Under-five mortality rate convergence results.

Progress in health outcomes across Africa has been uneven, marked by significant disparities among countries, which not only challenges the global health security but impede progress towards achieving the United Nations’ Sustainable Development Goals 3 and 10 (SDG 3 and SDG 10) and Universal Health Coverage (UHC). This paper examines the progress of African countries in reducing intra-country health outcome disparities between 2000 and 2019. In other words, the paper investigates the convergence hypothesis in health outcome using a panel data from 40 African countries. Data were sourced from the World Development Indicators, the World Governance Indicators, and the World Health Organization database. Employing a non-linear dynamic factor model, the study focused on three health outcomes: infant mortality rate, under-5 mortality rate, and life expectancy at birth. The findings indicate that while the hypothesis of convergence is not supported for the selected countries, evidence of convergence clubs is observed for the three health outcome variables. The paper further examine the factors contributing to club formation by using the marginal effects of the ordered logit regression model. The findings indicate that the overall impact of the control variables aligns with existing research. Moreover, governance quality and domestic government health expenditure emerge as significant determinants influencing the probability of membership in specific clubs for the child mortality rate models. In the life expectancy model, governance quality significantly drives club formation. The results suggest that there is a need for common health policies for the different convergence clubs, while country-specific policies should be implemented for the divergent countries. For instance, policies and strategies promoting health prioritization in national budget allocation and reallocation should be encouraged within each final club. Efforts to promote good governance policies by emphasizing anti-corruption measures and government effectiveness should also be encouraged. Moreover, there is a need to implement regional monitoring mechanisms to ensure progress in meeting health commitments, while prioritizing urbanization plans in countries with poorer health outcomes to enhance sanitation access.

非洲各地健康结局的改善进程并不均衡，各国间存在显著差距，这不仅对全球健康安全构成挑战，也阻碍了联合国可持续发展目标3和10（Sustainable Development Goals 3 and 10, SDG 3、SDG 10）与全民健康覆盖（Universal Health Coverage, UHC）目标的实现。本文旨在考察2000年至2019年间非洲各国在缩小国内健康结局差距方面的进展。换言之，本研究利用40个非洲国家的面板数据，对健康结局的趋同假说进行了检验。本研究的数据来源于世界发展指标（World Development Indicators）、世界治理指标（World Governance Indicators）以及世界卫生组织数据库。本研究采用非线性动态因子模型，重点分析了三项健康结局指标：婴儿死亡率、5岁以下儿童死亡率以及出生时预期寿命。研究结果显示，尽管所选国家并不支持趋同假说，但三项健康结局指标均存在趋同俱乐部的现象。本文进一步利用有序logit回归模型的边际效应，分析了趋同俱乐部形成的影响因素。研究结果表明，控制变量的整体影响与现有研究结论一致。此外，在儿童死亡率模型中，治理质量与国内政府卫生支出是影响个体归入特定俱乐部概率的重要决定因素。而在出生时预期寿命模型中，治理质量对趋同俱乐部的形成具有显著驱动作用。研究结果表明，针对不同的趋同俱乐部需制定统一的健康政策，而对于非趋同的国家则应实施针对性政策。例如，应鼓励各最终趋同俱乐部内部推行旨在推动国家预算分配与再分配中优先保障卫生领域的政策与策略。同时，应推动通过强化反腐败举措与提升政府治理效能来完善良政政策的相关工作。此外，需建立区域监测机制以确保各国在兑现卫生承诺方面取得进展，同时应在健康结局较差的国家优先推进城镇化规划，以改善卫生设施可及性。