Health outcome convergence in Africa : the roles of immunization and public health spending

Background Reducing health outcomes disparities in Africa is a major concern for policymakers. Inter-country disparities in Africa is well documented. However, little is known about the accurate trajectory of these disparities over time. Thus, this paper investigates the convergence hypothesis in health outcomes in 40 African countries using data from the World Development Indicators. The study used panel data from 2000 to 2019. Method The study employs a nonlinear time-varying factor model to test the convergence hypothesis on infant mortality rate, under-fve mortality, and life expectancy at birth. Then, we use the marginal efects of the ordered logit regression model to investigate the factors that explain club memberships. Results The fndings showed the absence of overall convergence for the three variables of interest. However, we identifed the presence of convergence clubs. Moreover, we observed substantial gaps between the estimated clubs. The marginal efect results reveal that real GDP per capita, population structure, urbanization, trade, access to basic sanitation, and external health expenditure are essential to club formation. In addition, DTP immunization and the general government health expenditure as a percentage of the general government expenditure (our Abuja Declaration instrument) also play a signifcant role in explaining the club membership. Conclusion The fndings suggest that policymakers should develop and implement targeted club-specifc health policies. Furthermore, interventions to promote increased immunization, particularly among children, should be encouraged. Governments should also make substantial eforts to increase the share of their national budget allocated to the health sector by at least 15 percent.