In the ECOWAS, health systems are characterized by poor management and face many challenges (critical underfunding) that impact life expectancy, economic growth retardation, and maternal, and child mortalities (Akande-Sholabi et Adebisi, 2020). Despite the head of State's commitment through the Abuja Declaration (2001) , only a few countries have achieved this goal . However, the life expectancy is less than 60 years (52.3) compare to pacific regions (60.1) and European countries (83.3), infant and child mortality is more than 88 deaths per 1,000 live births (UNFPA, 2016), while the SDGs call for a maximum of 25 deaths of children aged 0-4 per 1,000 live births as a target to be achieved by 2030 (SDG 3.2). Therefore, it is necessary to promote governance quality to improve the population health outcomes in West African countries and achieve SDG_3 .
