School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, South Africa
Department of Economics, Federal University Oye-Ekiti, Ekiti State, Nigeria.
BMJ Open. 2023 May 2;13(5):e066970. doi: 10.1136/bmjopen-2022-066970.
The sub-Saharan African (SSA) countries have been recording a decline in total factor productivity (TFP) growth, inadequate health funding and poor health outcomes are regarded as problems that might have impeded productivity in the region. This study therefore aligns with Grossman's theory that better health could be instrumental to productivity growth. In this paper, we establish a predictive TFP model that accommodates the roles of health, which has been omitted in prior studies. To corroborate our findings we examine the threshold relationship between health and TFP.
The study employs the fixed and random effect model, panel two-stage least squares, static and dynamic panel threshold regression model on a balanced panel data of 25 selected SSA countries from 1995 to 2020 as the estimating technique for the linear relationship and the non-linear relationship between health and TFP.
The result of the analysis reveals a positive relationship between health expenditure and TFP, health expenditure per capita and TFP. Education and other non-health factors, like Information Communication Technology (ICT) and control of corruption equally have significant positive impact on TFP. The result further shows the existence of a threshold relationship between TFP and health at 3.5% level of public health expenditure. We also discover threshold relationship between TFP and some non-health variables like education and ICT at 2.56% and 21%, respectively CONCLUSIONS: More importantly, the study confirms health as a determinant of TFP and also validates the existence of a non-linear relationship between TFP and health. Overall, improvements in health and its proxies have implications for TFP growth in SSA. Therefore, the increase in public health expenditure stipulated in this study should be passed into law for optimal productivity growth rate.
撒哈拉以南非洲（SSA）国家的全要素生产率（TFP）增长一直在下降，卫生资金不足和卫生状况不佳被认为是阻碍该地区生产力的问题。因此，本研究符合格罗斯曼（Grossman）的理论，即更好的健康状况有助于提高生产率。在本文中，我们建立了一个预测 TFP 的模型，该模型考虑了健康因素的作用，而之前的研究忽略了这一因素。为了证实我们的发现，我们检验了健康与 TFP 之间的阈值关系。
本研究采用固定效应和随机效应模型、面板两阶段最小二乘法、静态和动态面板门限回归模型，对 2020 年从 1995 年至 2020 年期间 25 个选定的 SSA 国家的平衡面板数据进行分析，以线性关系和健康与 TFP 之间的非线性关系为研究对象。
分析结果表明，卫生支出与 TFP 之间存在正相关关系，人均卫生支出与 TFP 之间存在正相关关系。教育和其他非卫生因素，如信息通信技术（ICT）和腐败控制同样对 TFP 产生显著的积极影响。结果还表明，在公共卫生支出达到 3.5%的水平时，TFP 与健康之间存在阈值关系。我们还发现 TFP 与一些非卫生变量，如教育和 ICT 之间存在阈值关系，分别在 2.56%和 21%。
更重要的是，本研究证实了健康是 TFP 的决定因素，并且 TFP 与健康之间存在非线性关系。总的来说，改善健康及其代表指标对 SSA 的 TFP 增长具有重要意义。因此，本研究中规定的公共卫生支出的增加应该通过法律来实现最佳的生产率增长。
