Public Health Spending and Maternal Mortality Outcomes in Imo State: An Economic and Health Policy Analysis

Maternal mortality remains a critical public health and economic challenge in sub-Saharan Africa, with inadequate health financing frequently identified as a root cause of persistently poor obstetric outcomes in Nigerian states. This study investigates the relationship between public health spending and maternal mortality outcomes in Imo State from 2016 to 2024. The study is anchored on the Health Production Function Model, which treats health outcomes as outputs produced by combining health inputs such as government expenditure, medical facilities, and trained personnel within a productive health system. A longitudinal research design was employed using secondary data from the Imo State Ministry of Health, the National Bureau of Statistics, and the World Health Organization regional health database. Fixed-effects panel regression was applied to estimate the effect of health expenditure per capita on maternal mortality ratios at the LGA level. Findings reveal a statistically significant negative relationship between health expenditure per capita and maternal mortality, indicating that higher spending is associated with reduced maternal deaths. However, the effect size was moderated by facility delivery rates and the deployment density of skilled birth attendants, suggesting that spending alone is insufficient without structural service delivery improvements. The study concludes that health expenditure is a meaningful but incomplete determinant of maternal mortality in Imo State. It is recommended that the state government increase health sector budgetary allocation and direct a minimum of 30 percent of maternal health funding toward frontline primary healthcare center staffing and obstetric equipment.

Keywords: Public health spending, maternal mortality, health production function, Imo State, primary healthcare