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A recent report from the World Health Organization (WHO) has revealed that only five countries in the WHO African Region met the recommended per capita health spending threshold in 2020. Botswana, Mauritius, Namibia, Seychelles and South Africa were the only nations to spend at least $271 per person on health, out of the 47 countries in the region.
Between 2012 and 2020, eight countries (Algeria, Botswana, Equatorial Guinea, Eswatini, Mauritius, Namibia, Seychelles and South Africa) averaged a minimum of $249 per capita on health, WHO’s African Region Health Expenditure Atlas 2023 highlighted. This figure aligns with estimates from a study in the journal Lancet, which suggested that per capita health expenditure should reach $249 to $271 to achieve United Nations-mandated Sustainable Development Goals related to health under progressive and ambitious scenarios, respectively.
The report underscored the myriad challenges confronting health systems in the African region, including health inequities, rising healthcare costs, increased exposure to health risks and limited access to quality care. It also stressed the importance of universal health coverage, which ensures access to essential health services without financial hardship.
The WHO report further noted that domestic government spending on health as a proportion of total government expenditure remained low, averaging between 6.3 per cent in 2012 and 7.3 per cent in 2020. This is well below the 15 per cent target set by the African Union’s 2001 Abuja Declaration. South Africa was the only country to consistently meet this target between 2014 and 2020.
Out-of-pocket payments (OOP), which are direct payments made by individuals for health services, continue to pose a financial burden on many households across the region. Malawi and Angola saw the highest increases in OOP spending between 2012 and 2020, with rises of 91 per cent and 111 per cent , respectively. Meanwhile, Zambia and Zimbabwe recorded significant decreases in OOP, by 49 per cent and 70 per cent , respectively.
The report warned that OOP spending remains high, averaging 35.8 per cent of current health expenditure across the region from 2012 to 2020. This far exceeds the recommended threshold of 15-20 per cent to ensure health services remain affordable and accessible.
External funding remained a key financial pillar for many countries in the African region, contributing less than 20 per cent of current health expenditures in most nations during the 2012–2020 period. The WHO report positioned the Health Expenditure Atlas as a vital resource for policymakers, guiding more effective health financing strategies and promoting the advancement of health and well-being across the region.
