Examining the Impact of Health Care Expenditures on Health Outcomes in the Middle East and N. Africa

Fevzi Akinci, Samer Hamidi, Farrukh Suvankulov, Alisher Akhmedjonov


Objective: To examine the impact of health care expenditures on selected health outcomes for 19 countries in the Middle East and North Africa (MENA) region.

Methods: We used panel data collected by the WHO and the World Bank for 1990-2010 to estimate the impact of both government and private health care expenditures on infant, under-five, and maternal mortality rates. Pooled ordinary least regression, random effects, and Hausman-Taylor instrumental variable models were used to examine the relationship between health care expenditures and selected health outcomes.

Results: The results show that after controlling for confounding factors, both government and private spending on health care significantly improve infant, under-five, and maternal mortality in the MENA region. The relationships are causal in nature. Specifically, a percentage increase in per capita government expenditures reduces the infant mortality rate by 8.6-9.5 deaths per 1000 live births (p<0.01), the under-five mortality by 10.3-12.1 under-five deaths per 1000 live births (p<0.01), and maternal mortality by 26.0-26.3 deaths per 100000 live births (p<0.01). Similarly, a percentage increase in the log per capita private expenditures reduces the infant mortality rate by 7.2-8.1 deaths per 1000 live births (p<0.01), under-five mortality rate by 9.5-9.8 deaths per 1000 live births (p<0.01), and the maternal mortality rate by 25.8-25.9 deaths per 100000 live births (p<0.01).

Conclusion: Overall, we observe a notable improvement of the selected health outcomes in the MENA region from 1990 to 2010 mostly due to government and private health spending on health care. Consistent with existing literature, improvements in access to safe drinking water, increasing share of births attended by the health personnel, and adult literacy rate also reduce infant, under-five, and maternal mortality rates.

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