{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:08:48Z","timestamp":1788865728418,"version":"build-2803163510"},"reference-count":79,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Planning &amp;amp; Management"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The COVID\u201019 pandemic has not only revealed pre\u2010existing vulnerabilities in global health systems and imposed heavy costs on countries worldwide, but also exacerbated existing disparities. These institutional and financing limitations were part of the development strategy, which did not adequately accommodate the health risks accompanying the outbreak of the virus. This disruption has ongoing implications for access to healthcare and treatment, particularly in economically disadvantaged and marginalised communities. This study documents the spatial spillover and threshold effects of health development assistance per capita (HDApc) and health expenditure (HEAEXP) on health\u2010related outcomes (HROs) in Sub\u2010Saharan Africa (SSA), which is a potential vector of the dissimilation of viruses. The study utilises panel data from 38 SSA countries spanning the period from 2000 to 2021. Employing the fixed effect (FE), fixed effect spatial Durbin Model (FE\u2010SDM) and the threshold methods, and adding immunisation rate, GDP per capita growth and democracy as additional variables, this study finds that (1) HDApc and HEAEXP significantly improve the health status of the population, (2) HDApc and HEAEXP have a favourable spatial effect as both significantly reduce the under\u2010five mortality rate, infant mortality rate, age\u2010standardized deaths from infectious diseases, and the death rate in neighbouring countries, (3) HDApc has a double threshold effect on HROs and that its effect on the HROs is higher at higher threshold level of 12%.<\/jats:p>","DOI":"10.1002\/hpm.70110","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:46:59Z","timestamp":1785178019000},"page":"950-966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Spatiotemporal Threshold Effects of Health Expenditure and Health Developmental Assistances on Health\u2010Related Outcome in Sub\u2010Saharan Africa Post Covid19: The Case of the Public\u2010Private Partnerships Donors"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9472-6710","authenticated-orcid":false,"given":"Toh Ryan Peters","family":"Akembom","sequence":"first","affiliation":[{"name":"Beijing Technology and Business University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0821-8547","authenticated-orcid":false,"given":"Andam Andin Ndi","family":"Buma","sequence":"additional","affiliation":[{"name":"College of Humanities and Development Studies China Agricultural University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8020-2566","authenticated-orcid":false,"given":"Hubert","family":"Visas","sequence":"additional","affiliation":[{"name":"University of International Business and Economics  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5314-6092","authenticated-orcid":false,"given":"Jabbar","family":"Ul\u2010Haq","sequence":"additional","affiliation":[{"name":"Department of Economics University of Sargodha  Sargodha Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12081295"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010021\u201001381\u2010y"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.00429"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.24294\/jipd.v5i1.1251"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.14202"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2024.02.014"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-38815-7_3"},{"key":"e_1_2_11_9_1","article-title":"Ensure Healthy Lives and Promote Well\u2010Being for All at All Ages","author":"Viliani F.","year":"2020","journal-title":"Geosciences and the Sustainable Development Goals"},{"key":"e_1_2_11_10_1","unstructured":"The Top 10 Causes of Death. [press release].2020."},{"key":"e_1_2_11_11_1","unstructured":"Nations Union Good Health and well\u2010being: Why it Matters (Rep.)(2020)."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234642"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0047279421000775"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czx145"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939\u2010022\u201001665\u2010w"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41256\u2010017\u20100043\u2010x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00220388.2018.1439267"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.13169\/worlrevipoliecon.13.3.0322"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468018119896465"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1787\/health_glance-2017-en"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.14419\/ijh.v4i1.5794"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.5455\/ijmsph.2016.13032016457"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/2191\u20101991\u20102\u201022"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10754\u2010019\u201009272\u2010z"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467\u20108268.2009.00215.x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2013.29"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2013.29"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","unstructured":"F.Lichtenberg Sources of U.S. Longevity Increase 1960\u20101997(2002).","DOI":"10.3386\/w8755"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v17i1.30"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542\u20104774.2012.01105.x"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-16-4601-0_7"},{"key":"e_1_2_11_32_1","article-title":"Political Determinants of Public\u2010Private Partnerships","author":"Cabrera P.","year":"2021","journal-title":"Inter\u2010American Devvelopment Bank"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.13.04123"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/08039410.2024.2322503"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2023.2296562"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta19140"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273\u2010014\u20100162\u2010x"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.02.017"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1142\/9789813272378_0003"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2325\u20108012.2008.tb00898.x"},{"key":"e_1_2_11_41_1","first-page":"47","article-title":"How Effective Is Foreign Aid at Improving Health Outcomes in Recipient Countries?","author":"Toseef M. U.","year":"2020","journal-title":"Atlantic Economic Journal"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/23322039.2020.1774970"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2009.05.004"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/00036846.2011.613779"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.292"},{"key":"e_1_2_11_46_1","article-title":"Effect of Health Development Assistance on Health Outcome Indicators in Sub\u2010Saharan African Countries","author":"A O.","year":"2023","journal-title":"International Journal of Humanities & Social Studies"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.2147\/rmhp.s101343"},{"key":"e_1_2_11_48_1","first-page":"18","article-title":"How Important Are Health Care Expenditures for Life Expectancy? A Comparative, European Analysis","author":"Heuvel W.","year":"2017","journal-title":"Journal of the American Medical Directors Association"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpolmod.2018.09.001"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1080\/13504851.2016.1173174"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1080\/00220388.2018.1536264"},{"key":"e_1_2_11_52_1","unstructured":"A. J.Barenberg D.Basu andC.Soylu \u201cThe Effect of Public Health Expenditure on Infant Mortality: The Effect of Public Health Expenditure on Infant Mortality: Evidence From a Panel of Indian States 1983\u201084 to 2011\u201012 Evidence From a Panel of Indian States 1983\u201084 to 2011\u201012 \u201d (2021)."},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.5812\/semj.88526"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100451"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.794177"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00038\u2010019\u201001251\u2010y"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12942\u2010023\u201000330\u2010x"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191912758"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004488"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/ecaf.12507"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.05.006"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1108\/econ\u201006\u20102022\u20100072"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2024.104997"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010025\u201012631\u2010x"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18179368"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(10)61289\u20105"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czab004"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(10)61293\u20107"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4365205"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.energy.2020.118200"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0304\u20104076(99)00025\u20101"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010066970"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajems.v27i1.5183"},{"key":"e_1_2_11_74_1","unstructured":"P.Clist Aid Allocation Composition and Effects(2010)."},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2016.07.009"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eap.2017.06.005"},{"key":"e_1_2_11_77_1","volume-title":"Which Role Do Health Indicators Play?","author":"Stepping K.","year":"2012"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1002\/jae.951"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.2307\/2082979"},{"key":"e_1_2_11_80_1","volume-title":"Introduction to Econometrics","author":"Maddala G.","year":"2006"}],"container-title":["The International Journal of Health Planning and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.70110","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hpm.70110","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.70110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:25:57Z","timestamp":1788863157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hpm.70110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":79,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/hpm.70110"],"URL":"https:\/\/doi.org\/10.1002\/hpm.70110","archive":["Portico"],"relation":{},"ISSN":["0749-6753","1099-1751"],"issn-type":[{"value":"0749-6753","type":"print"},{"value":"1099-1751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]},"assertion":[{"value":"2025-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}