Government Health Expenditure, Environmental Quality, Medical Technology and Maternal Mortality in Nigeria: A Dynamic Analysis

Nigeria remains among the countries with the highest maternal mortality ratios globally, recording nearly 512 deaths per 100,000 live births in spite of sustained policy interventions and considerable international assistance. Against this background, this study examines the effects of government health expenditure, environmental quality, and medical technology on maternal mortality in Nigeria over the period 1985–2024. The study relies on annual time-series data obtained from the World Bank's World Development Indicators and applies the Autoregressive Distributed Lag (ARDL) bounds testing framework to estimate both short-run dynamics and long-run relationships among the variables. The empirical findings indicate that, in the short run, government health expenditure has a negative and statistically significant effect on maternal mortality, indicating that increases in public health spending contribute to a reduction in maternal deaths in the short run. Environmental quality also shows a significant negative effect in its lagged form, suggesting that improvements in environmental conditions increase maternal health outcomes, although with a delayed impact. However, the long-run estimates reveal that neither government health expenditure nor environmental quality has a statistically significant influence on maternal mortality. Furthermore, the estimated error correction term is negative and statistically significant, showing the existence of a stable long-run equilibrium relationship among the variables. These findings imply that while short-term interventions in health spending and environmental management can yield immediate improvements in maternal health outcomes, long-term progress requires addressing deeper systemic constraints within the health and environmental sectors. The study highlights the importance of targeted short-run policy measures together with comprehensive structural reforms. It recommends strengthening budget implementation processes, integrating environmental health monitoring into maternal healthcare programmes, and enhancing the distribution and capacity of the health workforce to ensure sustained reductions in maternal mortality in Nigeria