Does energy poverty undermine health spending in Africa? A comparative analysis of public and private healthcare spending

Sustainable health is seen as playing a key role in achieving the UN's global sustainable development agenda to 2030, which is why the third of the seventeen Sustainable Development Goals (SDGs) specifically calls for improvements to achieve good health and wellbeing for people everywhere. However, the accessibility and availability of clean cooking energy varies between countries and regions, regardless of their urban or rural status. In this paper, we assess the effects of energy poverty on health expenditure (total, public and private) in Africa. To do so, we use various estimation techniques, including ordinary least squares (OLS) for the basic analyses and the Lewbel 2SLS method and the Kinky least squares (KLS) method. Our study covers a panel of 42 African countries from 2000 to 2021. We arrive at three major results. First, energy poverty through access to total, urban and rural clean cooking energy has a negative and significant effect on total health expenditure (Current Heath) and on external health assistance to government (EXT-public). Secondly, fuel poverty through access to total, urban and rural clean cooking energy has a positive and significant effect on government health expenditure from domestic sources (GGHED-public), on household consumption expenditure on private health (OOPS-private) and on health expenditure on private health insurance (SHI-private). Finally, fuel poverty may mitigate the adverse effects on public and private health expenditure through increasing levels of urbanisation and the volume of migrant remittances. On this basis, our results have important implications for health expenditure policies and renewable energy transitions.