Better Governance and Skilled Health Workforce Density: Are They Twin Catalysts for Health Outcomes in Sub-Saharan Africa?

Sub-Saharan Africa (SSA) faces a persistent shortage of skilled health workers, which constrains health system performance and population health outcomes. Although previous studies examine either health workforce density or governance quality separately, little empirical evidence exists on their interaction. This study investigates the relationship between skilled health workforce density and health outcomes in 45 SSA countries over the period 1996-2023, with particular attention to the moderating role of governance quality. Using a dynamic panel approach and the two-step system generalised method of moments (GMM) estimator, the analysis evaluates the impact of health workforce density on life expectancy (LE), maternal mortality and under-5 mortality. The results show that greater availability of skilled health professionals significantly improves health outcomes, particularly by increasing LE and reducing maternal mortality. Furthermore, governance quality strengthens the effectiveness of health workforce investments, indicating that institutional capacity is crucial to translating human resources into better health outcomes. Control variables, such as GDP per capita, government health expenditure and primary education, also contribute to improved population health. The findings highlight the importance of integrating governance reforms with policies aimed at expanding the health workforce. Strengthening institutional quality alongside investments in medical training and workforce retention can provide a sustainable pathway to improving health outcomes in SSA.