Public Healthcare Provisions and Children's Health Outcomes in sub-Saharan Africa

The importance of human capital in promoting economic development is widely acknowledged. Health is a key part of human capital as it complements education in affecting productivity. The roadmap to achieving a healthy and productive population begins with paying close attention to the health of the population at the infant stage, usually the under-five age bracket (WHO, 2016). This is because the first 2 years of life from birth are crucial for the growth of brain networks necessary for the development of perception and cognition (Walker et al. 2011; Batura et al. 2014). Regrettably, while the majority of nations have made strides in lowering child mortality since 1990, progress has been far-fetched in achieving the SDGs goal, which calls for each nation to eliminate preventable infant and young child deaths by lowering neonatal mortality to as low as 12 per 1,000 live births and under-5 mortality to as low as 25 per 1,000 live births. In sub-Saharan Africa (SSA), where newborn and child mortality rates are rising in most countries, progress has been particularly slow.
While there is a plethora of evidence on the effectiveness of public health spending in promoting health outcomes in sub-Saharan Africa (SSA), particularly documented on the basis of budgetary monetary allocations to the health sector, evidence of benefits of non-monetary public healthcare provisions such as nutrition and immunisation, health infrastructure and health education for the female population has been grossly scarce. Motivated by the need to address the adverse children's health outcomes in Africa, this study evaluates the effectiveness of public healthcare provisions in engendering improved children's health outcomes, focusing on four key areas of public health care provisions namely, (i) monetary healthcare; (ii) nutrition and immunisation; (iii) health infrastructure, and (iv) female health education, to ascertain their influence on children's health outcomes in SSA.
This study is based on an advanced quantitative method rooted in an econometric model to analyse a regional panel dataset covering 48 sub-Saharan African countries from 1990 to 2021. Being aware of the impending violation of the assumptions underpinning traditional panel data regression methods (e.g., Pool OLS [POLS], Fixed Effect [FE] and Random Effect [RE]), the study will employ a dynamic Instrumental Variable (IV) panel regression within the framework of the System Generalised Method of Moments (GMM-SYS) estimator to capture the pattern of children's health outcomes, as well as address the problems of serial correlation, cross-sectional dependence, endogeneity, and unobserved country-specific heterogeneity. This methodological approach is underscored by the likelihood of endogeneity, and the correlation between unobserved country-fixed effects and the error term, which tends to violate the assumption of orthogonality while creating doubt about the consistency of the traditional estimators (FE and RE). This study will extend beyond academia and lend itself to dissemination across ministries of health and international organisations like UNICEF, WHO, African regional health associations (ECSA-HC, Southern Africa Development Community and West African Health Organization), who are working with national ministries of health and stakeholders to drive quality healthcare and reduce child mortality rates in Africa. Owing to its focus on achievements relating to the UN SDGs of eliminating preventable infant and young child deaths, the proposed research will reveal how policies related to health monetary spending, infrastructure, immunisation and nutritional provisions alongside female health literacy will drive the attainment of the SDGs targets of good health and well-being of children and infants in the sub-Saharan African region. Beyond its primary objective, this study will provide useful insights along the economics of health financing, budget planning for health, and community healt