The objective of this study is to evaluate the effects of major, minor, and moderate changes in public health expenditures on health outcomes in the Comoros. Quarterly data series from 1990Q1 to 2020Q4, obtained from the World Development Indicators (WDI, 2023), were used for the empirical analysis. The estimates show that MTNARDL model provides more robust results than NARDL model. Similarly, the results of this improved framework indicate that the effects of extremely large changes in public health expenditures on health outcomes differ significantly from the effects of extremely small changes. Once again, the results reveal that the positive impacts of health expenditures on health outcomes diminish at the lowest thresholds. Furthermore, the asymmetric effects between health expenditures and outcomes are more pronounced in the long term than in the short term. Therefore, to ensure moderate rates of infant and adult mortality and an increase in life expectancy at birth in the Comoros, policymakers should pay adequate attention to long-term dynamics and ensure that the level of public health expenditure does not trend towards lower thresholds where the positive impacts of health expenditures fade.
References
[1]
Akinci, F., Hamidi, S., & Suvankulov, F. (2017). Examining the Impact of Health Care Expenditures on Health Outcomes in Turkey. Journal of Health Management, 19, 1-15.
[2]
Akinkugbe, O., & Mohanoe, M. (2009). Public Health Expenditure as a Determinant of Health Status in Lesotho. SocialWorkinPublicHealth,24, 131-147. https://doi.org/10.1080/19371910802569716
[3]
Akinlo, A. E., & Sulola, A. O. (2019). Health Care Expenditure and Infant Mortality in Sub-Saharan Africa. JournalofPolicyModeling,41, 168-178. https://doi.org/10.1016/j.jpolmod.2018.09.001
[4]
Arthur, E., & Oaikhenan, H. E. (2017). The Effects of Health Expenditure on Health Outcomes in Sub-Saharan Africa (SSA). AfricanDevelopmentReview,29, 524-536. https://doi.org/10.1111/1467-8268.12287
[5]
Bloom, D. E., Canning, D., & Sevilla, J. (2004). The Effect of Health on Economic Growth: A Production Function Approach. WorldDevelopment,32, 1-13. https://doi.org/10.1016/j.worlddev.2003.07.002
[6]
Boachie, M. K. (2017). Health and Economic Growth in Ghana: An Empirical Investigation. FudanJournaloftheHumanitiesandSocialSciences,10, 253-265. https://doi.org/10.1007/s40647-016-0159-2
[7]
Boachie, M. K., Kyei, K. A., & Amponsah, E. N. (2018). Determinants of Life Expectancy in Lower-Middle-Income Countries: A Study of Selected Countries in Africa. African Journal of Economic and Management Studies, 9, 314-325.
[8]
Chang, B. H., Rajput, S. K. O., & Bhutto, N. A. (2019). Impact of Exchange Rate Volatility on the US Exports: A New Evidence from Multiple Threshold Nonlinear ARDL Model. JournalofInternationalCommerce,EconomicsandPolicy,10, Article ID: 1950009. https://doi.org/10.1142/s1793993319500091
[9]
Chang, Y. (2020). A Multiple Threshold Nonlinear Model for Analyzing the Impact of Energy Consumption on Economic Growth: Evidence from OECD Countries. JournalofEconomicDynamics and Control, 115, Article ID: 103930.
[10]
Dollar, D., & Burnside, C. (1999). Aid, Policies, and Growth. American Economic Review, 89, 847-868.
[11]
Filmer, D. (1999). ChildMortalityandPublicSpendingonHealth:HowMuchDoesMoneyMatter? The World Bank.
[12]
Grossman, M. (1972). On the Concept of Health Capital and the Demand for Health. JournalofPoliticalEconomy,80, 223-255. https://doi.org/10.1086/259880
[13]
Gupta, S., Verhoeven, M., & Tiongson, E. R. (2002). The Effectiveness of Government Spending on Education and Health Care in Developing and Transition Economies. EuropeanJournalofPoliticalEconomy,18, 717-737. https://doi.org/10.1016/s0176-2680(02)00116-7
[14]
Gyimah-Brempong, K., & Wilson, M. (2004). Health Human Capital and Economic Growth in Sub-Saharan African and OECD Countries. TheQuarterlyReviewofEconomicsandFinance,44, 296-320. https://doi.org/10.1016/j.qref.2003.07.002
[15]
Jakovljevic, M. B., Vukovic, M., & Fontanesi, J. (2016). Life Expectancy and Health Expenditure Evolution in Eastern Europe—Did and DEA Analysis. ExpertReviewofPharmacoeconomics&OutcomesResearch,16, 537-546. https://doi.org/10.1586/14737167.2016.1125293
[16]
Mhango, M., & Chirwa, G. C. (2018). Determinants of Public Health Expenditure in Sub-Saharan Africa: A Panel Data Analysis. AfricanJournalofEconomicandManagementStudies,9, 368-382.
[17]
Novignon, J., Olakojo, S. A., & Nonvignon, J. (2012). The Effects of Public and Private Health Care Expenditure on Health Status in Sub-Saharan Africa: New Evidence from Panel Data Analysis. HealthEconomicsReview,2, Article No. 22. https://doi.org/10.1186/2191-1991-2-22
[18]
Oluyemi, T. O., & Omola, A. A. (2019). Public Health Expenditure and Health Outcomes in Sub-Saharan Africa. InternationalJournalofHealthEconomicsandPolicy,4, 17-25.
[19]
Pal, D., & Mitra, S. K. (2015). Asymmetric Impact of Crude Price on Oil Product Pricing in the United States: An Application of Multiple Threshold Nonlinear Autoregressive Distributed Lag Model. EconomicModelling,51, 436-443. https://doi.org/10.1016/j.econmod.2015.08.026
[20]
Pal, D., & Mitra, S. K. (2016). Asymmetric Oil Product Pricing in India: Evidence from a Multiple Threshold Nonlinear ARDL Model. EconomicModelling,59, 314-328. https://doi.org/10.1016/j.econmod.2016.08.003
[21]
Pal, D., & Mitra, S. K. (2019). Asymmetric Oil Price Transmission to the Purchasing Power of the U.S. Dollar: A Multiple Threshold NARDL Modelling Approach. ResourcesPolicy,64, Article ID: 101508. https://doi.org/10.1016/j.resourpol.2019.101508
[22]
Richards, J., & Vining, A. (2016). The Puzzle of Public Health Expenditures and Population Health. InternationalJournalofHealthEconomicsandManagement,16, 297-319.
[23]
Sbia, R., Shahbaz, M., & Hamdi, H. (2018). A Contribution of Foreign Direct Investment, Clean Energy, Trade Openness, Carbon Emissions and Economic Growth to Energy Demand in UAE. EconomicModelling,36, 191-197. https://doi.org/10.1016/j.econmod.2013.09.047
[24]
Sen, A. (2006). Chapter Two. Conceptualizing and Measuring Poverty. In D. B. Grusky, & R. Kanbur (Eds.), PovertyandInequality (pp. 30-46). Stanford University Press. https://doi.org/10.1515/9780804767590-003
[25]
Shin, Y., Yu, B., & Greenwood-Nimmo, M. (2014). Modelling Asymmetric Cointegration and Dynamic Multipliers in a Nonlinear ARDL Framework. In R. C. Sickles, & W. C. Horrace (Eds.), FestschriftinHonorofPeterSchmidt: Econometric Methods and Applications (pp. 281-314). Springer. https://doi.org/10.1007/978-1-4899-8008-3_9
[26]
Ullah, I., Ullah, A., Ali, S., Poulova, P., Akbar, A., Haroon Shah, M. et al. (2021). Public Health Expenditures and Health Outcomes in Pakistan: Evidence from Quantile Autoregressive Distributed Lag Model. RiskManagementandHealthcarePolicy,14, 3893-3909. https://doi.org/10.2147/rmhp.s316844
[27]
Verheyen, F. (2013). Interest Rate Pass-Through in the EMU: New Evidence Using Nonlinear ARDL Framework. EconomicModelling,35, 31-40.
[28]
Von Schirnding, Y. (2005). Health and Sustainable Development: Can We Rise to the Challenge? TheLancet,364, 1004-1009.
[29]
Wagstaff, A. (1986). The Demand for Health: Theory and Applications. JournalofEpidemiology&CommunityHealth,40, 1-11. https://doi.org/10.1136/jech.40.1.1
[30]
Weisbrod, B. A. (1966). The Valuation of Human Capital. JournalofPoliticalEconomy, 69, 425-436.
[31]
World Bank (1993). WorldDevelopmentReport 1993: Investing in Health. Oxford University Press.
[32]
World Bank (2019). World Development Indicators. World Bank.
[33]
World Bank (2020). World Development Indicators 2020. World Bank. https://datatopics.worldbank.org/world-development-indicators/
[34]
World Bank (2023). WorldDevelopmentIndicators. The World Bank. https://databank.worldbank.org/source/world-development-indicators
[35]
Yaqub, J. O., Ojapinwa, T. V., & Yussuff, R. O. (2012). Public Health Expenditure and Health Outcome in Nigeria: The Impact of Governance. EuropeanScientificJournal,ESJ,8, 189-201.
[36]
Zivot, E., & Andrews, D. W. K. (1992). Further Evidence on the Great Crash, the Oil-Price Shock, and the Unit-Root Hypothesis. JournalofBusiness&EconomicStatistics,10, 251-270. https://doi.org/10.1080/07350015.1992.10509904
