ABSTRACT
As enshrined among the Millennium Development Goals in 2000 and now Sustainable Development Goals of 2015, human health is an important factor to be considered in the development process of any country. Sequel to this, efforts have been made by regional, national and local governments to promote health outcomes of their populations and this includes the Abuja Declaration of 2001. This study therefore examines the relationship between public health spending and reproductive health outcomes in Nigeria. It aims to analyze the effectiveness and efficiency of public health spending in improving reproductive health outcomes in Nigeria considering the Abuja Declaration.
A dataset of relevant variables for the period 1981 through 2016 were obtained from the Central Bank of Nigeria (2016) and World Bank’s World Development Indicators (2017) database. Two indicators of reproductive health outcomes used were maternal mortality ratio and neonatal mortality rate. The explanatory variables are public health spending per capita, income per capita, access to improved water or sanitation facilities, inflation rate and proportion of female primary school enrolment in gross enrolment. The non-linear autoregressive distributed lag and the stochastic frontier models were specified and the Ordinary Least Squares and Maximum Likelihood Estimation techniques were adopted respectively in estimating the specified models. The estimation of the models specified were preceded by preliminary analyses which include: descriptive statistics, correlation analysis, test for unit root and bounds test of cointegration among the variables. Some post diagnostic tests were also conducted to ascertain the reliability of the estimated models namely; Jarque-Bera test, Breusch-Godfrey Lagrangean Multiplier serial correlation test, Harvey’s test of heteroscedasticity, Ramsey’s regression specification error test and Wald’s test of asymmetry.
The estimated results of the non-linear autoregressive distributed lag models indicate that public health spending per capita reduces and has an asymmetric impact on maternal mortality ratio and neonatal mortality rate in Nigeria. Also, the results show that while per capita income and access to improved water sources or sanitation facilities significantly hinders the growth in maternal and neonatal mortalities in the country, the inflation rate spurs significantly, these mortalities in the country. Education measured by proportion of female enrolment in gross enrolment, reduce the magnitude of these mortalities but not significantly. Results from the stochastic cost frontier analysis indicate that there are inefficiencies related to public health spending in enhancing the reproductive health indicators in the country. More so, the average efficiency score associated with actual level of public health spending was found not to be significantly different from that which is obtained from its agreed level in line with the Abuja Declaration. The study recommends, amongst others, the need to scale-up public funds to the health sector with an efficient management and monitoring framework put in place for proper and effective use of such funds.
