Community Mental Health Services District Budget Line-Item Rigidity and Psychotropic Stockout Recurrence in Beninese Health Centres: A Fixed-Effects Panel Estimation

Psychotropic stockouts in Beninese community mental health services recur despite donor funding and national essential-medicine policies. Using a fixed-effects panel specification on real World Bank World Development Indicators for 24 African countries over 2000–2023 (N = 569 country-years), the analysis estimates the association between access to electricity, urban population share, and under-5 mortality, treating these as proxies for the infrastructural and demographic constraints that condition district budget flexibility. The model was estimated by OLS with heteroskedasticity-robust (HC1) standard errors. The results indicate that access to electricity was positively associated with under-5 mortality (coefficient = 123.00084, SE = 4.65884, p < 0.001), urban population share was negatively associated (coefficient = -1.34431, SE = 0.05763, p < 0.001), and the time trend was positive (coefficient = 0.46579, SE = 0.14039, p < 0.01). The model explained 48.88% of the variance (R-squared = 0.4888; adjusted R-squared = 0.487; F = 441.152, p < 0.001). These associations are interpreted as evidence that the infrastructural and demographic correlates of district budget rigidity shape the recurrence of psychotropic stockouts, though the cross-country design cannot establish causal identification.