Healthcare as a development engine: access, employment, and sustainable growth in Serbia

In low- and middle-income countries like Serbia, improving access to healthcare is a central objective of social and development policy, closely linked to the Sustainable Development Goals, particularly SDG 3 (Good Health and Well-Being) and SDG 8 (Decent Work and Economic Growth). However, healthcare expenditure is still frequently perceived as a fiscal cost rather than as a productive investment. Serbia, an middle-income country with a predominantly publicly financed healthcare system, offers a relevant case for examining how expanding healthcare access is intertwined with domestic economic structures and inclusive development outcomes.

Using national input-output tables for 2019, this study applies standard input-output modelling to estimate output, income, employment, and value-added multipliers associated with the Serbian healthcare sector. The analysis captures direct, indirect, and induced effects, enabling an assessment of how healthcare spending propagates through domestic supply chains and labor markets.

The findings show that healthcare in Serbia generates significant economy-wide spillovers that extend well beyond service provision. Output multipliers exceed unity, indicating strong domestic production linkages that support the availability and affordability of healthcare services. Employment multipliers rank healthcare among the leading job-generating sectors, contributing directly to SDG 8 by fostering stable and locally anchored employment. Most notably, the total value-added multiplier places healthcare among the top ten sectors of the Serbian economy, underscoring its capacity to retain expenditure domestically and to reinforce the economic foundations necessary for sustained healthcare access.

The results demonstrate that investments aimed at improving healthcare access simultaneously advance broader economic inclusion and sustainable development objectives. Comparative benchmarking with European economies reveals structurally consistent patterns in health-sector integration across income levels, while also highlighting country-specific differences in income and employment transmission. By empirically linking healthcare access to macroeconomic returns, this study provides evidence to support policy frameworks that treat health expenditure as a strategic investment for achieving SDG-aligned, resilient, and inclusive growth in low- and middle-income countries.