Child Mortality in sub-Saharan Africa: Why Public Health Spending Matters

Since 2000, child mortality has dramatically decreased in Africa. Based on an econometrical analysis over 45 sub-Saharan African countries, this paper analyses the determinants of such evolution, and shows that urbanization, sanitation improvement and GDP growth per capita played a critical role in this overall improvement over 2000-2011. The increase in public health expenditures proved to be also decisive, though the elasticity with mortality rate is much weaker. Reaching the Abuja target of 15% of public health expenditure in total public expenditures would have decreased the under-5 child mortality rate by 9% over 2001-2011. It could further reduce this rate by 14% over 2012-2021, and allow Africa to save 19.8 million of children lives. It would also help the region to achieve the Millennium Development Goal on child mortality (reduce by two thirds under-5 child mortality over 1990-2015) by 2022-23, while it would not be reached before 2027 otherwise, according to our estimates.