WHO highlighted Africa’s high burden of public health emergencies arising from epidemics, extreme weather events, humanitarian crises and other acute public health events
The health system in Africa is in shambles as the region continues to suffer from systemic weaknesses at all levels, flagged a report by World Health Organization (WHO) African Region.
The overall health system performance — the degree to which a health system carries out its functions of governing, financing, and delivering services — is abysmal, pointed out the Framework for sustaining resilient health systems to achieve universal health coverage and promote health security, 2023–2030 in the WHO African Region report.
The health system of the region is currently functioning at an average of 52.9 per cent of the expected performance, noted the report released on July 28, 2023. It has been hindered by shortages of funds as well as staff.
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Moreover, the proportion of the population spending 10 per cent or more of household income on out-of-pocket health costs increased from 7.7 per cent to 8.4 per cent, stated the framework document.
Though there is a political commitment towards universal health coverage (UHC) and a clear road map, the progress across the region has been uneven and stagnated, noted the report, to be presented at the 73rd session of the Regional Committee for Africa.
UHC ensures that everyone can access the health services they need without financial hardships. It is a target (target 3.8) associated with the Sustainable Development Goals (SDG). UHC is listed under goal 3, which aims to ensure health for all by 2030. It has an association with goal 1 (ending poverty) as well.
This report is among the eleven documents on public health matters of regional concern to be presented for consideration by the regional committee. The WHO session will be held from August 23 to September 1, 2023, at Gaborone, Republic of Botswana.
The document also highlighted the high burden of public health emergencies arising from epidemics, extreme weather events, humanitarian crises and other acute public health events on African health systems and economies.
Though countries in the region are highly vulnerable to the negative impacts of climate change and associated health impacts, they are the least prepared to address these crises.
Service Coverage Index (UHC SCI), a measure of progress in universal health coverage, ranges from 28-75 (out of 100) across 47 member states, said WHO.
A map showing the Service Coverage Index of African countries. Source: WHO.
The continent has shown improvements in regional population-weighted UHC SCI over the last decade. This index stood at 46 in 2019, up from 24 in 2000, WHO acknowledged in 2022. This progress, though significant, falls short of SDG 3.8.1, which targets a minimum of 80 per cent coverage of essential health services.
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Furthermore, the region continues to suffer from systemic health system weaknesses at all levels. On an average, $54 per capita is the current health expenditure across the member states of the African region. General government health expenditure here averages $14.8 per capita, compared to the estimated per capita requirement of $127.
Africa contributes to 4 per cent of the global workforce despite shouldering a quarter of the global disease burden. WHO African Region would face a projected shortage of 5.3 million health workers (52 per cent) by 2030.
So, with just seven years left to meet SDGs, there is an urgency to accelerate post-COVID recovery and progress, suggested the document.
The framework draws from WHO’s position paper on health system resilience, builds on other resilience frameworks and incorporates the outcomes of a special event on “Building back better” held at the 72nd session of the regional committee.
It includes proposals on priority actions towards resilient health systems that can cope with disruptive shocks or stress from all hazards.
The unified approach for strengthening the health systems proposed in the framework document includes some ambitious targets by 2030 and milestones by 2025.
For example, by 2030, at least 45 member states are expected to have developed essential health service packages delivered through the primary healthcare approach.
The framework to be examined by the regional committee called upon the member states to invest in transformed, resilient health systems that are equitable and efficient.
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