Assessing the impact of COVID-19 and health system determinants on health outcomes in South Asia

COVID-19 has significantly reduced life expectancy in South Asia, with notable declines in Bhutan, Maldives, and Nepal. It has also increased under-5 mortality and mortality from chronic conditions more than in other regions like East Asia and the Pacific, as well as Central Asia and Europe. This study analyzes variations in health outcomes using panel quantile regression and seemingly unrelated regression models on data from eight countries (1990–2023). At the panel level, COVID-19 does not show a statistically significant impact on key health indicators, but country-level analysis reveals significant differences. Higher health expenditure, physician density, and per capita income are associated with improved life expectancy and lower under-5 mortality, while increased hospital bed availability helps reduce chronic disease mortality. Furthermore, environmental factors show mixed effects. Greenhouse gas emissions contribute to higher under-5 mortality in Afghanistan and India, likely due to air pollution, while greater renewable energy consumption in Pakistan correlates with lower under-5 mortality. To improve post-pandemic health outcomes, investments in physician recruitment, healthcare funding, and economic growth are necessary. Strengthening healthcare infrastructure, particularly in underserved areas, is crucial for mitigating the long-term impacts of the pandemic.