Assessing the impact of total health expenditure on life expectancy in Zimbabwe: an instrumental variable approach.

Abstract

This study assesses the impact of total health expenditure on life expectancy in Zimbabwe, utilizing a two-stage least squares regression model, an instrumental variable approach. Data were collected from the World Bank's Health Nutrition and Population Statistics database, spanning 1990-2024. The results reveal an inverse relationship between total health expenditure and life expectancy, contrary to theoretical expectations. This unexpected finding suggests that inefficient allocation of health resources, dominance of the private sector with profit-driven motives, insufficient healthcare infrastructure, and inequitable access to healthcare due to income disparities may be contributing factors. The study controls for population density, literacy rate, and GDP per capita, revealing complex relationships with life expectancy. Health workforce density is used as a valid instrumental variable, satisfying the relevance and exogeneity conditions. The study's findings have significant implications for healthcare policy and resource allocation in Zimbabwe. To improve healthcare outcomes, the study recommends conducting budget analysis, engaging the private sector through public private partnerships, strengthening community-based approaches, conducting institutional capacity assessments, and capacitating village health workers.