Abstract. This article analyses the effect of unemployment on out-of-pocket health expenditures in 35 sub-Saharan Africa countries. The defactored instrumental variables method was used over the period 2010-2022. The results of this research show that the unemployment rate leads to an increase in out-of-pocket health expenditures in this area. The policy suggestions that emerge from this research for African governments concern the promotion of employment through easier access to credit and skills development programmes that consider women. Governments could also put in place measures to protect against the financial risk associated with direct payments by making universal health insurance operational.

Keywords: Out-of-pocket health expenditure, unemployment, defactored instrumental variables method, sub-Saharan Africa.