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    The effectiveness of public health spending in Sub-Saharan Africa.
    (2023) Kabongo, Wa Ntita Serge.; Mbonigaba , Josue.
    This research conducted a thorough analysis of the effectiveness of public health spending (PHS) in enhancing population health outcomes (PHO) across sub-Saharan African (SSA) countries. Implementing PHS interventions in these countries faces challenges due to the disregard of critical intermediate factors that are specific to them. These factors include high prevalence of infectious diseases, inadequate immunization coverage, inefficiencies in the health system, governance issues, low levels of education, and underlying processes. Consequently, although the diligent allocation of financial resources towards enhancing health, PHO in the region persistently lag behind those of other global regions. This research aims to investigate the role of the above-mentioned intermediaries as transmission mechanisms of PHS and understand how these intermediaries interact with PHS to shape the effectiveness of PHS intervention. Moreover, the research assesses the benefits of using disaggregated data for measuring PHS. To achieve its objectives, the research employed panel data from selected SSA countries and applied several quantitative methodologies, such as longitudinal growth curve mediation modelling, partial least squares structural equation modelling, and system generalised method of moments. These approaches were chosen owing to the characteristics of the different processes investigated. The findings show that malaria incidence and female education, as indicators of infectious disease burdens and education, work sequentially as the transmission mechanism of PHS, while no indication of immunisation as a mediator was found. The findings also show that health system efficiency (HSE) and country governance are moderating factors in the PHS-PHO relationship, with weaker HSE or governance adversely affecting PHS effectiveness. Additionally, disaggregated data measuring PHS is shown to offer better evidence of PHS effectiveness. In conclusion, the research highlights the significant role of structural factors specific to SSA in shaping the effectiveness of PHS in improving PHO in the region. Its findings underscore the imperative of integrating these factors into the development of PHS interventions in SSA. The research provides invaluable insights into the complex nature of PHS effectiveness in SSA and proposes avenues for more targeted and impactful PHS interventions. Iqoqa. Lolu cwaningo lwenze uhlaziyo lokusebenza ngendlela kokusetshenziswa kwemali empilweni yomphakathi, ipublic health spending (PHS) ekuphuculeni imiphumela yempilo yoqoqobantu, ipopulation health outcomes (PHO) emazweni akwiSub-Saharan African (SSA). Ukuqalisa ukusebenza kokungenelela kwi-PHS kula mazwe kubhekene nezinselelo ngenxa yokunganaki izimo ezimaphakathi eziyingcuphe ezisondelene nawo. Lezi zimo zifaka ukuvama okuphezulu kwezifo ezithelelanayo, ukujova okungenele endaweni, ukungasebenzi ngendlela kohlelo lwezempilo, amazinga aphansi ezemfundo, nezinqubo eziyisisekelo. Njengomphumela, nakuba kunesabelo esihle semithombo yezimali ezophucula izimpilo, i-PHO esifundeni ilokhu isele ngemuva ngokungaguquki kulokho kwezifunda zomhlaba jikelele. Lolu cwaningo luhlose ukuphenya indima yezingeneleli ezibalulwe ngenhla njengendlela yokwedlulisa i-PHS nokuqonda ukuthi lezi zingeneleli zisebenzisana kanjani ne-PHS ukwakha ukungenelela ngempumelelo kwe-PHS. Ngaphezu kwalokho, ucwaningo luhlola izinzuzo kusetshenziswa imininingo engahlangene yokukala i-PHS. Ukufeza izinhloso, ucwaningo lusebenzise imininingo yephaneli emazweni akhethiwe ase-SSA kwase kusetshenziswa izindlela zokwenza ucwaningo lwekhwantithethivu, njengemodeli yokuxazulula ilongithudi, imodeli yomumozikwele ze-ikhwejini, nohlelo lwendlelakwenza ejwayelekile. Lezi zindlelasu zakhethwa ngokomumozici omayelana nezinqubo ezizophenywa. Okutholakele kukhombisa isehlakalo sikamalaleveva nemfundo yabesifazane, njengezinkomba zomthwalo wezifo ezithathelwanayo nemfundo, okusebenza ngokulandelana njengendlela yokwedlulisela izindlela ze-PHS, nakuba kungenankomba yokugoma njengoba kwatholakala isixazululo. Okutholakele kuphinde kwakhombisa ukusebenza ngendlela kohlelo lwezokwelapha, ihealth system efficiency (HSE) okubuswa kwezwe kuyizizathu eziguqulayo ebudlelwaneni be-PHS-PHO, ne-HSE entekenteke noma ukubusa okukhubaza ukusebenza ngendlela kwe-PHS. Ukongezo, imininingo engahlangene ekala i-PHS ikhombisa ukuletha ubufakazi obungcono bokusebenza ngendlela kwe-PHS. Ukuphetha, ucwaningo lugqamisa indima ebalulekile yezizathu zesakhiwo kwi-SSA ekuguquleni ukusebenza ngendlela kwe-PHS ekuphuculeni i-PHO esifundeni. Okutholakele kuveza okubalulekile ngokudidiyela lezi zizathu ekuthuthukiseni ukungenelela kwe-PHS e-SSA. Ucwaningo luhlinzeka imibono enzulu ngomumo ombaxa wokusebenza ngendlela kwe-PHS kwi-SSA bese luphakamisa izindlela zokungenelela okunenhloso nokunomthelela kwi-PHS.