Friday, April 13, 2012

INFOCUS: The State of African Health - an introduction to our new series.

Friday, April 13, 2012
As we mentioned in one of our last posts, our focus for the next 3 months will be on health. With the new face-lift on the Blog, this segment will be covered under INFOCUS. When a new focus subject is announced, they will move to this segment and the current subject moved under the Issues tab.

Pic: Africa Heritage Cultural Centre
We hope to generate debate on diverse issues during this time and depending on your reactions, those issues may feature in the coming periods. The question we are asking on the first post of our INFOCUS series on Health is then, What is the State of Health in Africa today?

From a policy perspective, Africa is facing significant challenges in the health sector that are demanding significant political, economic and social action. Access to services, health services infrastructure, health human resource (doctors, nurses, technicians and pharmacists), health commodities and research are some of the aspects impeding the health sector and people.

People’s ability to access services is based on whether or not health centres are within easy reach; whether services are paid, shared cost or free; whether if infrastructure to the services makes it difficult to reach services or not and whether they know about the services being provided. This very much relates to health services infrastructure (buildings – hospitals and clinics).

Health human resource is another aspect challenging the health sector. Are there adequate numbers of health human resource to provide services? The ratio of Doctors, nurses, technicians, pharmacists and managers to people and facilities is not sufficient. The question of what ratio of particular health workers per patient is adequate, is relative. But it remains a fact that in most African countries, the ratio is still less desiring. Countries like Tanzania and Malawi have a ratio of 1:50000 and are least performing. South Africa has a just over 1:1200 ratio. Small Island states such as the Seychelles and Mauritius and North Africa countries are performing well.

But the question still remains – are the services accessible to everyone equally in Urban and Rural areas? Are they affordable and is the available service package the same for everyone, despite the individual influence and financial standing? 

Commodities availability (medication, medical tools and machinery, condoms) are also another aspect challenging the sector. Reports from different parts of the continent express dismay in the lack of and proliferation of fake medication; health workers lack the tools needed to perform their duties effectively – from hygiene to tools for medical attention.

And the continent is making slow progress in the arena of research, especially on health issues. In 2011, 7 African Women Scientists were awarded under the African Union Kwame Nkrumah Scientific Awards. The awards symbolized the progress being made in medical research on diseases such as malaria. It encouraged greater and equal participation of women in taking leadership to address challenges. This is but a small step in strengthening the research base on the continent.

How does this respond to the core question we are asking? We think these parameters are critical to determining whether society is healthy. We think if health is not serviced, it will ultimately deteriorate. So we are placing precedence on service delivery as a key indicator of health among the African Population.

Now whilst the multitude of challenges facing the health sector are diverse, the continent has for decades attempted to speak the same language and take action based on overarching policy frameworks. But this in time has also become a challenge in itself. There are many policies and strategies informing the health mandate at the continental level to-date. From the Abuja +15 Call from 2001, the Maputo Plan of Action from 2006, the Africa Health Strategy, to the Campaign on Accelerated Reduction of Maternal Mortality (CARMA). Can the continent afford to run parallel policy and strategic processes such as these and be able to assure adequate monitoring and evaluation at all levels? Can it ensure that systems developed trickle down to countries and provide the relevant data to improve the sector in the concerned area(s)?

We think there is no need for all the policies and strategies and campaigns. We think this de-compartmentalization means coordination is not based on a broad result. We think cutting down this ambition to one broad strategic policy framework may well be the way to go. An example in our view is how much commitment we made to implement the MDGs whilst they did not speak entirely to the African context or the fact that 30 years into the HIV/AIDS pandemic, Africa does not have a common stance.

In the next three months, we will explore these issues as part of our INFOCUS page. We welcome your reactions. We welcome articles on progress, on programmes, on what is and is not working with respect to advancing health on the African continent. We also expect for the question we are asking on whether Africa is Healthy to be answered gradually as this content comes through.

Editorial Team.
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