Sustaining healthcare financing in Africa: the stakeholder approach

A key challenge in meeting the Sustainable Development Goals (SDGs) by 2030 is the achievement of universal health coverage for all. To achieve this, providing adequate budgetary allocations to create a resilient healthcare system is inevitable. However, many developing countries, particularly in Africa, seem to be inadequately financing their healthcare systems and developing innovative healthcare financing systems to have a positive impact on life expectancy. Adopting a Smart PLS Structural Equation Modelling (Smart PLS-SEM) with a panel data between 2004-2019 and drawing on the stakeholder theory (ST), we examine the cumulative effect of Domestic healthcare expenditure, Out-of-pocket health expenditure, External healthcare expenditure and Voluntary health expenditure on Life Expectancy across 48 African countries. Our data evidence suggests that both Domestic and External healthcare financing sources do not have any impact on life expectancy in Africa. African governments seem to over depend on Central Government Debts to finance their health systems. Secondly, Out-of-pocket payments have a negative impact on life expectancy in Africa. Finally, the current practice and delivery of Voluntary health insurance schemes in Africa seem to have a negative impact on the life expectancy population. However, the employment ratio in Africa has a positive moderating effect on female life expectancy. We, therefore, argue that African countries need to seek much more buoyant and innovative financial resources to increase their budgetary allocations in creating a resilient healthcare system. We conclude by delineating some relevant implications of our study for the theory and practice of health financing policy planning in Africa.