private health investment, strengthening risk-pooling mechanisms, scaling up WASH and immunization programs, addressing urban health challenges, and improving governance. Without comprehensive reforms, SDG 3 targets are unlikely to be achieved by 2030.