Economics at your fingertips  

The impact of IMF conditionality on government health expenditure: A cross-national analysis of 16 West African nations

Thomas Stubbs, Alexander Kentikelenis, David Stuckler, Martin McKee and Lawrence King

Social Science & Medicine, 2017, vol. 174, issue C, 220-227

Abstract: How do International Monetary Fund (IMF) policy reforms—so-called ‘conditionalities’—affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI −0.435 to −0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage.

Keywords: Health systems; International Monetary Fund; West Africa; Health expenditures; Universal health coverage (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5) Track citations by RSS feed

Downloads: (external link)
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link:

Ordering information: This journal article can be ordered from
http://www.elsevier. ... _01_ooc_1&version=01

DOI: 10.1016/j.socscimed.2016.12.016

Access Statistics for this article

Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian

More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Haili He ().

Page updated 2020-06-02
Handle: RePEc:eee:socmed:v:174:y:2017:i:c:p:220-227