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Despite the increase in public spending by Sub-Saharan African (SSA) Governments in a bid to foster the growth of human capital and sustainable development, they continue to experience a very slow rate of progress. This study aims to investigate the impacts of public spending on sustainable economic development in SSA.

The study adopts the system generalized method of moments to account for cross-sectional dependence and endogeneity for 38 SSA countries from 1996 to 2019.

The findings indicate that public spending inhibits sustainable economic development while human capital enhances sustainable economic development in SSA. Furthermore, the study equally reveals that the development-inhibiting role of public spending is modulated through human capital and governance quality. Public spending interacts with human capital and governance quality to produce negative net effects and positive synergy effects, respectively.

Based on these findings, the study suggests that governments in SSA countries should discourage heavy dependence on public spending. Policies that provide a framework for financial incentives in the domain of health and education should be encouraged to increase investment in human capital.

The purpose of this paper is to assess whether the relative efficiency of South African municipalities in primary health care and hospital care is different and whether South African municipalities can learn from each other to improve on their efficiency.

The paper employs efficiency scores, estimated with data envelopment analysis using data from the District Health Barometer of the Health Systems Trust to rank South African municipalities across primary health care and hospital health care.

The finding is that the ranking of municipalities is not the same across both types of health care when efficiency scores and efficiency score growth are contemplated. These results imply that municipalities in South Africa are generally inefficient, but with the possibility of learning from each other’s practice in order to increase their technical efficiency.

The health system authority should monitor service-specific best practices among municipalities so that they can use them as practice guidelines for other municipalities.

Previous studies in South Africa have not dis-aggregated efficiency analysis across municipalities which are health system components of the broader national health system.