Health
Africa faces major health challenges, which are adversely impacting economic development, human development, and poverty reduction efforts. In addition to a high disease burden resulting from persistence of such infectious diseases as HIV/AIDS, malaria and tuberculosis, ongoing demographic and epidemiological transitions have precipitated a substantial rise in prevalence of non-communicable diseases, accidents and injuries.
Furthering this problem is the poor health delivery systems in most of Africa, the migration of health professionals to urban areas and to other countries and continents, the weak infrastructure including lack of clean water, poor roads and communications, and poorly maintained health facilities. Underlying all of this is a very poor funding base for health and historic biases towards urban curative care. However, during the past decade, funding for health in Africa from international agencies has dramatically increased and governments have become more aware of the importance of health in economic and social development.
Project Portfolio
| Reference | Project | Status |
|---|---|---|
| P-NE-IB0-003 |
Projet d'amélioration de l'offre des soins (Santé III) Country: Niger |
LendingLEND |
| P-NG-IB0-008 |
Support to the National Strategic Health Development Plan (Health V) Country: Nigeria |
PipelinePIPE |
| P-SZ-IB0-001 |
Health Sector Dev. Project (Health II) Country: Swaziland |
PipelinePIPE |
| P-TN-IBD-001 |
Projet d'appui à la reforme du secteur de la santé (Santé II) Country: Tunisia |
PipelinePIPE |
| P-UG-IB0-006 |
Support Mulago Hospital and Improvement of Kampala Health Services Country: Uganda |
LendingLEND |
Maternal Health
Maternal morbidity and mortality continues to be a problem of major concern in sub-Saharan Africa. Reduction of the number of mothers who die per 100,000 live births by three quarters from 1990 to 2015 is one of the eight MDGs. Globally there has been less progress in meeting this goal; however, the situation is much worse in Africa than in other regions. The risks of dying from pregnancy related complications in developed countries is about 1 to 3,000, compared to sub-Saharan Africa where it is estimated that about 1,000 women per 100,000 live births die annually due to pregnancy related causes. The leading causes of maternal mortality in most countries in Africa are hemorrhage (ante-partum and post-partum), anemia and eclampsia mainly due to poor access to emergency obstetric services.
Furthermore, the poor quality of care, exemplified by shortage of qualified staff, low staff morale, lack of quality control and patient management, is contributing to the low rate of deliveries at health facilities, resulting in high maternal mortality ratio. In some countries the rate of caesarean sections is extremely low indicating that mothers have insufficient access to essential maternal health services and specifically services for complicated deliveries.
In spite of the fact that effective measures to prevent high maternal morbidity and mortality are known, they remain unavailable to poorer segments of the population. A large proportion of these deaths are avoidable. Social determinants such as poverty, social exclusion and low levels of education all contribute to maternal mortality. The poor utilization of services reflects the existing poor quality of health services. Similarly, the low caesarian rate confirms the fact that most obstetric emergencies do not reach health facilities.
The reasons behind the low percentage of birth attended by skilled health personnel and the low rate of facility based births are related to problems both at facility and community levels. Choice of place of birth is determined by where women or their families feel they get the best help. At the community level a number of socio-cultural factors including inadequate male involvement also affect the health seeking behavior of pregnant women.
Health Financing
African health systems face huge funding deficits. Compared to a global average of 5.4 per cent of GDP, current government spending averages 2.5 per cent of GDP and falls far short of that needed even for basic care provision. While spending on health care in high income countries exceeded US$ 2,000 per person per year, in Africa it averaged between US$ 13 and US$ 21 in 2001 (Commission for Africa 2004). The Commission for Macroeconomics and Health recommended that spending for health care in sub-Saharan Africa should rise to US$ 34 per person per year by 2007, and to US$ 38 by 2015, which represent roughly 12 per cent of GNP. This is the minimum amount needed to deliver basic treatment and care for the major communicable diseases (HIV/AIDS, TB and malaria), and early childhood and maternal illnesses.