The moderating role of corruption in the relationship between public health expenditure and childhood mortality in East Africa

This study examines the effect of public health expenditure on childhood mortality in East Africa and assesses whether governance quality, measured by the Control of Corruption index, moderates this relationship. Using balanced panel data for eleven East African countries from 2000 to 2024 for 25 years, the study applies fixed-effects model and robustness checks to control for unobserved country-specific heterogeneity. The findings show that public health expenditure is negatively and significantly associated with childhood mortality, indicating that higher government investment in health contributes to improved child survival. The moderation results further reveal that the mortality-reducing effect of public health expenditure becomes stronger where control of corruption is higher, suggesting that governance quality plays a critical role in translating health spending into effective service delivery. GDP growth, immunization coverage, and primary school completion are also associated with lower childhood mortality, while HIV prevalence increases mortality risks. These results demonstrate that increased health financing alone is insufficient unless supported by transparent governance, accountable public financial management, and efficient implementation systems. The study recommends that East African governments combine expanded public health investment with anti-corruption reforms, stronger expenditure monitoring, improved immunization coverage, HIV prevention, and education policies to achieve sustainable reductions in childhood mortality.