ABSTRACT

This study examined the response of maternal and child health outcomes to counterfactual shocks in malaria prevalence and neglected tropical diseases in Sub-Saharan Africa. The study was motivated by the persistence of high maternal and infant mortality in the region despite global health commitments and policy interventions aimed at improving health equity. Specifically, the study focused on maternal mortality ratio and infant mortality rate as the main health outcomes, while malaria incidence and neglected tropical diseases were treated as disease-burden shocks that could worsen or improve health outcomes depending on their direction. The analysis was anchored on the social determinants of health theory, which explains health outcomes as a function of socioeconomic conditions, environmental factors, public health interventions, and institutional capacity. The study used annual panel data for 19 Sub-Saharan African countries covering 1990 to 2023. The selected countries included Nigeria, Ghana, Kenya, South Africa, Ethiopia, Uganda, Tanzania, the Democratic Republic of Congo, Cameroon, Senegal, Zambia, Malawi, Mozambique, Zimbabwe, Rwanda, Côte d'Ivoire, Burkina Faso, Madagascar, and Benin. The dynamic autoregressive distributed lag model was employed to examine the short-run and long-run responses of maternal and infant mortality to positive and negative counterfactual shocks in malaria and neglected tropical diseases. Descriptive statistics and panel unit root tests were also used to establish the basic properties of the data. The results showed that positive shocks in malaria prevalence and neglected tropical diseases increased maternal and infant mortality, while negative shocks reduced both mortality outcomes over time. The descriptive evidence also showed high average maternal mortality, high infant mortality, high malaria incidence, low physician density, low health expenditure, undernourishment, and uneven immunization coverage across the selected countries. The study concluded that maternal and child health outcomes in Sub-Saharan Africa are shaped not only by the direct burden of infectious diseases but also by social determinants such as health expenditure, nutrition, education, immunization, and health worker availability. The study recommended stronger malaria and neglected tropical disease control, increased health financing, improved maternal and infant health services, better sanitation, and integrated disease surveillance.