Connect African Development Blog's InFocus Series on Health (Summary)
What is the State ofHealth in Africa today?Our InFocus series each runfor a maximum of 3 months.With the new face-lift on theBlog, this segment is coveredunder INFOCUS. Picture: AHCCWhen a new focus subject isannounced, they will move tothis segment and the current But the question still remains – are the services accessiblesubject moved under the to everyone equally in Urban and Rural areas? Are theyIssues tab. affordable and is the available service package the same for everyone, despite the individual influence andWe hope to generate debate on diverse issues during this financial standing?time and depending on your reactions, those issues mayfeature in the coming periods. The question we are asking Commodities availability (medication, medical toolson the first post of our INFOCUS series on Health is then, and machinery, condoms) are also another aspectWhat is the State of Health in Africa today? challenging the sector. Reports from different parts of the continent express dismay in the lack of and proliferationFrom a policy perspective, Africa is facing significant of fake medication; health workers lack the tools neededchallenges in the health sector that are demanding to perform their duties effectively – from hygiene to toolssignificant political, economic and social action. Access for medical attention.to services, health services infrastructure, health humanresource (doctors, nurses, technicians and pharmacists), And the continent is making slow progress in the arenahealth commodities and research are some of the aspects of research, especially on health issues. In 2011, 7impeding the health sector and people. African Women Scientists were awarded under the African Union Kwame Nkrumah Scientific Awards. ThePeople’s ability to access services is based on whether or awards symbolized the progress being made in medicalnot health centres are within easy reach; whether services research on diseases such as malaria. It encouragedare paid, shared cost or free; whether if infrastructure to greater and equal participation of women in takingthe services makes it difficult to reach services or not and leadership to address challenges. This is but a small stepwhether they know about the services being provided. in strengthening the research base on the continent.This very much relates to health services infrastructure(buildings – hospitals and clinics). How does this respond to the core question we are asking?Health human resource is another aspect challengingthe health sector. Are there adequate numbers of health Click HERE to read the rest of the articlehuman resource to provide services? The ratio of Doctors, on Connect African Development Blog.nurses, technicians, pharmacists and managers to peopleand facilities is not sufficient. The question of what ratioof particular health workers per patient is adequate, isrelative. But it remains a fact that in most African countries,the ratio is still less desiring. Countries like Tanzania andMalawi have a ratio of 1:50000 and are least performing.South Africa has a just over 1:1200 ratio. Small Islandstates such as the Seychelles and Mauritius and NorthAfrica countries are performing well.
A Crisis - Africa’sHealth HumanResources Shortage Picture: AllAfrica.com On this second piece of our INFOCUS series, we examine the Health Human Resource crisis on the African continent. The biggest challenge in putting this piece together was getting data to give us an impression of the situation on the ground. We discovered that this challenge to us was in-fact one of the main issues behind this crisis; weak Human Resource for Health Information Systems and generally, Health Information Systems. In this encounter, we will be looking at specifically, others. In the 2006 Edition of the World Health what the situation is collectively on the African Report by WHO 57 countries were identified as continent with respect to Human Resource for having a Human Resources for Health crisis. Of Health - the doctors, nurses, laboratory technicians, these, 36 countries were in Africa. Despite the pharmacists, managers - in all over 20 different cadre continued forecasting of relatively good economic types. Again, information for all these levels is not performance by many countries on the African readily available. Most of the little reporting and data continent, there is a still a burden in a number that is available looks at Doctors and Nurses and is of areas including efficient management of outdated. More comprehensive information and data development capital. is needed. Here is what the Africa Health Workforce Observatory says about the challenge of accessing But if we can go back to the issue at hand, here are information on health workers through current HR for some facts we collected on what is happening on the Health Information Systems; ground; The entire system depends on different Though we do not like this Sub-Saharan sources such as health professional regulatory Africa phrasing, the region faces the greatest bodies, health facilities staffing, health training challenges. According to WHO, while it has institutions, faith based organizations, censuses 25% of the global burden of disease, it has only or surveys, payroll records and other various 3% of the world’s health workers. services in statistics for which the completeness, timeliness and comparability are widely 36 countries in Africa, as aforementioned, are variable with the challenges of combining and confronting critical Human Resource for Health compilation of information from multiple sources. shortages, meaning they have fewer than 2.3 doctors, nurses and midwives per 1000 people. What is the situation? This figure is the minimum required to achieve an 80% coverage rate for deliveries by skilled In the first piece we posted in our INFOCUS series, birth attendants or for measles immunization. one of the things we highlighted was the Doctor Patient ratio on the continent. We saw that some Click here to finish reading this piece. countries were performing considerably well than
Profile of ongoing Our last InFocus piece looked at the Africa’s Health Human Resources Shortage as a growing crisis. We noted that whilst Programs addressing the challenge was significant, there were some noteworthy the Health Human programs on the ground working to address the shortages. In this piece, we will be profiling some of these programs. If there Resource Crisis in is a program we did not feature, please send us information Africa about it. These are only a few we were able to find; Tanzania: Benjamin William Mkapa Foundation - Mkapa Fellows Program MKAPA Fellows is a pioneering, innovative human resource for health program that supports the efforts of the Tanzanian government to tackle HIV/AIDS. What they do is simple; they recruit and deploy dedicated fellows to work in remote communities with acute short- age of health professionals. Picture: BMAF Kenya: Africa Medical and Research Foundation (AMREF) - Human Resource for Health Project The erosion of Kenya’s key health indicators -life expectancy, infant mortality and maternal mortality - during the last two decades can be traced in part to the deterioration of the health workforce. The acute shortage, inequitable distribution and inadequate skills of health workers have contributed to this negative trend. The Kenya health workforce currently stands at 1.69 health workers per 1,000, way below the WHO is recommended ratio. This small number of health workers is further inequitably distributed denying vast sections of the population access to quality health care therebyPicture: AMREF impacting negatively on health indicators despite the heavy investment made in the various areas. The HRH Project is working with the goal to contribute to the increase in the ratio of the health workforce to population and to achieve equitable distribution of health human resource in Kenya. The project seeks to build advocacy skills, capacity and knowledge among civil society, the government and non-state actors, including professional associations and recruiting agencies to address the problem of human resources for health (HRH) in Kenya. The objective of the project is to enhance the capacity of CSOs, Government officers and other non-state actors to advocate for HRH issues in Kenya. To see the entire list, Click Here.
Health Financing in Africa;a % comparison between TotalHealth Expenditure, GovernmentExpenditure & GDPAt the 2001 Abuja, Nigeria African Summit on HIV/AIDS, Tuberculosis and other related InfectionsDiseases, Heads of States and other actors agreedon what has been a key reference point on financingfor the health sector. The outcome of the Summit,the popular Abuja Declaration saw a commitmentby Heads of States to allocate at least 15% of thetotal budget for the Health Sector. How much of thiscommitment has been realized since then? Picture: Global Health Check WE COMMIT OURSELVES to take all neccesary measures to ensure the needed resources are made available from all sources and that they are efficiently and effectively Health Financing in Africa, a comparison utilized. In addition, WE PLEDGE to set a target of allocating at least 15% of our annual budget to the improvement of the health sector. Article 26: Abuja Declaration, 2001We have compiled data and generated presentationusing the World Bank Databank, selecting a totalof 54 African countries to make the progresscomparison. What we are comparing is thepercentage (%) of the following areas; Total Health Expenditure; this including both public and private, Total Government Expenditure i.e. total fiscal budget expenditure, GDP. Analysis of the information will show you that there is still much needed to be done. There Source: World Bank is also progress on a number of areas. We will discuss these areas in part To finish reading this article, please click here. two of this article, expected in a few days time.
Health Financing in Africa; Why is action so difficult? This is the second part to our two part post on Health Financing in Africa. It is also the final post on our INFOCUS series on Health. On this edition, we are concluding the discussion on health financing by asking, why is it difficult to take action on assuring the requisite financing for the health sector following regional commitments global standards and specifically, WHO’s Commission on Macroeconomics and Health (CMH) recommendations. The trend in health financing on the continent is not encouraging. We saw this in brief on the first part of this post where we looked at health expenditure comparisons on the continent. Information on country, regional and continental progress that is produced and actively disseminated by structures and platforms at these levels is also difficult to find.As we have noted on other issues we have covered, it is critical for Africa to produce, package and actively share information on socioeconomic issues it is facing. The continent can not be dependent on institutions beyond its borders to generate on understand of the state of our problems. Regional data on total Government spending per capita in dollars (weighted) how that East and West African country Governments are spending between $8 and $9 per head, Central African Governments are spending about $20 per head; while the corresponding amount for North African Governments is over $40 and Southern African ones over $140. Health Financing in Africa, Special Summit of African Union on HIV/AIDS, Tuberculosis and Malaria (2006). Why are countries not investing and financing health adequately? Our thinking is that the process of costing for national health delivery is still a challenge. There are still many puzzle pieces that are missing for the costing process to be smooth. We examined before the lack of human resource for health. Other challenges also include insufficient infrastructure and health commodities availability. Costing in these circumstances using the same approaches as elsewhere in the world may very well yield flawed results. But we believe many of these countries have the financing to meet ‘universal access to health’ commitments. What is required is for deliberate decisions to be taken to favor increases in health financing. For example the regions highlighted in the quote above; many countries in these blocks have extensive access to sources of financing in the form of minerals and an increasing tax base (both local and foreign). But mismanagement of resources, corruption and unfair speculation by the outside world on natural resources has diminished the revenue margins these countries work with. So if you are already working with an inadequate income, the focus will remain on spreading the revenue across all sectors and as a result, health indicators will remain unfulfilled for decades to come. This is the final post for this series. Read the rest by Clicking HERE.Visit us today on: www.connectafricandevelopment.org