Original Articles
Vol. 13 No. 3 (2025)
https://doi.org/10.4081/hls.2025.12874

The short-run effects of health aid in low-income countries: evidence from panel data analysis

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Received: 29 July 2024
Accepted: 28 August 2025
Published: 18 September 2025
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Articles
Health function, health aid, infant mortality, low-income countries, panel data

Authors

Keneni Gutema Negeri
kenenigut2000@yahoo.com
Health Systems Management and Policy Unit, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.

The effectiveness of health-targeted aid in improving health outcomes in developing countries remains a subject of debate. This paper investigates the short-run impact of health aid on health status in low-income countries globally. A panel dataset was constructed from 34 low-income countries spanning 2000 to 2017, with Infant Mortality Rate (IMR) serving as the primary proxy for health status. To estimate the short-run effect, First Difference GMM and System GMM estimators were employed, with a preference for System GMM due to its robustness against weak instrument problems in dynamic panel data models. The model incorporated log transformations for Health Development Aid (HDA), GDP per capita, and cereal yield, while exponential transformations were applied to human capital and governance indices, alongside adolescent fertility rate and elderly dependency rate. The System GMM estimation revealed a statistically significant and beneficial short-run effect of health aid on health status. Specifically, a doubling of health aid is associated with a reduction of 2 infant deaths per 1,000 live births. Other significant findings include the positive impact of GDP per capita, human capital, and governance, and the negative impact of adolescent fertility rate and elderly dependency rate on infant mortality. The Sargan test confirmed the validity of the over-identifying restrictions (p=0.2279), and the Arellano-Bond test for AR(2) indicated no serial correlation in the idiosyncratic errors (p=0.158). The findings strongly suggest that health aid serves as a potent instrument for narrowing the health status gap between high and low-income countries, thereby contributing to the achievement of Universal Health Coverage. However, recipient countries should also prioritize fostering domestic factors that positively influence the health sector to reduce persistent reliance on external resources.

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1. Goryakin Y, Suhrcke M. The prevalence and determinants of catastrophic health expenditures attributable to non-communicable diseases in low- and middle-income countries: a methodological commentary. Int J Equity Health 2014;13:107. DOI: https://doi.org/10.1186/s12939-014-0107-1
2. WHO. New perspectives on global health spending for universal health coverage. Geneva: World Health Organization; 2018.
3. Levine R, Kinder M. Millions saved: proven successes in global health. Washington: Center for Global Development; 2004.
4. Easterly W. The white man's burden. London: Penguin; 2006. DOI: https://doi.org/10.1016/S0140-6736(06)68925-3
5. Mishra P, Newhouse D. Health aid and infant mortality. IMF Working Paper WP/07/100. Washington: International Monetary Fund; 2007. DOI: https://doi.org/10.5089/9781451866643.001
6. Chauvet L, Gubert F, Mesple S. Aid, remittances, medical brain drain and child mortality: evidence using inter and intra-country data. J Dev Stud 2013;49:801-8. DOI: https://doi.org/10.1080/00220388.2012.742508
7. Ebeke C, Drabo A. Remittances, public health spending and foreign aid in the access to health care services in developing countries. Etudes Doc CERDI 2011.
8. Mishra P, Newhouse D. Does health aid matter? J Health Econ 2009;28:855-72. DOI: https://doi.org/10.1016/j.jhealeco.2009.05.004
9. Chauvet L, Guillaumont P. Aid, volatility, and growth again: when aid volatility matters and when it does not. Rev Dev Econ 2009;13:452-63. DOI: https://doi.org/10.1111/j.1467-9361.2009.00501.x
10. Gormanee K, Girma S, Morrissey O. Aid, public spending and human welfare: evidence from quantile regressions. J Int Dev 2005;17:299-309. DOI: https://doi.org/10.1002/jid.1163
11. Cutler D, Deaton A, Lleras-Muney A. The determinants of health disparities. J Econ Perspect 2006;20:97-120. DOI: https://doi.org/10.1257/jep.20.3.97
12. Leunig I, Dijkstra G, Tuytens P. Health aid and health outcomes in developing countries. Forum Dev Stud 2024;51:45–68. DOI: https://doi.org/10.1080/08039410.2024.2322503
13. Williamson CR. Foreign aid and human development: the impact of foreign aid to the health sector. South Econ J 2008;75:188-207. DOI: https://doi.org/10.1002/j.2325-8012.2008.tb00898.x
14. Wilson S. Chasing success: health sector aid and mortality. World Dev 2011;39:2032-43. DOI: https://doi.org/10.1016/j.worlddev.2011.07.021
15. Pettersson J. Child mortality: is aid fungibility in pro-poor expenditure decisive? Rev World Econ 2007;143:673-93. DOI: https://doi.org/10.1007/s10290-007-0127-7
16. Friedman M. Foreign economic aid. Yale Rev 1958;47:500-16.
17. Rajan R, Subramanian A. What undermines aid’s impact on growth? IMF Working Paper 05/126. Washington: International Monetary Fund; 2005. DOI: https://doi.org/10.5089/9781451861457.001
18. Mushkin SJ. Health as an investment. J Polit Econ 1962;70:129-57. DOI: https://doi.org/10.1086/258730
19. Becker GS. Human capital. New York: Columbia Univ Press; 1964.
20. Grossman M. On the concept of health capital and the demand for health. J Polit Econ 1972;80:223-55. DOI: https://doi.org/10.1086/259880
21. Berman P, Kendall C, Bhattacharyya K. The household production of health: integrating social science perspectives on micro-level health determinants. Soc Sci Med 1994;38:205-15. DOI: https://doi.org/10.1016/0277-9536(94)90390-5
22. Negeri G, Haile Mariam D. Effect of health development assistance on health status in sub-Saharan Africa. Risk Manag Healthc Policy 2016;9:33. DOI: https://doi.org/10.2147/RMHP.S101343
23. Arellano M, Bond S. Some tests for panel data: Monte Carlo evidence and an application to an employment equation. Rev Econ Stud 1991;58:277-97. DOI: https://doi.org/10.2307/2297968
24. Blundell R, Bond S. GMM estimation with persistent panel data: an application to production functions. Econ Rev 2000;19:321-40. DOI: https://doi.org/10.1080/07474930008800475
25. Alonso-Borrego C, Arellano M. Symmetrically normalized instrumental variable estimation using panel data. CEMFI Working Paper No. 9612, September; 1996.
26. Blundell R, Bond S. Initial conditions and moment restrictions in dynamic panel data models. J Econom 1998;87:115-43. DOI: https://doi.org/10.1016/S0304-4076(98)00009-8
27. Yousuf AS. Impact of health aid on infant mortality rate. MPRA Paper No. 4294; 2012.
28. Boone P. Politics and the effectiveness of foreign aid. Eur Econ Rev 1996;40:289-329. DOI: https://doi.org/10.1016/0014-2921(95)00127-1
29. World Bank. World development indicators. [Accessed 5 Mar 2018]; 2018a.
30. Feenstra RC, Inklaar R, Timmer MP. The next generation of the Penn World Table. Am Econ Rev 2015;105:3150-82. DOI: https://doi.org/10.1257/aer.20130954
31. World Bank. Worldwide governance indicators. [Accessed 5 Mar 2018]. Available from: http://data.worldbank.org/data-catalog/worldwide-governance-indicators; 2018b.
32. WHO. Global health expenditure atlas. Geneva: World Health Organization; 2014.
33. Negeri G. The long-run effects of health aid in low-income countries. J Public Health Afr 2023;14:2219. DOI: https://doi.org/10.4081/jphia.2023.2219
34. Pritchett L, Lawrence HS. Wealthier is healthier. J Hum Resour 1996;31:841-68. DOI: https://doi.org/10.2307/146149
35. Preston SH. Causes and consequences of mortality declines in less developed countries during the 20th century. In: Easterlin RA, ed. Population and economic change in developing countries. Chicago: Univ Chicago Press; 1980.
36. Wang L. Determinants of child mortality in LDCs: empirical findings from demographic and health surveys. Health Policy 2002;65:277-99. DOI: https://doi.org/10.1016/S0168-8510(03)00039-3
37. Fogel RW. Economic growth, population theory and physiology: the bearing of long-term processes on the making of economic policy. Am Econ Rev 1994;84:369-95. DOI: https://doi.org/10.3386/w4638
38. Link BG, Phelan J. Social conditions as the fundamental causes of disease. J Health Soc Behav 1995;35:80-94. DOI: https://doi.org/10.2307/2626958

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The short-run effects of health aid in low-income countries: evidence from panel data analysis. (2025). Healthcare in Low-Resource Settings, 13(3). https://doi.org/10.4081/hls.2025.12874
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