Inadequacies in the healthcare sector in Africa have long been a major issue, which precedes the global health crisis. The COVID-19 pandemic exposed the weaknesses in African economies in dealing with health hazards and exponentially highlighted several shortcomings in health care – from lack of medical supplies and care facilities to inequalities in the delivery of quality health care services.
Due to poor infrastructure in the health sector in Africa, the response to the pandemic has been reactive, with countries struggling to put systems in place to address the crisis. And although the extent of the COVID-19 effect was somewhat unforeseen, epidemiologists have been warning governments for years that a virus pandemic like this is likely to occur.
This type of unpreparedness is simply not acceptable – both in terms of a crisis as well as for existing healthcare issues. It is the responsibility of governments to implement important reforms that support sustainable health care in Africa. These reforms must take into account current urgent needs as well as address future needs based on changing socio-political factors, technological advances, medical advances, and so on.
The following are some key considerations for policy reforms that support sustainable health care in Africa:
Develop emergency preparedness health systems: Health systems in many African countries are ill-prepared to respond to health emergencies. Social welfare programs should be designed to support the most vulnerable sections of the population during an epidemic outbreak. Such emergency packages guarantee proper investment to ensure quick response when a disaster occurs. We live in a world of uncertainty and emergency preparedness is paramount.
Finances and resources: In the majority of African countries, there is one hospital per one million people, one doctor per 10,000 people and one hospital bed per 10,000 (World Health Organization). Conservative figures from the World Bank claim that Africa needs $ 100 billion to tackle COVID-19 in all sectors except existing healthcare needs. Rapid and effective regulatory changes are essential to help manage financial claims. These include improved budget models, public-private partnerships, investment in preventative measures, performance-based funding, review of procurement processes to be more transparent and inclusive, and the development of comprehensive, government-sponsored sustainable health coverage schemes.
Research: Data-based decision-making based on research will pave the way for effective and result-driven solutions. The World Economic Forum states that ‘an emerging approach is for healthcare organizations to collect data as part of ongoing clinical care to generate data on patient and economic outcomes.’ This approach has been emphasized by economists and researchers, both for the development of solutions to overcome health challenges, and for robust predictive models for future health and wellness demand.
Technology: Amid the negative effects of COVID-19, it is an opportunity to advance technology and innovation in Africa. Technology has already worked well as a tool for public health. Examples include the use of drones in Rwanda to provide blood transfusion services to remote regions, the use of WhatsApp in West Africa to disseminate information during the 2014 Ebola outbreak and the “SMS for Life”[ a programme that works to improve access to essential medicines and vaccines at the point of care, the health facility, by eliminating stock-outs first launched in Tanzania in 2019 later expanded to Cameroon, the Democratic Republic of the Congo, Ghana and Kenya] to help manage malaria treatments and livestock. However, countries need policy frameworks to support emerging health technologies, especially with the advent of COVID-19 and the vital need to detect and manage this viral threat.
Education and workforce: Policy change needs to start from the education sector to develop a skilled staff to effectively manage improved healthcare systems. This includes the above technology-driven models. The healthcare sector is not exempt from the Future of Jobs and the fourth industrial revolution requires progress, and the failure of this factor will have serious consequences for the already inadequate healthcare industry in Africa.
Good management and capacity building: My Health Care Policy Guide in Cameroon (co-author of Rosy Pascale Meyet Tchouapi) explains that despite government efforts to improve good governance and the performance of health systems, poor governance and corruption seem to be a problem, including in the health sector . COVID-19 and health care research by the African Economic Research Consortium (AERC) say that even at an early stage, health effectiveness is strongly correlated with the institutional strength of a country, especially in terms of political stability and the rule of law. . The way forward therefore points to the development of public confidence in following government guidelines and increasing the funding of healthcare funding systems, including reform of reach to the masses, and the willingness to deal with the pandemic effectively.
Conservative figures from the World Bank claim that Africa needs $ 100 billion to tackle COVID-19 in all sectors except existing healthcare needs. Rapid and effective regulatory changes are essential to help manage financial claims.
Diversify supply chains and strengthen trade within Africa: The pandemic showed that Africa has serious shortages of medical products and equipment. This is an opportunity for the continent to explore alternatives to diversify the supply chains to reduce the dependence on the export of primary commodities. African governments must support the manufacturing sector that paves the way for the structural transformation and industrialization of economies. It is also time for Africans to think regionally and to design cross-border co-operation programs that promote trade within Africa.
Improve health infrastructure and working conditions of staff: African countries are concerned about raising money to provide health care, but more important are questions about how to organize health care facilities and compensate medical staff. Health infrastructure and wages of health workers in Africa are appalling, leading to large brain drain in the health sector.
Mechanisms for change need to be implemented urgently and strictly when it comes to health reforms in Africa. Such measures must be sustainable and aimed at addressing existing healthcare needs, as well as creating resistance to shocks such as the COVID-19 pandemic.
Healthcare is closely linked to the economic landscape of a region. As explained by economic researcher Janvier Mwisha-Kasiwa, “Health is both a direct component of human well-being and a form of human capital that increases an individual’s ability and opportunities to generate income and reduce vulnerability.” This approach can be used to justify increased investment in health in developing countries.
At present, fewer than five countries in Africa meet the Abuja Declaration goal set 19 years ago to devote 15 percent of public spending to health, with COVID-19 emphasizing poor health systems and fragmentation due to vertical funding systems.
Health care sector reforms are both possible and essential for the continent, especially as we face the social and economic aftermath (and possible revival) of the global health crisis.
Strong, purposeful and decisive action by leaders is critical to circumventing destructive social and economic regression.
The good news, however, is that positive change through policy reform and capacity building can turn the tide and revolutionize the African healthcare landscape.