The effect of foreign aid for health and government health expenditure on the mortality rate in Zambia

This study investigates how foreign health aid and government health spending affect mortality rates in Zambia. Zambia’s health sector faces limited access, high disease burden, and population growth that strains infrastructure. Foreign aid, especially for HIV/AIDS, malaria, and TB, has been vital. However, concerns about aid sustainability and low domestic spending necessitate examining their combined effects on health. Using a positivist, deductive, correlational design, we investigate whether foreign aid has a positive impact on health. We use secondary data (1980–2022) from the World Bank, the Bank of Zambia, and UNCTAD. Regression and Johansen cointegration analyses assess relationships among foreign aid, government spending, population growth, and mortality. Results show foreign aid significantly lowers mortality (Coef = –0.28781; Z = –6.22; P = 0.000); initiatives like PEPFAR and the Global Fund reduce deaths. However, reliance on aid may hinder domestic financing, leaving Zambia vulnerable to donor shifts. Population growth also significantly reduces mortality (Coef = –6.47965; Z = –5.13; P = 0.000), reflecting a demographic advantage. As the population ages, healthcare demand may outpace capacity, potentially reversing this trend. Government health expenditure shows no significant effect (Coef = 0.0092040; Z = 0.11; P = 0.913), suggesting inefficiencies from corruption and poor governance. Improving governance, accountability, and strategic use of public funds is essential. Findings underscore the need for policy reforms to strengthen domestic financing and prepare the healthcare system for demographic changes. Overall, these insights inform stakeholders and policymakers. Informed decisions are crucial for health improvements.