Dinga Gildas Dohba, Mah Gisele, Mosikari Teboho
Department of Economics, North West University, Mafikeng 2735, South Africa.
Healthcare (Basel). 2024 Oct 12;12(20):2030. doi: 10.3390/healthcare12202030.
BACKGROUND/OBJECTIVES: The impact of government health spending and external debt on maternal mortality has been the subject of ongoing theoretical and empirical discussions. However, this relationship has remained controversial with no perspective on the moderating role of external debt on the government's health expenditure and maternal mortality link. This study examines the moderating effect of external debt on the government's health expenditure and maternal mortality relation using data from 13 Southern African economies spanning from 2000 to 2022.
We employed the augmented mean group, the dynamic common correlation effect mean group, and the Driscoll-Kraay and Granger causality techniques to attain the study's objective.
The outcome revealed that government health expenditure and external debt reduce maternal mortality in the Southern African Development Community (SADC) region. Equally, the magnitude of government health spending is moderated by external debt. The results revealed a bidirectional relation amidst maternal mortality and government health expenditure, and maternal mortality and external debt.
The study recommends that policymakers within the SADC zone should avoid austerity measures and encourage expansionary measures in terms of spending, and the contraction of debt for capital investment in the health sector. This will enhance the delivery of health services within the zone and equally reduce the rate of maternal mortality that is still a major health concern within the sub-region.
背景/目的：政府卫生支出和外债对孕产妇死亡率的影响一直是理论和实证讨论的主题。然而，这种关系仍存在争议，对于外债在政府卫生支出与孕产妇死亡率之间关系中所起的调节作用，尚无相关研究。本研究利用2000年至2022年期间13个南部非洲经济体的数据，考察外债对政府卫生支出与孕产妇死亡率关系的调节作用。
我们采用增强平均组、动态共同相关效应平均组以及德里斯考尔-克拉伊和格兰杰因果关系技术来实现研究目标。
结果显示，政府卫生支出和外债降低了南部非洲发展共同体（SADC）地区的孕产妇死亡率。同样，外债也调节了政府卫生支出的规模。结果揭示了孕产妇死亡率与政府卫生支出之间以及孕产妇死亡率与外债之间存在双向关系。
该研究建议，南部非洲发展共同体区域内的政策制定者应避免采取紧缩措施，鼓励在支出方面采取扩张性措施，并减少卫生部门资本投资的债务。这将提高该区域内卫生服务的提供水平，并同样降低孕产妇死亡率，孕产妇死亡率仍是该次区域主要的卫生问题。
