Is rapid urbanisation in Africa jeopardising the health and education of the population?

• Published in: Review of development economics Vol. 29; no. 1; pp. 499 - 547
• Main Authors: Ngounou, Borice Augustin, Tekam Oumbe, Honoré, Fowagap, Jean‐Marie Gankou, Domguia, Edmond Noubissi
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.02.2025
• Subjects: Birth rate; Central government; Christianity; Communications technology; education; Epidemics; health; Health care expenditures; Health education; Health insurance; Health status; Higher education; Information technology; Islam; Islamic countries; Kinkyreg; Lewbel 2SLS; Life expectancy; Marginality; Mortality rates; Panel data; Religion; Religious behavior; Robustness; Sexually transmitted diseases; STD; Sustainable development; Tuberculosis; urbanisation; Urbanization; Africa
• ISSN: 1363-6669; 1467-9361
• DOI: 10.1111/rode.13137

Improving and achieving better health and education is one of the main objectives of the Sustainable Development Goals (SDGs), and there is an extremely fertile literature on this issue. Therefore, in this paper, we study the impact of urbanisation on health and education in a sample of 49 African countries. To this end, we specify and estimate panel data models using fixed effects methods, the Driscoll–Kraay method, whose robustness has been demonstrated by Lewbel, 2SLS and the Kinky least squares method over the period 1996–2020. Our results suggest that urbanisation has a positive impact on healthcare spending and education in African countries. We obtain the same result by regional zone (North and West Africa), by level of development (Low Middle‐Income Countries) and by dominant religion (Christianity) with the exception of Central Africa, East Africa, Southern Africa, Middle Income Countries and Islamic religion and Others. Similarly, our results reveal that although urbanisation significantly worsens healthcare spending and significantly improves education in African countries, this result may be further amplified by the level of development and religious practices. This result remains the same when we take into account public (national government health expenditure) and private (private health insurance and household consumption expenditure on health) health expenditure, as well as secondary and tertiary education enrolment rates, with the exception of reducing external support for health in government, where urbanisation rather contributes to its reduction. Furthermore, taking into account other health measures, such as life expectancy at birth, prevalence of undernutrition, birth rate, prevalence of tuberculosis and mortality rate, our results indicate that urbanisation plays an important role. This leads to an increase in life expectancy, a higher prevalence of undernutrition, an increase in the birth rate and a decrease in tuberculosis and mortality rates. We therefore suggest that the governments of African countries invest in advanced information and communication technologies and encourage their adoption, particularly among marginalised populations, as these new tools have the potential to considerably improve health outcomes. These technologies make it possible to monitor and manage epidemics and sexually transmitted diseases more effectively. They can also facilitate better training in health and education, leading to better results in both areas.