Abstract Good governance is a key driver of human capital development, deeply affecting health outcomes. In West Africa, where health challenges persist, understanding how governance dimensions affect vital health indicators is essential for informed policymaking. This study investigates the effect of governance quality on health outcomes, namely life expectancy, infant mortality, under-five mortality, crude death rate, and maternal mortality, across 15 West African countries from 1996 to 2022. Using a 27-year panel dataset, the study first applies Instrumental Variables Two-Stage Least Squares (IV-2SLS) to address potential endogeneity. The results show that regulatory quality, government effectiveness, control of corruption, rule of law, voice and accountability, and political stability significantly correlate with improved health outcomes. Enhancing these governance dimensions reduces mortality rates and improves life expectancy, highlighting the importance of accountable institutions, equitable service delivery, and efficient resource use. Policymakers should update health policies, strengthen enforcement, and promote transparency in healthcare delivery. Build
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