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Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa
Thesis (PhD)--Stellenbosch University, 2026.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2026
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| _version_ | 1867613863348797440 |
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| access_status_str | Open Access |
| author | Ajibona, Olusola Thomas |
| author2 | Phimister, Euan |
| author_browse | Ajibona, Olusola Thomas Phimister, Euan |
| author_facet | Phimister, Euan Ajibona, Olusola Thomas |
| author_sort | Ajibona, Olusola Thomas |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2026. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/135545 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:42:53.367Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/135545 Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa Ajibona, Olusola Thomas Phimister, Euan Stellenbosch University. Faculty of Economic and Management Sciences. University of Stellenbosch Business School. Thesis (PhD)--Stellenbosch University, 2026. Ajibona, O. T. 2026. Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa. Unpublished doctoral dissertation. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/4a068600-9793-431e-9f45-a8e79fc3a1e1 Sub-Sahara Africa faces major health challenges, including high maternal mortality, a substantial share of global under-five deaths, and a significant burden of diseases such as malaria and HIV. Achieving much improved health outcomes depends on sustainable financing. Given the systematic market failures in health, government intervention and health expenditure remain the most reliable sources of such funding. This study considers various crucial aspects of government health spending in Sub-Sahara Africa and compares these to non-Sub-Sahara countries. Specifically, the study explores four questions. First, what patterns of factors determine government health spending? Second, what is the impact of economic growth on public health financing? Third, to what extent do labour cost pressures, such as Baumol’s Cost Disease and health worker migration, intensify health funding challenges? And fourth, does health aid remain fungible, that is, does external health aid lead recipient governments to reduce domestic health financing through substitution? Using aggregate country-level data from a variety of sources, the study applies a range of methods to address each research question. First, it uses principal component analysis to identify key themes linked to demography, governance, disease burden, and available financial resources. These components are then incorporated into a regression framework to demonstrate how the pattern of government health expenditure in Sub-Sahara Africa differs from that in other regions. The second question is addressed by estimating the relationship between economic growth and public health spending in Sub-Sahara Africa compared to other developing non-Sub-Sahara countries. Using various statistical models, the study finds that GDP per capita significantly influences health expenditure, with notable regional differences. It also indicates that domestic health spending tends to return to a long-term equilibrium, though the rate of adjustment varies. However, it remains unclear whether health expenditure in SSA is elastic to economic growth, which has implications for funding strategies. To explore labour cost pressures, the study investigated the Baumol Cost Disease using minimum wages as a proxy for nominal wages. This novel approach was informed by findings from OECD countries. The analysis demonstrated evidence of Baumol cost effects in Sub-Sahara Africa, although these appear largely driven by external aid inflows. The study also examined the migration spillover effects of health worker migration on health expenditure, although data limitations prevented the identification of clear effects. Doctoral 2026-04-01T09:31:22Z 2026-04-01T09:31:22Z 2026-03 Thesis https://scholar.sun.ac.za/handle/10019.1/135545 en Stellenbosch University 124 pages : ill. application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Ajibona, Olusola Thomas Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa |
| title | Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa |
| title_full | Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa |
| title_fullStr | Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa |
| title_full_unstemmed | Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa |
| title_short | Government Health Expenditure in Developing Countries: A Comparative Analysis with a focus on Sub-Sahara Africa |
| title_sort | government health expenditure in developing countries a comparative analysis with a focus on sub sahara africa |
| url | https://scholar.sun.ac.za/handle/10019.1/135545 |
| work_keys_str_mv | AT ajibonaolusolathomas governmenthealthexpenditureindevelopingcountriesacomparativeanalysiswithafocusonsubsaharaafrica |