Africa’s Healthcare: Advances and Concerns (Part 1)
Despite Africa’s economic growth in recent years, healthcare remains one area where the continent struggles. Governments are faced with the challenges of coming up with solutions that will help maintain a healthy and thriving society. In this two-part series, I will be exploring the areas, which remain a major main source of concern and where are improvement being made?
As Africa continues to develop economically, so has the need for quality and affordable healthcare. Over the last few years, the emergence of the middle class on the continent means many can afford private healthcare which is in high demand in countries like Nigeria, Kenya and South Africa, creating a booming healthcare industry in sub-Saharan Africa. It is estimated that at the end of 2010, the private sector healthcare industry was delivering half of the region’s health products and services. Nevertheless, African governments are faced with greater demands and an urgent need to meet the dire health needs of those, who neither belong to the elite or middle class. Despite registering the economic growth, health experts contend that some African governments may not be able to provide adequate healthcare to its neediest of citizens by 2020.
Primary healthcare remains one area of contention as African governments continue to falter in their struggle to deliver a robust system that is accessible and affordable for all. Of the eight UN Millennium Development Goals, three of them, MDGs 4, 5 and 6 are health focused. However, there are hindrances to these goals being achieved due to the lack of infrastructure and government policies which are yet to be implemented.
Dr. Ken Simiyu, originally from Kenya is a fellow at McLaughlin-Rotman Centre for Global Health, Canada, with a special focus on health innovation in developing countries. In past times, he has written extensively about primary healthcare on the continent. In a 2007 essay titled, Health care In Africa: Status Projection by 2020, he estimated ‘over 50 percent of the African population do not have access to modern health facilities and more than 60 percent of people in rural areas have no access to primary healthcare.’ He spoke to me from Rwanda and described the current state of primary health care in Africa (with the exception of South Africa) as generally weak.
“Some countries are better than others in primary healthcare facilities. But in the rural areas, it’s a pathetic situation. Patients have to travel long distance to care facilities, some of which do not have medically trained personnel or equipments to cater for people in the area they serve. You cannot generalise and say it is uniform across Africa.” Simuyi says governments have become heavily reliant on medical aid relief and donor support. Notwithstanding, he admits there are areas with major improvements in many countries. “Training is one area, the training of doctors and nurses and there is more access to mosquito nets in most African countries with malaria. Statistics have shown that the increment of malaria has really dropped in African countries like Kenya and Rwanda because of the distribution of mosquito net to children under five and for free by the government. So, policies in that regard are having an effect.” It is his opinion that Africa governments should not look at health care as a social service provided for society but also as a way to help their economy. “Hence, link health to the social economic development of the country like they have done in India, where the pharmaceutical industry and healthcare system is now receiving patients from foreign countries and use it for economic growth. He adds: “African countries need to be innovative and invest in innovative ways of providing healthcare and its time Africa takes full advantage of the world’s mobile technology to improve primary healthcare and the delivery of its health care policies.”
There are hundreds of non-governmental organisations operating in Africa, providing a plethora of services, including the healthcare sector. In 2002, the former UN Secretary General, Kofi Annan said Non-Governmental Organisations (NGOs) were the “Conscience of humanity.” In some African countries, they are welcomed with open arms but in others, their presence poses is sometimes seen as meddling with the affairs of a sovereign country especially in the area of human rights. Nevertheless, where healthcare is concerned, NGOs have played a critical role during conflict times and in countries where health structures are insufficient or non-existent, they work with authorities such as the Ministry of Health to provide assistance.
Médecins Sans Frontières (MSF) provides emergency medical assistance to people in danger, in over 70 countries and has been in operation since 1971. In Africa, MSF is one of numerous NGOs and has 32 projects in 26 nations, including Sudan, Zambia, Burkina Faso and Burundi. A total of 42.1 percent of its global programmes are carried out on the continent and this ranges from being a health providers in conflict zones, like North and South Kivu, in DRC where it carried out 530,000 medical consultations and working closely with national governments on immunisation campaigns in Niger and Nigeria, where an estimated 8 million people were vaccinated against meningitis in 2009. The fight against HIV⁄AIDS and Tuberculosis epidemics continues to be an integral part of MSF’s work and in countries like Kenya, it played a key role alongside other national and international NGOs in lobbying the government to declare the disease a natural disaster in the 90s, paving the way for access to affordable generic drugs in the country. In all of these, the role of NGOs and national governments cannot be blurred and the question as to where the overall burden of responsibility lies remains.
Dr Unni Karunakara is the International Président of MSF. He said: “As a medical humanitarian organisation working mainly in emergencies, MSF does not replace national governments and their respective Ministries of Health in health care delivery. In fact, we always seek to work closely with the Ministry of Health, by keeping them informed and involved in the activities we do, as they are ultimately responsible for the well-being of their citizens. In large emergencies it is often difficult for governments to mobilise the capacity to respond without the help of organizations such as MSF. But once the situation stabilises, we start working towards handing over our projects and interventions so that the country can resume its responsibility of providing health care to its citizens. In all situations, the vast majority of MSF staff are from the country where our activities are.”
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To Be Concluded Tomorrow