Dualism of the Health System for Sustainable Health System Financing in Benin: Collaboration or Competition?

Calixe Bidossessi Alakonon (), Josette Rosine Aniwuvi Gbeto, Nassibou Bassongui and Alastaire Sèna Alinsato
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Calixe Bidossessi Alakonon: Laboratoire d’Economie Publique, Université d’Abomey-Calavi, Cotonou 04 BP 966, Benin
Josette Rosine Aniwuvi Gbeto: Département d’Économique, Université de Laval, Quebec, QC G1V 0A6, Canada
Nassibou Bassongui: Laboratoire d’Economie Publique, Université d’Abomey-Calavi, Cotonou 04 BP 966, Benin
Alastaire Sèna Alinsato: Laboratoire d’Economie Publique, Université d’Abomey-Calavi, Cotonou 04 BP 966, Benin

Economies, 2025, vol. 13, issue 8, 1-23

Abstract: This study analyses the conditions under which co-opetition improves the supply of healthcare services in Benin. Using non-centralised administrative data from a sample of public and private health centres, we apply network theory and negative binomial regression to assess the extent to which competition affects collaboration between public and private healthcare providers. We found that competition reduces the degree of collaboration between private and public health providers. However, the COVID-19 pandemic significantly mitigated this effect, highlighting the potential for competition within the healthcare system without compromising social welfare. Notwithstanding that, we show that these benefits are not sustained over time. These findings have policy implications for the sustainability of health system financing in Africa, particularly by promoting sustainable financial mechanisms for the private sector and more inclusive governance structures.

Keywords: dualism; health system financing; collaboration; competition; COVID-19; Benin (search for similar items in EconPapers)
JEL-codes: E F I J O Q (search for similar items in EconPapers)
Date: 2025
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